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Sample records for chart documentation practices

  1. Chart Smart: A Need for Documentation and Billing Education Among Emergency Medicine Residents?

    Directory of Open Access Journals (Sweden)

    Brian Dawson, MD

    2010-05-01

    Full Text Available Objective: The healthcare chart is becoming ever more complex, serving clinicians, patients, third party payers, regulators, and even medicolegal parties. The purpose of this study was to identify our emergency medicine (EM resident and attending physicians’ current knowledge and attitudes about billing and documentation practices. We hypothesized that resident and attending physicians would identify billing and documentation as an area in which residents need further education.Methods: We gave a 15-question Likert survey to resident and attending physicians regarding charting practices, knowledge of billing and documentation, and opinions regarding need for further education.Results: We achieved a 100% response rate, with 47% (16/34 of resident physicians disagreeing or strongly disagreeing that they have adequate training in billing and documentation, while 91% (31/34 of residents and 95% (21/22 of attending physicians identified this skill as important to a resident’s future practice. Eighty-two percent (28/34 of resident physicians and 100% of attending physicians recommended further education for residents.Conclusion: Residents in this academic EM department identified a need for further education in billing and documentation practices. [West J Emerg Med. 2010;11(2: 116-119.

  2. Accuracy of nurse documentation of delirium symptoms in medical charts.

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    Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne

    2008-04-01

    The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

  3. Assessment of dizziness among older patients at a family practice clinic: a chart audit study

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    Pimlott Nicholas JG

    2005-01-01

    Full Text Available Abstract Background Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Although it is a common problem the assessment and management of dizziness in the elderly is challenging for family physicians. There is little published research which assesses the quality of dizziness assessment and management by family physicians. Methods We conducted a retrospective, chart audit study of patients with dizziness attending the Sunnybrook Family Practice Center of Sunnybrook and Women's College Health Sciences Center (SWCHSC in Toronto. We audited a random sample of 50 charts of patients from 310 eligible charts. Quality indicators across all dizziness subtypes were assessed. These quality indicators included: onset and course of symptoms; symptoms in patients' own words; number of medications used; postural blood pressure changes; symptoms of depression or anxiety; falls; syncope; diagnosis; outcome; specialty referrals. Quality indicators specific to each dizziness subtype were also audited. Results 310 charts satisfied inclusion criteria with 20 charts excluded and 50 charts were randomly generated. Documentation of key quality indicators in the management of dizziness was sub-optimal. Charts documenting patients' dizziness symptoms in their own words were more likely to have a clinical diagnosis compared to charts without (P = 0.002. Conclusions Documentation of selected key quality indicators could be improved, especially that of patients' symptoms in their own words.

  4. Intelligent bar chart plagiarism detection in documents.

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    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Rehman, Amjad; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  5. Intelligent Bar Chart Plagiarism Detection in Documents

    Science.gov (United States)

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts. PMID:25309952

  6. Intelligent Bar Chart Plagiarism Detection in Documents

    Directory of Open Access Journals (Sweden)

    Mohammed Mumtaz Al-Dabbagh

    2014-01-01

    Full Text Available This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR. By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  7. Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME competency in practice-based learning and improvement

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    Patel Sangnya

    2007-07-01

    Full Text Available Abstract Background The Accreditation Council on Graduate Medical Education (ACGME supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33% (p = 0.001, 26% (from 45% to 71% (p Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

  8. A standardized, uniform and universal dental chart for documenting state of dentition before anaesthesia.

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    Gatt, S P; Aurisch, J; Wong, K

    2001-02-01

    It is vital to have adequate and precise documentation of the condition of a patient's dentition before commencing an anaesthetic. The incidence of dental damage during anaesthesia is not low. To the authors' knowledge, there is no standardized method used by anaesthetists to document the state of a patient's dentition. We propose the introduction of a standardized uniform dental chart to enable anaesthetists to accurately document the condition of their patients' teeth. This vital information can be easily obtained during the preanaesthetic assessment. With the increase in medical litigation and demands for adequate documentation, we believe this chart can become an invaluable part of every hospital's preanaesthetic assessment form. The dental chart is to be offered as a service to anaesthetists in the form of a copyright-free "Freeware" computer diskette or adhesive sticker and will be downloadable from the internet.

  9. Falls documentation in nursing homes: agreement between the minimum data set and chart abstractions of medical and nursing documentation.

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    Hill-Westmoreland, Elizabeth E; Gruber-Baldini, Ann L

    2005-02-01

    To assess the agreement between falls as recorded in the Minimum Data Set (MDS) and fall events abstracted from chart documentation of elderly nursing home (NH) residents. Secondary analysis of data from a longitudinal panel study. Fifty-six randomly selected NHs in Maryland stratified by facility size and geographic region. Four hundred sixty-two NH residents, aged 65 and older, in NHs for 1 year. Falls were abstracted from resident charts and compared with MDS fall variables. Fall events data obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1-year MDS assessment date. For a 30-day period, concordance between the MDS and chart abstractions of falls occurred in 65% of cases, with a kappa coefficient of 0.29 (Pfalls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use. The MDS underreported falls. Nurses completing MDS assessments must carefully review residents' medical records for falls documentation. Future studies should use caution when employing MDS data as the only indicator of falls.

  10. Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

    Directory of Open Access Journals (Sweden)

    Olson Matthew D

    2012-08-01

    Full Text Available Abstract Background Medical records that do not accurately reflect the patient’s current medication list are an open invitation to errors and may compromise patient safety. Methods This cross-sectional study compares primary care provider (PCP medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. Results Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age ≥45 years. Conclusion Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.

  11. Inaccurate Dental Charting in an Audit of 1128 General Dental Practice Records.

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    Brown, Nathan L; Jephcote, Victoria E L

    2017-03-01

    Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. Clinical relevance: Dental charting forms part of the patient’s dental records, and the GDC requires dentists to maintain complete and accurate dental records.

  12. User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study.

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    Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

    2017-12-01

    To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  13. Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

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    Martin, Krystle; Ham, Elke; Hilton, Zoe

    2018-05-12

    To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is

  14. Practice and documentation of palliative sedation: a quality improvement initiative

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    McKinnon, M.; Azevedo, C.; Bush, S.H.; Lawlor, P.; Pereira, J.

    2014-01-01

    Background Palliative sedation (ps), the continuous use of sedating doses of medication to intentionally reduce consciousness and relieve refractory symptoms at end of life, is ethically acceptable if administered according to standards of best practice. Procedural guidelines outlining the appropriate use of ps and the need for rigorous documentation have been developed. As a quality improvement strategy, we audited the practice and documentation of ps on our palliative care unit (pcu). Methods A pharmacy database search of admissions in 2008 identified, for a subsequent chart review, patients who had received either a continuous infusion of midazolam (≥10 mg/24 h), regular parenteral dosing of methotrimeprazine (≥75 mg daily), or regular phenobarbital. Documentation of the decision-making process, consent, and medication use was collected using a data extraction form based on current international ps standards. Results Interpretation and comparison of data were difficult because of an apparent lack of a consistent operational definition of ps. Patient records had no specific documentation in relation to ps initiation, to clearly identified refractory symptoms, and to informed consent in 60 (64.5%), 43 (46.2%), and 38 (40.9%) charts respectively. Variation in the medications used was marked: 54 patients (58%) were started on a single agent and 39 (42%), on multiple agents. The 40 patients (43%) started on midazolam alone received a mean daily dose of 21.4 mg (standard deviation: 24.6 mg). Conclusions The lack of documentation and standardized practice of ps on our pcu has resulted in a quality improvement program to address those gaps. They also highlight the importance of conducting research and developing clinical guidelines in this area. PMID:24764700

  15. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

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    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

  16. The impact of an oral hygiene education module on patient practices and nursing documentation.

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    Coke, Lola; Otten, Karine; Staffileno, Beth; Minarich, Laura; Nowiszewski, Candice

    2015-02-01

    Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.

  17. INIS: Terminology charts

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    NONE

    1970-08-01

    This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

  18. INIS: Terminology charts

    International Nuclear Information System (INIS)

    1970-08-01

    This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

  19. Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

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    Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

    2017-09-22

    Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

  20. Concordance of chart and billing data with direct observation in dental practice.

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    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

    2008-10-01

    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  1. FusionCharts Beginner's Guide The Official Guide for FusionCharts Suite

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    Nadhani, Sanket; Bhattacharya, Shamasis

    2012-01-01

    The book is written as a practical, step-by-step guide to using FusionCharts Suite. The book not only teaches you the fundamentals and implementation of FusionCharts Suite, but also makes you the data visualization guru among your friends and colleagues by teaching how to select the right chart type and usability tips. Filled with examples, code samples and practical tips in a no-nonsense way, the book is a breeze to read.This book is both for beginners and advanced web developers who need to create interactive charts for their web applications. No previous knowledge of FusionCharts Suite is a

  2. MO-A-BRB-00: Electronic Charting in EBRT and Brachytherapy

    International Nuclear Information System (INIS)

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  3. (W)righting women: constructions of gender, sexuality and race in the psychiatric chart.

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    Daley, Andrea; Costa, Lucy; Ross, Lori

    2012-01-01

    This paper examines the interpretative nature of psychiatry in relation to gender, sexuality and race within the particular time and place of one urban, Canadian, clinical psychiatric setting. We bring women's psychiatric inpatient charts and a critical feminist perspective into dialogue in an effort to focus on gender, sexuality and race in psychiatric narratives on women's madness. The research used a qualitative, retrospective research design to examine the psychiatric narrative as a technique of power as it operates on women. This paper focuses on the overarching theme of 'medicalisation', identified from the analysis of women's psychiatric inpatient charts, including two subthemes: (1) language and composition and (2) decontextualisation. Our analysis suggests that psychiatric chart documentation practices that reproduce gendered, sexualised, and racialised biases and assumptions and decontextualise the social and structural context of women's experiences of madness serve to create the paradox of women's visibility/erasure in psychiatric charts. The paper concludes with an exploration of the significance of women's authorship legitimacy in psychiatric chart documentation.

  4. MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy

    International Nuclear Information System (INIS)

    Richardson, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  5. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  6. MO-A-BRB-03: Integration Issues in Electronic Charting for External Beam Therapy

    International Nuclear Information System (INIS)

    Sutlief, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  7. Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

    Science.gov (United States)

    Feuerstein, Joseph D; Castillo, Natalia E; Siddique, Sana S; Lewandowski, Jeffrey J; Geissler, Kathy; Martinez-Vazquez, Manuel; Thukral, Chandrashekhar; Leffler, Daniel A; Cheifetz, Adam S

    2016-03-01

    Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P measures. We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures. Copyright © 2016 AGA Institute. Published by Elsevier Inc

  8. Flowcharting with D-charts

    Science.gov (United States)

    Meyer, D.

    1985-01-01

    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

  9. A comparative study of ICU patient diaries vs. hospital charts

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Christensen, Doris

    2010-01-01

    Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after...... discharge. The central question we posed in this study was: Why do nurses write diaries in addition to conventional charting in the medical record? To answer this question, we compared intensive care diaries and hospital charts using textual analysis and narrative theory. The aims of our study were...... to compare patient diaries and hospital charts to explore (a) what each documentation instrument has to offer patients in their quest to make sense of their illness, and (b) why it is worthwhile for nurses to sustain the practice of writing diaries. The study findings show that the diary is coherent...

  10. Control of control charts

    NARCIS (Netherlands)

    Sri Nurdiati, S.N.

    2005-01-01

    Although the Shewhart chart is widely used in practice because of its simplicity, applying this control chart to monitor the mean of a process may lead to two types of problems. The first concerns the typically unknown parameters involved in the distribution, while the second concerns the validity

  11. Off the Charts: Medical documentation and selective redaction in the age of transparency.

    Science.gov (United States)

    McCarthy, Matthew William; de Asua, Diego Real; Gabbay, Ezra; Fins, Joseph J

    2018-01-01

    A growing demand for transparency in medicine has the potential to strain the doctor-patient relationship. While information can empower patients, unrestricted patient access to the electronic medical record may have unintended consequences. Medical documentation is often written in language that is inaccessible to people without medical training, and without guidance, patients have no way to interpret the constellation of acronyms, diagnoses, treatments, impressions, and arguments that appear throughout their own chart. Additionally, full transparency may not allow physicians the intellectual or clinical freedom they need to authentically express questions, problematic impressions, and concerns about the patient's clinical and psychosocial issues. This article examines the ethical challenges of transparency in the digital era and suggests that selective redaction may serve as a means to maintain transparency, affirm physician's discretion, and uphold the core values of the doctor-patient relationship amidst disruptive technological change.

  12. Shoulder dystocia documentation: an evaluation of a documentation training intervention.

    Science.gov (United States)

    LeRiche, Tammy; Oppenheimer, Lawrence; Caughey, Sharon; Fell, Deshayne; Walker, Mark

    2015-03-01

    To evaluate the quality and content of nurse and physician shoulder dystocia delivery documentation before and after MORE training in shoulder dystocia management skills and documentation. Approximately 384 charts at the Ottawa Hospital General Campus involving a diagnosis of shoulder dystocia between the years of 2000 and 2006 excluding the training year of 2003 were identified. The charts were evaluated for 14 key components derived from a validated instrument. The delivery notes were then scored based on these components by 2 separate investigators who were blinded to delivery note author, date, and patient identification to further quantify delivery record quality. Approximately 346 charts were reviewed for physician and nurse delivery documentation. The average score for physician notes was 6 (maximum possible score of 14) both before and after the training intervention. The nurses' average score was 5 before and after the training intervention. Negligible improvement was observed in the content and quality of shoulder dystocia documentation before and after nurse and physician training.

  13. Mission statements and vision documents in medical practices.

    Science.gov (United States)

    Drury, Ivo; Slomski, Carol

    2006-01-01

    Thoughtful, carefully constructed mission statements and vision documents serve both to signal the purpose of a medical practice to the public and other professional colleagues, and to keep the practice's providers focused on its key purposes. Practice culture is the primary driver ofmission and vision. We clarify the differences between mission statements and vision documents, and offer guidelines to aid in constructing them.

  14. Excel PivotTables and PivotCharts Your Visual Blueprint for Creating Dynamic Spreadsheets

    CERN Document Server

    McFedries, Paul

    2010-01-01

    Master two of the most powerful features of Excel. Even if you use Excel all the time, you may not be up to speed on two of Excel's most useful features. PivotTable and PivotChart turn long lists of unreadable data into dynamic, easy-to-read tables and charts that highlight the information you need most; you can tweak results with a click or easily fuse data from several sources into one document. Now you can learn how to tap these powerful Excel tools with this practical guide. Using a series of step-by-step tutorials and easy-to-follow screenshots, this book shows you in a visual way how to

  15. US Nuclear Regulatory Commission organization charts and functional statements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This document is the US NRC organizational structure and chart as of July 1, 1996. It contains the org charts for the Commission, ACRS, ASLAB, Commission staff offices, Executive Director for Operations, Office of the Inspector General, Program offices, and regional offices.

  16. US Nuclear Regulatory Commission organization charts and functional statements

    International Nuclear Information System (INIS)

    1996-01-01

    This document is the US NRC organizational structure and chart as of July 1, 1996. It contains the org charts for the Commission, ACRS, ASLAB, Commission staff offices, Executive Director for Operations, Office of the Inspector General, Program offices, and regional offices

  17. Using Statistical Process Control to Drive Improvement in Neonatal Care: A Practical Introduction to Control Charts.

    Science.gov (United States)

    Gupta, Munish; Kaplan, Heather C

    2017-09-01

    Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial.

    Science.gov (United States)

    Gidwani, Risha; Nguyen, Cathina; Kofoed, Alexis; Carragee, Catherine; Rydel, Tracy; Nelligan, Ian; Sattler, Amelia; Mahoney, Megan; Lin, Steven

    2017-09-01

    Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency. We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 year. Scribes drafted all relevant documentation, which was reviewed by the physician before attestation and signing. In encounters without a scribe, the physician performed all charting duties. Our outcomes were physician satisfaction, measured by a 5-item instrument that included physicians' perceptions of chart quality and chart accuracy; patient satisfaction, measured by a 6-item instrument; and charting efficiency, measured by time to chart close. Scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic (OR = 10.75), having enough face time with patients (OR = 3.71), time spent charting (OR = 86.09), chart quality (OR = 7.25), and chart accuracy (OR = 4.61) (all P values patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours (OR =1.18, P =.028). To our knowledge, we have conducted the first randomized controlled trial of scribes. We found that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy, and charting efficiency without detracting from patient satisfaction. Scribes appear to be a promising strategy to improve health care efficiency and reduce physician burnout. © 2017 Annals of Family Medicine, Inc.

  19. Software tool for physics chart checks.

    Science.gov (United States)

    Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

    2014-01-01

    Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

  20. DOES PRESENTING PATIENT'S BMI INCREASE DOCUMENTATION OF OBESITY?

    Directory of Open Access Journals (Sweden)

    Norm Clothier, MD, M. Kim Marvel, PhD, Courtney S. Cruickshank, MS

    2002-09-01

    Full Text Available Purpose: Despite the associated health consequences, obesity is infrequently documented as a problem in medical charts. The purpose of this study is to determine whether a simple intervention (routine listing of the BMI on the medical chart will increase physician documentation of obesity in the medical record. Methods: Participants were resident physicians in a family medicine residency program. Participants were randomly assigned to either an experimental group or a control group. For experimental group physicians, the Body Mass Index was listed alongside other vital signs of patients seen in an ambulatory setting. Physician documentation of patient obesity was assessed by chart review after patient visits. Documentation was defined as inclusion of obesity on the problem list or in the progress note. Results: The intervention did not significantly increase the rate of documentation of obesity in the medical chart. Several reasons for the lack of change are explored, including the difficulty of treating obesity successfully.

  1. Electronic growth charts: watching our patients grow.

    Science.gov (United States)

    Murphy, Cynthia A; Carstens, Kimberly; Villamayor, Precy

    2005-01-01

    Pediatric Growth Charts have been used in the pediatric community since 1977. The first growth charts were developed by the National Center for Health Statistics as a clinical tool for health care professionals. The growth charts, revised in 2000, by the Center for Disease Control consists of a series of percentile curves for selected body measurements in children [1]. Capitalizing on the benefits of our Electronic Medical Record (EMR), and as a byproduct of nursing electronic documentation of routine heights, weights, and frontal occipital circumferences, our system plots the routine measurements without additional intervention by the staff. Clinicians can view the graphs online or generate printed reports as needed during routine examination for outpatient or hospitalized care. This abstract outlines the background, design process, programming rules utilized to plot growth curves, and the evaluation of the electronic CDC growth charts in our organization.

  2. Health physics source document for codes of practice

    International Nuclear Information System (INIS)

    Pearson, G.W.; Meggitt, G.C.

    1989-05-01

    Personnel preparing codes of practice often require basic Health Physics information or advice relating to radiological protection problems and this document is written primarily to supply such information. Certain technical terms used in the text are explained in the extensive glossary. Due to the pace of change in the field of radiological protection it is difficult to produce an up-to-date document. This document was compiled during 1988 however, and therefore contains the principle changes brought about by the introduction of the Ionising Radiations Regulations (1985). The paper covers the nature of ionising radiation, its biological effects and the principles of control. It is hoped that the document will provide a useful source of information for both codes of practice and wider areas and stimulate readers to study radiological protection issues in greater depth. (author)

  3. Robust control charts in statistical process control

    NARCIS (Netherlands)

    Nazir, H.Z.

    2014-01-01

    The presence of outliers and contaminations in the output of the process highly affects the performance of the design structures of commonly used control charts and hence makes them of less practical use. One of the solutions to deal with this problem is to use control charts which are robust

  4. Registration document 2005; Document de reference 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This reference document of Gaz de France provides information and data on the Group activities in 2005: financial informations, business, activities, equipments factories and real estate, trade, capital, organization charts, employment, contracts and research programs. (A.L.B.)

  5. The medicolegal importance of enhancing timeliness of documentation when using an anesthesia information system and the response to automated feedback in an academic practice.

    Science.gov (United States)

    Vigoda, Michael M; Lubarsky, David A

    2006-07-01

    Documentation should ideally occur in real time immediately after completion of a service. Although electronic records often do not print the time that documentation notes were entered on the medical record, automated anesthesia record keeping systems store an audit trail that time stamps events entered by all anesthesia providers. As more lawyers become aware of this fact and requisition audit trails, prospective charting of necessary documentation may undermine the integrity of an anesthesia care team accused of malpractice, with potentially significant medicolegal consequences. We changed existing documentation practices of a large academic practice via a three-step process. Educational sessions increased the percentage of cases with correct timing of emergence documentation from 25% to 60% over a 2-mo period. Automated email performance feedback further increased correct note timing to 70%. When combined with personal contact by a member of the billing office and email copy notification of the chair, the percentage increased to >99.5%. The behavioral change was seen in all individuals, as 95% of attendings had < or = 2 records/mo with untimely documentation at the end of the study period. Once the habits were ingrained, further input was rarely necessary over the next 9 mo. This suggests physician behavioral change related to work process flow, unlike that related to patient care, is easily sustained.

  6. Preparation of exposures charts for X-ray tubes

    International Nuclear Information System (INIS)

    Zoofan, B.

    1988-01-01

    An exposure chart is a fundamental graph which provides guidance of the exposure conditions in relation to the thickness for a given specimen. It must be prepared specially for the X-ray unit and the type of the film to be used. Although exposure charts are available for each particular X-ray tube from its manufacturer, individual radiographic laboratory should be able to prepare its own exposure charts in a precise manner. Here a typical procedure to prepare such a chart is provided in a practical way with some necessary recommendations

  7. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

    Science.gov (United States)

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

    2015-12-01

    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  8. Documentation of Contraception and Pregnancy Intention In Medicaid Managed Care

    Directory of Open Access Journals (Sweden)

    Heike Thiel de Bocanegra

    2018-01-01

    Full Text Available Context: Clinical guidelines recommend the documentation of pregnancy intention and family planning needs during primary care visits. Prior to the 2014 Medicaid expansion and release of these guidelines, the documentation practices of Medicaid managed care providers are unknown. Methods: We performed a chart review of 1054 Medicaid managed care visits of women aged 13 to 49 to explore client, provider, and visit characteristics associated with documentation of immediate or future plans for having children and contraceptive method use. Five managed care plans used Current Procedural Terminology and International Classification of Diseases, Ninth Revision codes to identify providers with at least 15 women who had received family planning or well-woman care in 2013. We conducted multilevel logistic regression analyses with documentation of contraceptive method and pregnancy intention as outcome variables and clinic site as the level 2 random effect. Results: Only 12% of charts had documentation of pregnancy intention and 59% documented contraceptive use. Compared to women with a family planning visit reason, women with an annual, reproductive health, or primary care reason for their visit were significantly less likely to have contraception documented (odds ratio [OR] = 11.0; 95% confidence interval [CI] = 6.8-17.7. Age was also a significant predictor with women aged 30 to 49 (OR = 0.6; 95% CI = 0.4-0.9, and women aged 13 to 19 (OR = 0.2; 95% CI = 0.1-0.6 being less likely to have a note about pregnancy intention in their chart. Pregnancy intention was more likely to be documented in multispecialty clinics (OR = 15.5; 95% CI = 2.7-89.2. Conclusions: Interventions to improve routine medical record documentation of contraception and pregnancy intention regardless of patient age and visit characteristics are needed to facilitate the provision of family planning in managed care visits and, ultimately, achieving better maternal infant health outcomes

  9. TU-D-201-02: Medical Physics Practices for Plan and Chart Review: Results of AAPM Task Group 275 Survey

    Energy Technology Data Exchange (ETDEWEB)

    Fong de los Santos, L [Mayo Clinic, Rochester, MN (United States); Dong, L [Scripps Proton Therapy Center, San Diego, CA (United States); Greener, A [VA Medical Center, East Orange, NJ (United States); Johnson, J [UT MD Anderson Cancer Center, Houston, TX (United States); Johnson, P [University of Miami, Miami, FL (United States); Kim, G [University of California, San Diego, La Jolla, CA (United States); Mechalakos, J; Yorke, E [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Napolitano, B [Massachusetts General Hospital, Boston, MA (United States); Parker, S [Novant Health, Winston Salem, NC (United States); Schofield, D [Saint Vincent Hospital, Acton, MA (United States); Wells, M [Piedmont Hospital, Atlanta, GA (United States); Ford, E [Mayo Clinic, Rochester, MN (United States); Scripps Proton Therapy Center, San Diego, CA (United States)

    2016-06-15

    Purpose: AAPM Task Group (TG) 275 is charged with developing riskbased guidelines for plan and chart review clinical processes. As part of this work an AAPM-wide survey was conducted to gauge current practices. Methods: The survey consisted of 103 multiple-choice questions covering the following review processes for external beam including protons: 1) Initial Plan Check, 2) On-Treatment and 3) End-of-Treatment Chart Check. The survey was designed and validated by TG members with the goal of providing an efficient and easy response process. The survey, developed and deployed with the support of AAPM headquarters, was released to all AAPM members who have self-reported as working in the radiation oncology field and it was kept open for 7 weeks. Results: There are an estimated 4700 eligible participants. At the time of writing, 962 completed surveys have been collected with an average completion time of 24 minutes. Participants are mainly from community hospitals (40%), academicaffiliated hospitals (31%) and free-standing clinics (18%). Among many other metrics covered on the survey, results so far indicate that manual review is an important component on the plan and chart review process (>90%) and that written procedures and checklists are widely used (>60%). However, the details of what is reviewed or checked are fairly heterogeneous among the sampled medical physics community. Conclusion: The data gathered from the survey gauging current practices will be used by TG 275 to develop benchmarks and recommendations for the type and extent of checks to perform effective physics plan and chart review processes.

  10. Management Documentation: Indicators & Good Practice at Cultural Heritage Places

    Science.gov (United States)

    Eppich, R.; Garcia Grinda, J. L.

    2015-08-01

    Documentation for cultural heritage places usually refers to describing the physical attributes, surrounding context, condition or environment; most of the time with images, graphics, maps or digital 3D models in their various forms with supporting textural information. Just as important as this type of information is the documentation of managerial attributes. How do managers of cultural heritage places collect information related to financial or economic well-being? How are data collected over time measured, and what are significant indicators for improvement? What quality of indicator is good enough? Good management of cultural heritage places is essential for conservation longevity, preservation of values and enjoyment by the public. But how is management documented? The paper will describe the research methodology, selection and description of attributes or indicators related to good management practice. It will describe the criteria for indicator selection and why they are important, how and when they are collected, by whom, and the difficulties in obtaining this information. As importantly it will describe how this type of documentation directly contributes to improving conservation practice. Good practice summaries will be presented that highlight this type of documentation including Pamplona and Ávila, Spain and Valletta, Malta. Conclusions are drawn with preliminary recommendations for improvement of this important aspect of documentation. Documentation of this nature is not typical and presents a unique challenge to collect, measure and communicate easily. However, it is an essential category that is often ignored yet absolutely essential in order to conserve cultural heritage places.

  11. Document segmentation via oblique cuts

    Science.gov (United States)

    Svendsen, Jeremy; Branzan-Albu, Alexandra

    2013-01-01

    This paper presents a novel solution for the layout segmentation of graphical elements in Business Intelligence documents. We propose a generalization of the recursive X-Y cut algorithm, which allows for cutting along arbitrary oblique directions. An intermediate processing step consisting of line and solid region removal is also necessary due to presence of decorative elements. The output of the proposed segmentation is a hierarchical structure which allows for the identification of primitives in pie and bar charts. The algorithm was tested on a database composed of charts from business documents. Results are very promising.

  12. CHART in lung cancer: Economic evaluation and incentives for implementation

    International Nuclear Information System (INIS)

    Lievens, Yolande; Kesteloot, Katrien; Bogaert, Walter van den

    2005-01-01

    Background and purpose: To investigate the financial consequences and the impact on daily implementation of CHART in lung cancer. Patients and methods: A cost-effectiveness and cost-utility analysis were performed using Markov models, comparing the early and delayed costs and effects of CHART for NSCLC over a 4-year time span from a societal viewpoint. The outcome estimates were based on the CHART literature, the cost estimates on the standard practice of the Leuven University Hospitals, the radiotherapy costs being derived from an activity-based costing (ABC) programme developed in the department. Results: The additional societal cost per life-year gained was EURO 9164, the incremental cost per quality-adjusted life-year EURO 11,576. Sensitivity analyses confirmed the robustness of these results, the incremental cost-utility ratio remaining well under 20,000 EURO /QALY in all tested circumstances. The threshold analyses found the results of the study to be sensitive to the cost of CHART and to the quality of life after treatment. More specifically, standard treatment would become the optimal treatment if CHART would have a higher cost or would result in more long-term side effects. Conclusion: CHART should not be denied to patients with NSCLC on the basis of clinical or economic arguments. Other factors such as socio-economical, institutional, practical departmental and physician-bound barriers most probably explain the lack of implementation into daily practice

  13. 46 CFR 502.206 - Production of documents and things and entry upon land for inspection and other purposes.

    Science.gov (United States)

    2010-10-01

    ... GENERAL AND ADMINISTRATIVE PROVISIONS RULES OF PRACTICE AND PROCEDURE Depositions, Written Interrogatories... inspect and copy any designated documents (including writings, drawings, graphs, charts, photographs... of § 502.203(a) and which are in the possession, custody or control of the party upon whom the...

  14. Ethical and legal questions as regards filling out dental clinical charts

    Directory of Open Access Journals (Sweden)

    Mauro Henrique Nogueira Guimarãe de Abreu

    Full Text Available Objective: Evaluate imperfections in filling out dental clinical history charts of patients attended at the “Universidade Estadual de Montes Claros – Unimontes”, in 2005, from the ethical and legal aspects. Method: Descriptive statistical analysis, Pearson’s correlation, Chi-Square test (p<0.05 with Bonferroni correction in a contingency table (p<0.003 tests were performed, and Anova – Tukey (p<0.05 were calculate using SPSS software. This study was conducted using 881 clinical history charts of 19 subjects. Results: The highest percentage of charts concerned Stomatology (12% and 8 th period of the course (25%. The majority (63.3% of chartshad fields left blank and in 68% the handwriting was illegible. Unjustifiable erasures were found in 74.7% of charts. The majority of charts (98% were filled out in ink. The treatment plan was signed by course tutor in 83% of the cases. The term of consent was signed in the 94.9 % of the charts. As regards mistakes, 5.1% of documents had one error; 42% two errors; 23.5% three or more errors (average 1.89(± 0.9; percentile 25%=1; 50%=2 and 75%=2. The difference in the proportion of errors as regards filling out all fields differed statistically among the periods (p<0.05. Conclusion: It was concluded that an alarming number of documents were filled out incorrectly. The worst filling out performance was shown in the 5th, 6th and 7th periods (p<0.05.

  15. Survey of symbology for aeronautical charts and electronic displays : navigation aids, airports, lines, and linear patterns

    Science.gov (United States)

    2008-09-01

    This industry survey documents the symbols for navigation aids, airports, lines, and linear patterns currently in use by avionics manufactureres and chart providers for depicting aeronautical charting information. Nine avionics display manufacturers ...

  16. Theoretical and Practical Aspects of Logistic Quality Management System Documentation Development Process

    Directory of Open Access Journals (Sweden)

    Linas Šaulinskas

    2013-12-01

    Full Text Available This paper addresses aspects of logistics quality management system documentation development and suggests models for quality management system documentation development, documentation hierarchical systems and authorization approval. It also identifies logistic processes and a responsibilities model and a detailed document development and approval process that can be practically applied. Our results are based upon an analysis of advanced Lithuanian and foreign corporate business practices, a review of current literature and recommendations for quality management system standards.

  17. SpeckTackle: JavaScript charts for spectroscopy.

    Science.gov (United States)

    Beisken, Stephan; Conesa, Pablo; Haug, Kenneth; Salek, Reza M; Steinbeck, Christoph

    2015-01-01

    Spectra visualisation from methods such as mass spectroscopy, infrared spectroscopy or nuclear magnetic resonance is an essential part of every web-facing spectral resource. The development of an intuitive and versatile visualisation tool is a time- and resource-intensive task, however, most databases use their own embedded viewers and new databases continue to develop their own viewers. We present SpeckTackle, a custom-tailored JavaScript charting library for spectroscopy in life sciences. SpeckTackle is cross-browser compatible and easy to integrate into existing resources, as we demonstrate for the MetaboLights database. Its default chart types cover common visualisation tasks following the de facto 'look and feel' standards for spectra visualisation. SpeckTackle is released under GNU LGPL to encourage uptake and reuse within the community. The latest version of the library including examples and documentation on how to use and extend the library with additional chart types is available online in its public repository.

  18. Registration document 2005

    International Nuclear Information System (INIS)

    2005-01-01

    This reference document of Gaz de France provides information and data on the Group activities in 2005: financial informations, business, activities, equipments factories and real estate, trade, capital, organization charts, employment, contracts and research programs. (A.L.B.)

  19. Evidence-Based Practice and School Libraries: Interconnections of Evidence, Advocacy, and Actions

    Science.gov (United States)

    Todd, Ross J.

    2015-01-01

    This author states that a professional focus on evidence based practice (EBP) for school libraries emerged from the International Association of School Librarianship conference when he presented the concept. He challenged the school library profession to actively engage in professional and reflective practices that chart, measure, document, and…

  20. Documentation of polio eradication initiative best practices: Experience from WHO African Region.

    Science.gov (United States)

    Okeibunor, Joseph; Nshimirimana, Deo; Nsubuga, Peter; Mutabaruka, Evariste; Tapsoba, Leonard; Ghali, Emmanuel; Kabir, Shaikh Humayun; Gassasira, Alex; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries

  1. Charts for Guiding Adjustments of Irrigation Interval to Actual Weather Conditions

    International Nuclear Information System (INIS)

    Kipkorir, E.C.

    2002-01-01

    Major problems in irrigation management at short time-step during the season are unreliability of rainfall and absence of guidance. By considering the climate of region, crop and soil characteristics, the irrigation method and local irrigation practices, this paper presents the concept of irrigation charts. The charts are based on soil water technique. As an example irrigation chart for a typical irrigation system located in the semi-arid area in Naivasha, Kenya is presented. The chart guides the user in adjustment of irrigation interval to the actual weather conditions throughout the growing season. It is believed that the simplicity of the chart makes it a useful tool for a better utilisation of the limited irrigation water

  2. Comparison of Onsite Versus Online Chart Reviews as Part of the American College of Radiation Oncology Accreditation Program.

    Science.gov (United States)

    Hepel, Jaroslaw T; Heron, Dwight E; Mundt, Arno J; Yashar, Catheryn; Feigenberg, Steven; Koltis, Gordon; Regine, William F; Prasad, Dheerendra; Patel, Shilpen; Sharma, Navesh; Hebert, Mary; Wallis, Norman; Kuettel, Michael

    2017-05-01

    Accreditation based on peer review of professional standards of care is essential in ensuring quality and safety in administration of radiation therapy. Traditionally, medical chart reviews have been performed by a physical onsite visit. The American College of Radiation Oncology Accreditation Program has remodeled its process whereby electronic charts are reviewed remotely. Twenty-eight radiation oncology practices undergoing accreditation had three charts per practice undergo both onsite and online review. Onsite review was performed by a single reviewer for each practice. Online review consisted of one or more disease site-specific reviewers for each practice. Onsite and online reviews were blinded and scored on a 100-point scale on the basis of 20 categories. A score of less than 75 was failing, and a score of 75 to 79 was marginal. Any failed charts underwent rereview by a disease site team leader. Eighty-four charts underwent both onsite and online review. The mean scores were 86.0 and 86.9 points for charts reviewed onsite and online, respectively. Comparison of onsite and online reviews revealed no statistical difference in chart scores ( P = .43). Of charts reviewed, 21% had a marginal (n = 8) or failing (n = 10) score. There was no difference in failing charts ( P = .48) or combined marginal and failing charts ( P = .13) comparing onsite and online reviews. The American College of Radiation Oncology accreditation process of online chart review results in comparable review scores and rate of failing scores compared with traditional on-site review. However, the modern online process holds less potential for bias by using multiple reviewers per practice and allows for greater oversight via disease site team leader rereview.

  3. 7 CFR 51.2276 - Color chart.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Walnut Color Chart) to which reference is made in §§ 51.2281 and 51.2282 illustrates the four shades of...

  4. Statistical process control charts for monitoring military injuries.

    Science.gov (United States)

    Schuh, Anna; Canham-Chervak, Michelle; Jones, Bruce H

    2017-12-01

    An essential aspect of an injury prevention process is surveillance, which quantifies and documents injury rates in populations of interest and enables monitoring of injury frequencies, rates and trends. To drive progress towards injury reduction goals, additional tools are needed. Statistical process control charts, a methodology that has not been previously applied to Army injury monitoring, capitalise on existing medical surveillance data to provide information to leadership about injury trends necessary for prevention planning and evaluation. Statistical process control Shewhart u-charts were created for 49 US Army installations using quarterly injury medical encounter rates, 2007-2015, for active duty soldiers obtained from the Defense Medical Surveillance System. Injuries were defined according to established military injury surveillance recommendations. Charts display control limits three standard deviations (SDs) above and below an installation-specific historical average rate determined using 28 data points, 2007-2013. Charts are available in Army strategic management dashboards. From 2007 to 2015, Army injury rates ranged from 1254 to 1494 unique injuries per 1000 person-years. Installation injury rates ranged from 610 to 2312 injuries per 1000 person-years. Control charts identified four installations with injury rates exceeding the upper control limits at least once during 2014-2015, rates at three installations exceeded the lower control limit at least once and 42 installations had rates that fluctuated around the historical mean. Control charts can be used to drive progress towards injury reduction goals by indicating statistically significant increases and decreases in injury rates. Future applications to military subpopulations, other health outcome metrics and chart enhancements are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Candlestick Charting and Trading Volume: Evidence from Bursa Malaysia

    OpenAIRE

    Chin, Chee-Ling; Jais, Mohamad; Balia, Sophee Sulong; Ahmad, Ayoib Che; Abidin, Azlan Zainol

    2016-01-01

    Technical analysis is deemed to be a futile practice among academicians who propose efficient market hypothesis, typically the weak form market efficiency which strongly protests the application of past prices and trading volume data for prediction of future market movement. As candlestick charting is one of the oldest technical indicators for short term investment, therefore this study examines the predictability of candlestick charting with combination to trading volume for Malaysian stock ...

  6. US Nuclear Regulatory Commission organization charts and functional statements

    International Nuclear Information System (INIS)

    1996-01-01

    This document is the organizational chart for the US NRC. It contains organizational structure and functional statements for the following: (1) the Commission, (2) committees and boards, (3) staff offices, (4) office of the Inspector General, (5) executive director for operations, (6) program offices, and (7) regional offices

  7. US Nuclear Regulatory Commission organization charts and functional statements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-19

    This document is the organizational chart for the US NRC. It contains organizational structure and functional statements for the following: (1) the Commission, (2) committees and boards, (3) staff offices, (4) office of the Inspector General, (5) executive director for operations, (6) program offices, and (7) regional offices.

  8. Create dynamic charts in Microsoft Office Excel 2007 and beyond

    CERN Document Server

    Scheck, Reinhold

    2009-01-01

    Extend your Excel 2007 skills-and create more-powerful and compelling charts in less time. Guided by an Excel expert, you'll learn how to turn flat, static charts into dynamic solutions-where you can visualize and manipulate data countless ways with a simple mouse click. Get the hands-on practice and examples you need to produce your own, professional-quality results. No programming required! Maximize the impact of your ideas and data! Learn how your design decisions affect perception and comprehensionMatch the right chart type to your communication objectiveVisualize-then build-your solut

  9. US Nuclear Regulatory Commission organization charts and functional statements

    International Nuclear Information System (INIS)

    1997-01-01

    This document contains organization charts for the U.S. Nuclear Regulatory Commission (NRC) and for the five offices of the NRC. Function statements are provided delineating the major responsibilities and operations of each office. Organization and function are provided to the branch level. The head of each office, division, and branch is also listed

  10. US Nuclear Regulatory Commission organization charts and functional statements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-11-01

    This document contains organization charts for the U.S. Nuclear Regulatory Commission (NRC) and for the five offices of the NRC. Function statements are provided delineating the major responsibilities and operations of each office. Organization and function are provided to the branch level. The head of each office, division, and branch is also listed.

  11. Documenting a best practice model for successful female inmate ...

    African Journals Online (AJOL)

    Documenting a best practice model for successful female inmate and female ex ... of men and women within the prison and correctional services as well as inform and ... and beyond, with scope for transforming it into a robust business model.

  12. Taking note of the perceived value and impact of medical student chart documentation on education and patient care.

    Science.gov (United States)

    Friedman, Erica; Sainte, Michelle; Fallar, Robert

    2010-09-01

    To determine the extent of restrictions to medical student documentation in patients' records and the opinions of medical education leaders about such restrictions' impact on medical student education and patient care. Education deans (n = 126) of medical schools in the United States and Canada were surveyed to determine policies regarding placement of medical student notes in the patient record, the value of medical students' documentation in the medical record, and the use of electronic medical records (EMRs) for patient notes. The instrument was a 23-item anonymous Web survey. Seventy-nine deans responded. Over 90% believed student notes belong in medical records, but only 42% had a policy regarding this. Ninety-three percent indicated that without student notes, student education would be negatively affected. Fewer (56%) indicated that patient care would be negatively affected. Most thought limiting students' notes would negatively affect several other issues: feeling a part of the team (96%), preparation for internship (95%), and students' sense of involvement (94%). Half (52%) reported that fourth-year students could place notes in paper charts at "all" affiliated hospitals, and 6% reported that fourth-year students could do so at "no" hospitals. Although students' ability to enter notes in patients' records is believed to be important for student education, only about half of all hospitals allow all students' notes in the EMR. Policies regarding placement of student notes should be implemented to ensure students' competency in note writing and their value as members of the patient care team.

  13. Transformation of admission interview to documentation for nursing practice

    DEFF Research Database (Denmark)

    Højskov, Ida E; Glasdam, Stinne

    2014-01-01

    's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool......The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission...... interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired...

  14. Education in Neurology Resident Documentation Using Payroll Simulation.

    Science.gov (United States)

    Liang, John W; Shanker, Vicki L

    2017-04-01

    Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. To improve the quality of neurology resident documentation through payroll simulation. A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback "paystubs" every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits ( P < .001), with a reduction in the financial loss to 6% ($1,880). Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

  15. US Nuclear Regulatory Commission organization charts and functional statements. Revision 17

    International Nuclear Information System (INIS)

    1994-01-01

    This document is a detailed organizational chart detailing the different staffing and board offices. They include: the commission, the several committees and boards, the commission staff offices, the office of the Inspector General, the executive director for operations and staff offices, and the regional and program offices

  16. A practical iterative PID tuning method for mechanical systems using parameter chart

    Science.gov (United States)

    Kang, M.; Cheong, J.; Do, H. M.; Son, Y.; Niculescu, S.-I.

    2017-10-01

    In this paper, we propose a method of iterative proportional-integral-derivative parameter tuning for mechanical systems that possibly possess hidden mechanical resonances, using a parameter chart which visualises the closed-loop characteristics in a 2D parameter space. We employ a hypothetical assumption that the considered mechanical systems have their upper limit of the derivative feedback gain, from which the feasible region in the parameter chart becomes fairly reduced and thus the gain selection can be extremely simplified. Then, a two-directional parameter search is carried out within the feasible region in order to find the best set of parameters. Experimental results show the validity of the assumption used and the proposed parameter tuning method.

  17. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Science.gov (United States)

    Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

    2017-01-01

    This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  18. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Directory of Open Access Journals (Sweden)

    Yasaira Rodriguez Torres

    Full Text Available This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p 90% in 13 elements while Electronic Health Record B had high compliance (>90% in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  19. 'What is not written does not exist': the importance of proper documentation of medication use history.

    Science.gov (United States)

    Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

    2017-10-01

    Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

  20. Development of Markup Language for Medical Record Charting: A Charting Language.

    Science.gov (United States)

    Jung, Won-Mo; Chae, Younbyoung; Jang, Bo-Hyoung

    2015-01-01

    Nowadays a lot of trials for collecting electronic medical records (EMRs) exist. However, structuring data format for EMR is an especially labour-intensive task for practitioners. Here we propose a new mark-up language for medical record charting (called Charting Language), which borrows useful properties from programming languages. Thus, with Charting Language, the text data described in dynamic situation can be easily used to extract information.

  1. Managing the consistency of distributed documents

    OpenAIRE

    Nentwich, C.

    2005-01-01

    Many businesses produce documents as part of their daily activities: software engineers produce requirements specifications, design models, source code, build scripts and more; business analysts produce glossaries, use cases, organisation charts, and domain ontology models; service providers and retailers produce catalogues, customer data, purchase orders, invoices and web pages. What these examples have in common is that the content of documents is often semantically relate...

  2. Growth Charts (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Growth Charts KidsHealth / For Parents / Growth Charts What's in ... Problem? Print en español Tablas de crecimiento About Growth Charts Look at any class picture, and you' ...

  3. Sticky Dots and Lion Adventures Playing a Part in Preschool Documentation Practices

    Science.gov (United States)

    Elfström Pettersson, Katarina

    2015-01-01

    This article examines how material objects such as photographs, papers and computers influence documentation practices in a Swedish preschool. The importance of teacher documentation is emphasized in the 2010 revised Swedish preschool curriculum as a means of evaluating preschool quality. However, the curriculum gives no specific guidelines about…

  4. Forecasting of mechanical - and structural behavior of 316 austenitic stainless steels by deformation charts

    International Nuclear Information System (INIS)

    Monteiro, S.N.

    1980-01-01

    The utilization of deformation charts applied to AISI 316 austenitic stainless steel with the purpose of foreseeing its behavior associated with structural and mechanical phenomena, is evaluated. The ocurrence of phenomena such as dynamic aging, martensite transformation, static aging, failure at creep curve, cells, subgrains and boundary slips is discussed in the different regions of the chart. A practical example of the charts' utilization for components of fast reactors is finally presented. (Author) [pt

  5. Interactive SIGHT: textual access to simple bar charts

    Science.gov (United States)

    Demir, Seniz; Oliver, David; Schwartz, Edward; Elzer, Stephanie; Carberry, Sandra; Mccoy, Kathleen F.; Chester, Daniel

    2010-12-01

    Information graphics, such as bar charts and line graphs, are an important component of many articles from popular media. The majority of such graphics have an intention (a high-level message) to communicate to the graph viewer. Since the intended message of a graphic is often not repeated in the accompanying text, graphics together with the textual segments contribute to the overall purpose of an article and cannot be ignored. Unfortunately, these visual displays are provided in a format which is not readily accessible to everyone. For example, individuals with sight impairments who use screen readers to listen to documents have limited access to the graphics. This article presents a new accessibility tool, the Interactive SIGHT (Summarizing Information GrapHics Textually) system, that is intended to enable visually impaired users to access the knowledge that one would gain from viewing information graphics found on the web. The current system, which is implemented as a browser extension that works on simple bar charts, can be invoked by a user via a keystroke combination while navigating the web. Once launched, Interactive SIGHT first provides a brief summary that conveys the underlying intention of a bar chart along with the chart's most significant and salient features, and then produces history-aware follow-up responses to provide further information about the chart upon request from the user. We present two user studies that were conducted with sighted and visually impaired users to determine how effective the initial summary and follow-up responses are in conveying the informational content of bar charts, and to evaluate how easy it is to use the system interface. The evaluation results are promising and indicate that the system responses are well-structured and enable visually impaired users to answer key questions about bar charts in an easy-to-use manner. Post-experimental interviews revealed that visually impaired participants were very satisfied with

  6. Surface Prognostic Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Surface Prognostic Charts are historical surface prognostic (forecast) charts created by the United States Weather Bureau. They include fronts, isobars, cloud, and...

  7. Monitoring Poisson observations using combined applications of Shewhart and EWMA charts

    Science.gov (United States)

    Abujiya, Mu'azu Ramat

    2017-11-01

    The Shewhart and exponentially weighted moving average (EWMA) charts for nonconformities are the most widely used procedures of choice for monitoring Poisson observations in modern industries. Individually, the Shewhart EWMA charts are only sensitive to large and small shifts, respectively. To enhance the detection abilities of the two schemes in monitoring all kinds of shifts in Poisson count data, this study examines the performance of combined applications of the Shewhart, and EWMA Poisson control charts. Furthermore, the study proposes modifications based on well-structured statistical data collection technique, ranked set sampling (RSS), to detect shifts in the mean of a Poisson process more quickly. The relative performance of the proposed Shewhart-EWMA Poisson location charts is evaluated in terms of the average run length (ARL), standard deviation of the run length (SDRL), median run length (MRL), average ratio ARL (ARARL), average extra quadratic loss (AEQL) and performance comparison index (PCI). Consequently, all the new Poisson control charts based on RSS method are generally more superior than most of the existing schemes for monitoring Poisson processes. The use of these combined Shewhart-EWMA Poisson charts is illustrated with an example to demonstrate the practical implementation of the design procedure.

  8. Nursing care documentation practice: The unfinished task of nursing care in the University of Gondar Hospital.

    Science.gov (United States)

    Kebede, Mihiretu; Endris, Yesuf; Zegeye, Desalegn Tegabu

    2017-09-01

    Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.

  9. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    International Nuclear Information System (INIS)

    Lawrence, Yaacov Richard; Whiton, Michal A.; Symon, Zvi; Wuthrick, Evan J.; Doyle, Laura; Harrison, Amy S.; Dicker, Adam P.

    2012-01-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6–14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p 75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose–volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are rarely reviewed. Attendance by senior physicians is variable, but it improves when scheduling clashes are avoided. The potential effect of a more thorough quality assurance peer review on patient outcomes is not known.

  10. U.S. Nuclear Regulatory Commission organization charts and functional statements. Revision 18

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-23

    This document (NUREG-0325) is the current US NRC organization chart, listing all NRC offices and regions and their components down through the branch level as of July 23, 1995. Functional statements of each position are given, as is the name of the individual holding the position.

  11. U.S. Nuclear Regulatory Commission organization charts and functional statements. Revision 18

    International Nuclear Information System (INIS)

    1995-01-01

    This document (NUREG-0325) is the current US NRC organization chart, listing all NRC offices and regions and their components down through the branch level as of July 23, 1995. Functional statements of each position are given, as is the name of the individual holding the position

  12. APPLICATION OF U-CHART AND C-CHART IN TECHNOLOGICAL PROCESS OF PRIMARY WOOD PROCESSING

    Directory of Open Access Journals (Sweden)

    Damjan Stanojević

    2014-01-01

    Full Text Available Control charts are statistical methods of quality control. Basically it is a graph where the abscissa represents the order of control, and the ordinate is marked with parameter values, which are controled by samples over a certain size. Using charts determine varying quality and also related the stability and capacity of the production process in relation to the established control limits. Dr. Schuchardt, which can be regarded as the creator of control charts, says that their mission: to maintain the production process in a state of control, to lead the production process into a state of control, to show that the state of control has been achieved. According to Dr. Schuchardt „for a phenomenon is said to be controlled if based on current data we can predict, at least within certain limits, how the phenomenon will change in the future. Here, under certain prediction within limits means that we can determine, at least approximately, the probability that the phenomenon is found within the given limits“. Control charts for attribute quality characteristics are: p- control chart, m- control chart, u- control chart, c- control chart.

  13. MO-A-BRB-01: Review of TG-262 Internal Survey of Practices in EMR for External Beam Therapy

    International Nuclear Information System (INIS)

    Mechalakos, J.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  14. ICAO Aeronautical chart production: aerodrome obstruction charts from small–format aerial digital imagery

    Directory of Open Access Journals (Sweden)

    Jorge Padro Molina

    2012-11-01

    Full Text Available Aeronautical charts and aerodrome obstruction charts, provide information about obstacles around the airport, so pilots and air traffic controllers can comply with the procedures and limitations of its utilization. Safety in aviation demands updated and precise aeronautical charts production, adopting the standards of the International Civil Aviation Organization (ICAO. In this paper the methodology employed to generate obstruction charts for five airports in Mexico, using aerial digital imagery obtained with small–format cameras, is described. Through two aerial surveys on each airport, from 10 000 and 5 000 feet above ground level, two orthomosaics were generated covering the airport influence area, the runway, and the obstacle limitation surfaces: approach/Take–off climb, transitional, inner horizontal, and conical. Using stereopair photointerpretation most of the obstacles were identified, and by means of the orthomosaics; aerodrome charts, and aerodrome obstruction charts types A, B and C, were generated. Using satellite geodetic receivers, 18 points were surveyed on each runway in order to obtain its dimensions, and to establish ground control points for mosaics generation. Throughout detailed field work, height and location of the obstacles were verified, and finally, after several reviewing processes by aeronautical authorities, generation of ICAO charts was concluded when all airport maps were integrated in a Geographical Information System.

  15. [Ophthalmologic reading charts : Part 2: Current logarithmically scaled reading charts].

    Science.gov (United States)

    Radner, W

    2016-12-01

    To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations. Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality. Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.

  16. Spectral Imaging of Portolan Charts

    Science.gov (United States)

    France, Fenella G.; Wilson, Meghan A.; Ghez, Anita

    2018-05-01

    Spectral imaging of Portolan Charts, early nautical charts, provided extensive new information about their construction and creation. The origins of the portolan chart style have been a continual source of perplexity to numerous generations of cartographic historians. The spectral imaging system utilized incorporates a 50 megapixel mono-chrome camera with light emitting diode (LED) illumination panels that cover the range from 365 nm to 1050 nm to capture visible and non-visible information. There is little known about how portolan charts evolved, and what influenced their creation. These early nautical charts began as working navigational tools of medieval mariners, initially made in the 1300s in Italy, Portugal and Spain; however the origin and development of the portolan chart remained shrouded in mystery. Questions about these early navigational charts included whether colorants were commensurate with the time period and geographical location, and if different, did that give insight into trade routes, or possible later additions to the charts? For example; spectral data showed the red pigment on both the 1320 portolan chart and the 1565 Galapagos Islands matched vermillion, an opaque red pigment used since antiquity. The construction of these charts was also of great interest. Spectral imaging with a range of illumination modes revealed the presence of a "hidden circle" often referred to in relation to their construction. This paper will present in-depth analysis of how spectral imaging of the Portolans revealed similarities and differences, new hidden information and shed new light on construction and composition.

  17. Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

    Science.gov (United States)

    Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

    2015-09-01

    In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.

  18. Primary care practice organization influences colorectal cancer screening performance.

    Science.gov (United States)

    Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

    2007-06-01

    To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (pmanagement and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.

  19. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

    Directory of Open Access Journals (Sweden)

    Chang LF

    2007-06-01

    Full Text Available Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.Results: Findings from this chart review include: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative.Discussion: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

  20. Fractional smith chart theory

    KAUST Repository

    Shamim, Atif

    2011-03-01

    For the first time, a generalized Smith chart is introduced here to represent fractional order circuit elements. It is shown that the standard Smith chart is a special case of the generalized fractional order Smith chart. With illustrations drawn for both the conventional integer based lumped elements and the fractional elements, a graphical technique supported by the analytical method is presented to plot impedances on the fractional Smith chart. The concept is then applied towards impedance matching networks, where the fractional approach proves to be much more versatile and results in a single element matching network for a complex load as compared to the two elements in the conventional approach. © 2010 IEEE.

  1. Design and application of process control charting methodologies to gamma irradiation practices

    Science.gov (United States)

    Saylor, M. C.; Connaghan, J. P.; Yeadon, S. C.; Herring, C. M.; Jordan, T. M.

    2002-12-01

    The relationship between the contract irradiation facility and the customer has historically been based upon a "PASS/FAIL" approach with little or no quality metrics used to gage the control of the irradiation process. Application of process control charts, designed in coordination with mathematical simulation of routine radiation processing, can provide a basis for understanding irradiation events. By using tools that simulate the physical rules associated with the irradiation process, end-users can explore process-related boundaries and the effects of process changes. Consequently, the relationship between contractor and customer can evolve based on the derived knowledge. The resulting level of mutual understanding of the irradiation process and its resultant control benefits both the customer and contract operation, and provides necessary assurances to regulators. In this article we examine the complementary nature of theoretical (point kernel) and experimental (dosimetric) process evaluation, and the resulting by-product of improved understanding, communication and control generated through the implementation of effective process control charting strategies.

  2. MINIMIZING GLOVEBOX GLOVE BREACHES, PART IV: CONTROL CHARTS

    International Nuclear Information System (INIS)

    Cournoyer, Michael E.; Lee, Michelle B.; Schreiber, Stephen B.

    2007-01-01

    At the Los Alamos National Laboratory (LANL) Plutonium Facility, plutonium. isotopes and other actinides are handled in a glovebox environment. The spread of radiological contamination, and excursions of contaminants into the worker's breathing zone, are minimized and/or prevented through the use of glovebox technology. Evaluating the glovebox configuration, the glovebo gloves are the most vulnerable part of this engineering control. Recognizing this vulnerability, the Glovebox Glove Integrity Program (GGIP) was developed to minimize and/or prevent unplanned openings in the glovebox environment, i.e., glove failures and breaches. In addition, LANL implement the 'Lean Six Sigma (LSS)' program that incorporates the practices of Lean Manufacturing and Six Sigma technologies and tools to effectively improve administrative and engineering controls and work processes. One tool used in LSS is the use of control charts, which is an effective way to characterize data collected from unplanned openings in the glovebox environment. The benefit management receives from using this tool is two-fold. First, control charts signal the absence or presence of systematic variations that result in process instability, in relation to glovebox glove breaches and failures. Second, these graphical representations of process variation detennine whether an improved process is under control. Further, control charts are used to identify statistically significant variations (trends) that can be used in decision making to improve processes. This paper discusses performance indicators assessed by the use control charts, provides examples of control charts, and shows how managers use the results to make decisions. This effort contributes to LANL Continuous Improvement Program by improving the efficiency, cost effectiveness, and formality of glovebox operations.

  3. Comparison of accuracy of physical examination findings in initial progress notes between paper charts and a newly implemented electronic health record.

    Science.gov (United States)

    Yadav, Siddhartha; Kazanji, Noora; K C, Narayan; Paudel, Sudarshan; Falatko, John; Shoichet, Sandor; Maddens, Michael; Barnes, Michael A

    2017-01-01

    There have been several concerns about the quality of documentation in electronic health records (EHRs) when compared to paper charts. This study compares the accuracy of physical examination findings documentation between the two in initial progress notes. Initial progress notes from patients with 5 specific diagnoses with invariable physical findings admitted to Beaumont Hospital, Royal Oak, between August 2011 and July 2013 were randomly selected for this study. A total of 500 progress notes were retrospectively reviewed. The paper chart arm consisted of progress notes completed prior to the transition to an EHR on July 1, 2012. The remaining charts were placed in the EHR arm. The primary endpoints were accuracy, inaccuracy, and omission of information. Secondary endpoints were time of initiation of progress note, word count, number of systems documented, and accuracy based on level of training. The rate of inaccurate documentation was significantly higher in the EHRs compared to the paper charts (24.4% vs 4.4%). However, expected physical examination findings were more likely to be omitted in the paper notes compared to EHRs (41.2% vs 17.6%). Resident physicians had a smaller number of inaccuracies (5.3% vs 17.3%) and omissions (16.8% vs 33.9%) compared to attending physicians. During the initial phase of implementation of an EHR, inaccuracies were more common in progress notes in the EHR compared to the paper charts. Residents had a lower rate of inaccuracies and omissions compared to attending physicians. Further research is needed to identify training methods and incentives that can reduce inaccuracies in EHRs during initial implementation. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

    Science.gov (United States)

    John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

    2014-04-01

    Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

  5. Notre Dame Nuclear Database: A New Chart of Nuclides

    Science.gov (United States)

    Lee, Kevin; Khouw, Timothy; Fasano, Patrick; Mumpower, Matthew; Aprahamian, Ani

    2014-09-01

    Nuclear data is critical to research fields from medicine to astrophysics. We are creating a database, the Notre Dame Nuclear Database, which can store theoretical and experimental datasets. We place emphasis on storing metadata and user interaction with the database. Users are able to search in addition to the specific nuclear datum, the author(s), the facility where the measurements were made, the institution of the facility, and device or method/technique used. We also allow users to interact with the database by providing online search, an interactive nuclide chart, and a command line interface. The nuclide chart is a more descriptive version of the periodic table that can be used to visualize nuclear properties such as half-lives and mass. We achieve this by using D3 (Data Driven Documents), HTML, and CSS3 to plot the nuclides and color them accordingly. Search capabilities can be applied dynamically to the chart by using Python to communicate with MySQL, allowing for customization. Users can save the customized chart they create to any image format. These features provide a unique approach for researchers to interface with nuclear data. We report on the current progress of this project and will present a working demo that highlights each aspect of the aforementioned features. This is the first time that all available technologies are put to use to make nuclear data more accessible than ever before in a manner that is much easier and fully detailed. This is a first and we will make it available as open source ware.

  6. Using Poetic Documents: An Exploration of Poststructuralist Ideas and Poetic Practices in Narrative Therapy

    Science.gov (United States)

    Speedy, Jane

    2005-01-01

    This paper explores the use of poetic documents in narrative therapy practice. It considers the ways in which feminist and poststructuralist ideas inform these practices and speculates about the extent to which a "poetic-mindedness" might sustain the practice of double- (or multiple-) listening. The author illustrates these explorations…

  7. WWW chart of the nuclides

    International Nuclear Information System (INIS)

    Huang Xiaolong; Zhou Chunmei; Zhuang Youxiang; Zhao Zhixiang; Golashvili, T.V.; Chechev, V.P.

    2000-01-01

    WWW chart of the nuclides was established on the basis of the latest evaluations of nuclear structure and decay data. By viewing WWW chart of the nuclides, one can retrieve the fundamental data of nuclide such as atomic mass, abundance, spin and parity; the decay mode, branching ratio, half-life and Q-value of radioactive nuclide, energy and intensity of strong γ-ray, etc. The URL (Uniform Resource Locator) of WWW chart of the nuclides is: http://myhome.py.gd.cn/chart/index,asp

  8. MEASUREMENT ERROR EFFECT ON THE POWER OF CONTROL CHART FOR ZERO-TRUNCATED POISSON DISTRIBUTION

    Directory of Open Access Journals (Sweden)

    Ashit Chakraborty

    2013-09-01

    Full Text Available Measurement error is the difference between the true value and the measured value of a quantity that exists in practice and may considerably affect the performance of control charts in some cases. Measurement error variability has uncertainty which can be from several sources. In this paper, we have studied the effect of these sources of variability on the power characteristics of control chart and obtained the values of average run length (ARL for zero-truncated Poisson distribution (ZTPD. Expression of the power of control chart for variable sample size under standardized normal variate for ZTPD is also derived.

  9. Modified Exponential Weighted Moving Average (EWMA) Control Chart on Autocorrelation Data

    Science.gov (United States)

    Herdiani, Erna Tri; Fandrilla, Geysa; Sunusi, Nurtiti

    2018-03-01

    In general, observations of the statistical process control are assumed to be mutually independence. However, this assumption is often violated in practice. Consequently, statistical process controls were developed for interrelated processes, including Shewhart, Cumulative Sum (CUSUM), and exponentially weighted moving average (EWMA) control charts in the data that were autocorrelation. One researcher stated that this chart is not suitable if the same control limits are used in the case of independent variables. For this reason, it is necessary to apply the time series model in building the control chart. A classical control chart for independent variables is usually applied to residual processes. This procedure is permitted provided that residuals are independent. In 1978, Shewhart modification for the autoregressive process was introduced by using the distance between the sample mean and the target value compared to the standard deviation of the autocorrelation process. In this paper we will examine the mean of EWMA for autocorrelation process derived from Montgomery and Patel. Performance to be investigated was investigated by examining Average Run Length (ARL) based on the Markov Chain Method.

  10. Using patients' charts to assess medical trainees in the workplace: a systematic review.

    Science.gov (United States)

    Al-Wassia, Heidi; Al-Wassia, Rolina; Shihata, Shadi; Park, Yoon Soo; Tekian, Ara

    2015-04-01

    The objective of this review is to summarize and critically appraise existing evidence on the use of chart stimulated recall (CSR) and case-based discussion (CBD) as an assessment tool for medical trainees. Medline, Embase, CINAHL, PsycINFO, Educational Resources Information Centre (ERIC), Web of Science, and the Cochrane Central Register of Controlled Trials were searched for original articles on the use of CSR or CBD as an assessment method for trainees in all medical specialties. Four qualitative and three observational non-comparative studies were eligible for this review. The number of patient-chart encounters needed to achieve sufficient reliability varied across studies. None of the included studies evaluated the content validity of the tool. Both trainees and assessors expressed high level of satisfaction with the tool; however, inadequate training, different interpretation of the scoring scales and skills needed to give feedback were addressed as limitations for conducting the assessment. There is still no compelling evidence for the use of patient's chart to evaluate medical trainees in the workplace. A body of evidence that is valid, reliable, and documents the educational effect in support of the use of patients' charts to assess medical trainees is needed.

  11. Multivariate Statistical Process Control Charts: An Overview

    OpenAIRE

    Bersimis, Sotiris; Psarakis, Stelios; Panaretos, John

    2006-01-01

    In this paper we discuss the basic procedures for the implementation of multivariate statistical process control via control charting. Furthermore, we review multivariate extensions for all kinds of univariate control charts, such as multivariate Shewhart-type control charts, multivariate CUSUM control charts and multivariate EWMA control charts. In addition, we review unique procedures for the construction of multivariate control charts, based on multivariate statistical techniques such as p...

  12. Areva - 2011 Reference document; Areva - Document de reference 2011

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    After having indicated the person responsible of this document and the legal account auditors, and provided some financial information, this document gives an overview of the different risk factors existing in the company: law risks, industrial and environmental risks, operational risks, risks related to large projects, market and liquidity risks. Then, after having recalled the history and evolution of the company and the evolution of its investments over the last five years, it proposes an overview of Areva's activities on the markets of nuclear energy and renewable energies, of its clients and suppliers, of its strategy, of the activities of its different departments. Other information are provided: company's flow chart, estate properties (plants, equipment), an analysis of its financial situation, its research and development policy, the present context, profit previsions or estimations, management organization and operation

  13. The effects of EMR deployment on doctors' work practices: a qualitative study in the emergency department of a teaching hospital.

    Science.gov (United States)

    Park, Sun Young; Lee, So Young; Chen, Yunan

    2012-03-01

    The goal of this study was to examine the effects of medical notes (MD) in an electronic medical records (EMR) system on doctors' work practices at an Emergency Department (ED). We conducted a six-month qualitative study, including in situ field observations and semi-structured interviews, in an ED affiliated with a large teaching hospital during the time periods of before, after, and during the paper-to-electronic transition of the rollout of an EMR system. Data were analyzed using open coding method and various visual representations of workflow diagrams. The use of the EMR in the ED resulted in both direct and indirect effects on ED doctors' work practices. It directly influenced the ED doctors' documentation process: (i) increasing documentation time four to five fold, which in turn significantly increased the number of incomplete charts, (ii) obscuring the distinction between residents' charting inputs and those of attendings, shifting more documentation responsibilities to the residents, and (iii) leading to the use of paper notes as documentation aids to transfer information from the patient bedside to the charting room. EMR use also had indirect consequences: it increased the cognitive burden of doctors, since they had to remember multiple patients' data; it aggravated doctors' multi-tasking due to flexibility in the system use allowing more interruptions; and it caused ED doctors' work to become largely stationary in the charting room, which further contributed to reducing doctors' time with patients and their interaction with nurses. We suggest three guidelines for designing future EMR systems to be used in teaching hospitals. First, the design of documentation tools in EMR needs to take into account what we called "note-intensive tasks" to support the collaborative nature of medical work. Second, it should clearly define roles and responsibilities. Lastly, the system should provide a balance between flexibility and interruption to better manage the

  14. The Hill Chart Calculation for Pelton Runner Models using the HydroHillChart - Pelton Module Software

    Directory of Open Access Journals (Sweden)

    Adelina Bostan

    2015-07-01

    Full Text Available The Pelton turbines industrial design is based on the hill chart characteristics obtained by measuring the models. Primary data measurements used to obtain the hill chart can be processed graphically, by hand or by using graphic programs respectively CAD programs; the HydroHillChart - Pelton module software is a specialized tool in achieving the hill chart, using interpolation cubic spline functions. Thereby, based on measurements of several models of Pelton turbines, a computerized library, used to design industrial Pelton turbines can be created. The paper presents the universal characteristics calculated by using the HydroHillChart - Pelton module software for a series of Pelton runners.

  15. The use of quality control performance charts to analyze cesarean delivery rates nationally.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

  16. SMART AERONAUTICAL CHART MANAGEMENT SYSTEM DESIGN

    Directory of Open Access Journals (Sweden)

    M. E. Pakdil

    2015-10-01

    Full Text Available Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc. to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO’s Annex 4 and Annex 15, cartographic representation and page layout differs in each state’s publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  17. Invariant practical tasks for work with text documents at the secondary school

    Directory of Open Access Journals (Sweden)

    Л И Карташова

    2013-12-01

    Full Text Available In article examples of practical tasks on creation, editing and formatting of text documents focused on pupils of the secondary school are given. Tasks have invariant character and don't depend on concrete software.

  18. Statistical evaluation of the dose-distribution charts of the National Computerized Irradiation Planning Network

    International Nuclear Information System (INIS)

    Varjas, Geza; Jozsef, Gabor; Gyenes, Gyoergy; Petranyi, Julia; Bozoky, Laszlo; Pataki, Gezane

    1985-01-01

    The establishment of the National Computerized Irradiation Planning Network allowed to perform the statistical evaluation presented in this report. During the first 5 years 13389 dose-distribution charts were calculated for the treatment of 5320 patients, i.e. in average, 2,5 dose-distribution chart-variants per patient. This number practically did not change in the last 4 years. The irradiation plan of certain tumour localizations was performed on the basis of the calculation of, in average, 1.6-3.0 dose-distribution charts. Recently, radiation procedures assuring optimal dose-distribution, such as the use of moving fields, and two- or three-irradiation fields, are gaining grounds. (author)

  19. Documentation of pain care processes does not accurately reflect pain management delivered in primary care.

    Science.gov (United States)

    Krebs, Erin E; Bair, Matthew J; Carey, Timothy S; Weinberger, Morris

    2010-03-01

    Researchers and quality improvement advocates sometimes use review of chart-documented pain care processes to assess the quality of pain management. Studies have found that primary care providers frequently fail to document pain assessment and management. To assess documentation of pain care processes in an academic primary care clinic and evaluate the validity of this documentation as a measure of pain care delivered. Prospective observational study. 237 adult patients at a university-affiliated internal medicine clinic who reported any pain in the last week. Immediately after a visit, we asked patients to report the pain treatment they received. Patients completed the Brief Pain Inventory (BPI) to assess pain severity at baseline and 1 month later. We extracted documentation of pain care processes from the medical record and used kappa statistics to assess agreement between documentation and patient report of pain treatment. Using multivariable linear regression, we modeled whether documented or patient-reported pain care predicted change in pain at 1 month. Participants' mean age was 53.7 years, 66% were female, and 74% had chronic pain. Physicians documented pain assessment for 83% of visits. Patients reported receiving pain treatment more often (67%) than was documented by physicians (54%). Agreement between documentation and patient report was moderate for receiving a new pain medication (k = 0.50) and slight for receiving pain management advice (k = 0.13). In multivariable models, documentation of new pain treatment was not associated with change in pain (p = 0.134). In contrast, patient-reported receipt of new pain treatment predicted pain improvement (p = 0.005). Chart documentation underestimated pain care delivered, compared with patient report. Documented pain care processes had no relationship with pain outcomes at 1 month, but patient report of receiving care predicted clinically significant improvement. Chart review measures may not accurately

  20. International chart of the nuclides. 2001

    International Nuclear Information System (INIS)

    Golashvili, T.V.; Kupriyanov, V.M.; Lbov, A.A.

    2002-01-01

    The International Chart of Nuclides - 2001 has been developed taking into account the data obtained in 1998-2001. Unlike widespread nuclide charts the present Chart of Nuclides contains EVALUATED values of the main characteristics. These values are supplied with the standard deviations. (author)

  1. Shewhart control charts in new perspective

    NARCIS (Netherlands)

    Albers, Willem/Wim; Kallenberg, W.C.M.

    2007-01-01

    The effects of estimating parameters and the violation of the assumption of normality when dealing with control charts are discussed. Corrections for estimating errors and extensions of the normal control chart to parametric and nonparametric charts are investigated. The underlying theory is

  2. NNDC Chart of Nuclides

    International Nuclear Information System (INIS)

    Sonzogni, A.

    2008-01-01

    The National Nuclear Data Center has recently developed an interactive chart of nuclides, http://www.nndc.bnl.gov/chart/, that provides nuclear structure and decay data. Since its implementation, it has proven to be one of the most popular web products. The information presented is derived from the ENSDF and Nuclear Wallet Card databases. Experimentally known nuclides are represented by a cell in chart with the number of neutrons on the horizontal axis and the number of protons on the vertical axis. The color of the cell is used to indicate the ground state half-life or the ground state predominant decay mode. (author)

  3. An ex ante control chart for project monitoring using earned duration management observations

    Science.gov (United States)

    Mortaji, Seyed Taha Hossein; Noori, Siamak; Noorossana, Rassoul; Bagherpour, Morteza

    2017-12-01

    In the past few years, there has been an increasing interest in developing project control systems. The primary purpose of such systems is to indicate whether the actual performance is consistent with the baseline and to produce a signal in the case of non-compliance. Recently, researchers have shown an increased interest in monitoring project's performance indicators, by plotting them on the Shewhart-type control charts over time. However, these control charts are fundamentally designed for processes and ignore project-specific dynamics, which can lead to weak results and misleading interpretations. By paying close attention to the project baseline schedule and using statistical foundations, this paper proposes a new ex ante control chart which discriminates between acceptable (as-planned) and non-acceptable (not-as-planned) variations of the project's schedule performance. Such control chart enables project managers to set more realistic thresholds leading to a better decision making for taking corrective and/or preventive actions. For the sake of clarity, an illustrative example has been presented to show how the ex ante control chart is constructed in practice. Furthermore, an experimental investigation has been set up to analyze the performance of the proposed control chart. As expected, the results confirm that, when a project starts to deflect significantly from the project's baseline schedule, the ex ante control chart shows a respectable ability to detect and report right signals while avoiding false alarms.

  4. Documenting Sociolinguistic Variation in Lesser-Studied Indigenous Communities: Challenges and Practical Solutions

    Science.gov (United States)

    Mansfield, John; Stanford, James

    2017-01-01

    Documenting sociolinguistic variation in lesser-studied languages presents methodological challenges, but also offers important research opportunities. In this paper we examine three key methodological challenges commonly faced by researchers who are outsiders to the community. We then present practical solutions for successful variationist…

  5. 2008 HIMSS Survey results: best practices in implementing nursing/interdisciplinary documentation systems.

    Science.gov (United States)

    Newbold, Susan K; Kimmel, Kathleen C; O'Steen, Randy; Morgan, Gina Sauls

    2008-11-06

    Health care organizations are increasingly using computer systems to support nursing care documentation; however, processes used to deploy such systems are widely varied. The purpose of this survey was to understand current practices related to implementation of computerized nursing and interdisciplinary documentation systems with the goal to establish best practice guidelines. In Spring 2007, members from the Healthcare Information Management and Systems Society Nursing Informatics Working Group interviewed a sample of 15 hospitals to solicit information regarding the following processes: leadership activities, clinical transformation processes, project management activities, implementation processes, evaluation metrics, terminology and other standards used, and methods used to facilitate end-user adoption. This poster will report the results of this survey. Implications for Nurses will be discussed. The results are valuable to nursing informatics professionals who plan to implement systems and to their nursing executives responsible for the systems that are implemented.

  6. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    Science.gov (United States)

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

  7. de Sitter relativity in static charts

    Energy Technology Data Exchange (ETDEWEB)

    Cotaescu, Ion I. [West University of Timisoara, Timisoara (Romania)

    2018-02-15

    The relative geodesic motion in static (and spherically symmetric) local charts on the (1 + 3)-dimensional de Sitter spacetimes is studied in terms of conserved quantities. The Lorentzian isometries are derived, relating the coordinates of the local chart of a fixed observer with the coordinates of a mobile chart considered as the rest frame of a massive particle freely moving on a timelike geodesic. The time dilation and Lorentz contraction are discussed pointing out some notable features of the de Sitter relativity in static charts. (orig.)

  8. A new focalize of quality auditorship for documentation control. A practical case

    International Nuclear Information System (INIS)

    Young, R.B.; Malanij, D.

    1994-01-01

    Available as short communication only. A practical case of auditorship for Documentation Control System is described, showing the increase of efficiency when operated in the concept of Business Process Improvement, and this focalize is compatible with the nuclear area requirements. (C.G.C.). 2 refs

  9. Weighing Rain Gauge Recording Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Weighing rain gauge charts record the amount of precipitation that falls at a given location. The vast majority of the Weighing Rain Gauge Recording Charts...

  10. NOAA Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey, Marine Chart Division is responsible to build and maintain a suite of more than 1000 nautical charts that are...

  11. Construction and validation of a Tamil logMAR chart.

    Science.gov (United States)

    Varadharajan, Srinivasa; Srinivasan, Krithica; Kumaresan, Brindha

    2009-09-01

    To design, construct and validate a new Tamil logMAR visual acuity chart based on current recommendations. Ten Tamil letters of equal legibility were identified experimentally and were used in the chart. Two charts, one internally illuminated and one externally illuminated, were constructed for testing at 4 m distance. The repeatability of the two charts was tested. For validation, the two charts were compared with a standard English logMAR chart (ETDRS). When compared to the ETDRS chart, a difference of 0.06 +/- 0.07 and 0.07 +/- 0.07 logMAR was found for the internally and externally illuminated charts respectively. Limits of agreement between the internally illuminated Tamil logMAR chart and ETDRS chart were found to be (-0.08, 0.19), and (-0.07, 0.20) for the externally illuminated chart. The test - retest results showed a difference of 0.02 +/- 0.04 and 0.02 +/- 0.06 logMAR for the internally and externally illuminated charts respectively. Limits of agreement for repeated measurements for the internally illuminated Tamil logMAR chart were found to be (-0.06, 0.10), and (-0.10, 0.14) for the externally illuminated chart. The newly constructed Tamil logMAR charts have good repeatability. The difference in visual acuity scores between the newly constructed Tamil logMAR chart and the standard English logMAR chart was within acceptable limits. This new chart can be used for measuring visual acuity in the literate Tamil population.

  12. Chart Series

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality...

  13. Total output operation chart optimization of cascade reservoirs and its application

    International Nuclear Information System (INIS)

    Jiang, Zhiqiang; Ji, Changming; Sun, Ping; Wang, Liping; Zhang, Yanke

    2014-01-01

    Highlights: • We propose a new double nested model for cascade reservoirs operation optimization. • We use two methods to extract the output distribution ratio. • The adopted two methods perform better than the widely used methods at present. • Stepwise regression method performs better than mean value method on the whole. - Abstract: With the rapid development of cascade hydropower stations in recent decades, the cascade system composed of multiple reservoirs needs unified operation and management. However, the output distribution problem has not yet been solved reasonably when the total output of cascade system obtained, which makes the full utilization of hydropower resources in cascade reservoirs very difficult. Discriminant criterion method is a traditional and common method to solve the output distribution problem at present, but some shortcomings cannot be ignored in the practical application. In response to the above concern, this paper proposes a new total output operation chart optimization model and a new optimal output distribution model, the two models constitute to a double nested model with the goal of maximizing power generation. This paper takes the cascade reservoirs of Li Xianjiang River in China as an instance to obtain the optimal total output operation chart by the proposed double nested model and the 43 years historical runoff data, progressive searching method and progressive optimality algorithm are used in solving the model. In order to take the obtained total output operation chart into practical operation, mean value method and stepwise regression method are adopted to extract the output distribution ratios on the basis of the optimal simulation intermediate data. By comparing with discriminant criterion method and conventional method, the combined utilization of total output operation chart and output distribution ratios presents better performance in terms of power generation and assurance rate, which proves it is an effective

  14. New birthweight charts according to parity and type of delivery for the Spanish population.

    Science.gov (United States)

    Terán, José Manuel; Varea, Carlos; Bernis, Cristina; Bogin, Barry; González-González, Antonio

    Birthweight by gestational age charts enable fetal growth to be evaluated in a specific population. Given that maternal profile and obstetric practice have undergone a remarkable change over the past few decades in Spain, this paper presents new Spanish reference percentile charts stratified by gender, parity and type of delivery. They have been prepared with data from the 2010-2014 period of the Spanish Birth Statistics Bulletin. Reference charts have been prepared using the LMS method, corresponding to 1,428,769 single, live births born to Spanish mothers. Percentile values and mean birth weight are compared among newborns according to gender, parity and type of delivery. Newborns to primiparous mothers show significantly lower birthweight than those born to multiparous mothers (pparity and type of delivery-specific birthweight references. These new charts enable a better evaluation of the impact of the demographic, reproductive and obstetric trends currently in Spain on fetal growth. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. How education changes clinical documentation in early pregnancy.

    Science.gov (United States)

    Ali, Fida; Higgins, Mary F

    2016-05-01

    The aim of this audit was to record medical history taking in the records of women attending with early pregnancy issues in order to assess the effect of training in this area. The medical education intervention comprised of a 30-min interactive tutorial. Retrospective chart review at three time points: pre education (July 2013, n = 45), immediately post-education (August 2013, n = 45) and longer term post-intervention (October 2013, n = 20). Pre-education, medical history was missing in 77.8% of charts compared to 13.4% immediately post-intervention and 10% long-term post-intervention (p Education in requirements for medical history taking can improve documentation.

  16. Depreciation Accounting in the Uniform Chart of Accounts.

    Science.gov (United States)

    1982-12-01

    footage of building occupied. Reason( s ) for Compute full cost of Rate setting, cash accounting for patient care flow generation and fund- depreciation ing... Horngren , Charles T., Cost Accounting ; A Managerial Emphasis, Prentice-Hall Inc., 1972. 32. Sawyer, Lawrence B., The Practice of Modern Internal Auditing...Awd ubtlft) S . TYPE or RE PORT a PE*IoO CovIERWO Master’s Thesis; Depreciation Accounting in the Uniform Dembr18 Chart of Accounts .PSOiwON.EORlumm

  17. Documentation: Records and Reports.

    Science.gov (United States)

    Akers, Michael J

    2017-01-01

    This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  18. Charter of good practices in industrial radiography; Charte de bonnes pratiques en radiographie industrielle

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    This document describes good practices in the field of industrial radiography. After having presented the main prevention and radiation protection principles, the actors inside and outside of the company, and actors intervening during an operation subcontracting in industrial radiography, this report analyzes the activity: prerequisites for work preparation, prevention coordination, work preparation, transportation, work achievement, return on experience. It addresses personnel training and information, and the dosimetric and medical monitoring of technicians in industrial radiography. Some aspects are addressed in appendix: principles (justification, optimization, and limitation), regulations, intervention form, exposure form, and so on

  19. Immunization Documentation Practices and Vaccine-Preventable Disease Surveillance Capacity among Institutions of Higher Education in Indiana

    Science.gov (United States)

    Stevens, Taryn; Golwalkar, Mugdha

    2018-01-01

    ABSTRACTObjective: Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among…

  20. Implementation of a consent for chart review and contact and its impact in one clinical centre.

    Science.gov (United States)

    Druce, Irena; Ooi, T C; McGuire, Debbie; Sorisky, Alexander; Malcolm, Janine

    2015-05-01

    Informed consent and protection of patient confidentiality are central to the conduction of clinical research. Consent for chart review and contact (CCRC) allows a patient chart to be screened for research by persons outside the direct circle-of-care and for the patient to be contacted regarding potential studies. This study describes the process of implementation and benefits of such a consent. We present a descriptive report of a CCRC document that was created and presented to patients over a 3.5-year period at a tertiary care Endocrinology and Metabolism centre. To assess the potential impact of such a document on patient recruitment, the basic demographics of patients who did and did not consent were compared. In addition, we compared the recruitment rate at our centre, using our novel approach, with that at other centres for an ongoing study of patients with type 1 diabetes. A large proportion (6501/8025, or 81%) of patients gave their consent for chart review. Patients who denied consent were more likely to be women and older. Compared with other centres, our centre recruited at the highest rate for a known study of patients with type 1 diabetes. The majority (46/60, or 76.7%) of patients were recruited via the novel approach. Consent for chart review and contact addresses several important ethical issues regarding the use of patient clinical information for research purposes. Our study demonstrated how such a process can be implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Radar Chart

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Radar Chart collection is an archived product of summarized radar data. The geographic coverage is the 48 contiguous states of the United States. These hourly...

  2. [German translation of Suicidal Patient Observation Chart (SPOC) - an instrument for practice].

    Science.gov (United States)

    Löhr, Michael; Schulz, Michael; Hemkendreis, Bruno; Björkdahl, Anna; Nienaber, André

    2013-12-01

    Nursing of suicidal in-patients is a complex and responsible task. A direct and immediate intensive caring and therapeutic supervision, also known as special observation is still recommended in guidelines (DGPPN, 2012) and maybe one of the most used interventions in the caring of suicidal patients in inpatient settings. It involves many kinds to develop the relationship between the observer and the patient. The original SPOC was developed in Sweden with the aim to increase the quality of a systematically documentation during the supervision of suicidal patients. It is an instrument to ensure systematic documentation of observational behavior or noticeable mood during acute suicidal crisis, for example feelings like "worried, anxious" or other possible influencing factors like "sudden mood variation". By this means the SPOC can ensure the process of systematic documentation of special observation and increase its quality, i. e. who documented what at what time. Furthermore SPOC can facilitate a better communication of the observation process to the multidisciplinary team and to the patient as well. The SPOC includes the 28 items and covers 24 separate observation periods. The aim of this paper is to constitute the translation process from the English to the German SPOC version. The translation process followed a five step model. In the first step the English version was translated from two German native speakers. In the second step, the first two translation results where discussed by the Expert group (authors) and a new version was developed. In the third step the first german version was translated back (two English native Speakers) into English. The fourth step was taken, to review the results by the expert groups (authors) and set up the so called "pre version". The last step includes the proof of content validity by 52 nurses. The proof was able to identify a few misunderstandings and helped to enhance the tool in its final version. With the translation, the

  3. Motivating the Documentation of the Verbal Arts: Arguments from Theory and Practice

    Science.gov (United States)

    Fitzgerald, Colleen M.

    2017-01-01

    For language documentation to be sufficiently extensive to cover a given community's language practices (cf. Himmelmann 1998), then including verbal arts is essential to ensure the richness of that comprehensive record. The verbal arts span the creative and artistic uses of a given language by speakers, such as storytelling, songs, puns and…

  4. Medication communication through documentation in medical wards: knowledge and power relations.

    Science.gov (United States)

    Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

    2014-09-01

    Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.

  5. Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

    LENUS (Irish Health Repository)

    Donfrancesco, Chiara

    2010-08-01

    The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

  6. Growth charts of human development

    NARCIS (Netherlands)

    Van Buuren, Stef

    2014-01-01

    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate

  7. The Conjugate Acid-Base Chart.

    Science.gov (United States)

    Treptow, Richard S.

    1986-01-01

    Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)

  8. Guideline implementation in clinical practice: use of statistical process control charts as visual feedback devices.

    Science.gov (United States)

    Al-Hussein, Fahad A

    2009-01-01

    To use statistical control charts in a series of audits to improve the acceptance and consistant use of guidelines, and reduce the variations in prescription processing in primary health care. A series of audits were done at the main satellite of King Saud Housing Family and Community Medicine Center, National Guard Health Affairs, Riyadh, where three general practitioners and six pharmacists provide outpatient care to about 3000 residents. Audits were carried out every fortnight to calculate the proportion of prescriptions that did not conform to the given guidelines of prescribing and dispensing. Simple random samples of thirty were chosen from a sampling frame of all prescriptions given in the two previous weeks. Thirty six audits were carried out from September 2004 to February 2006. P-charts were constructed around a parametric specification of non-conformities not exceeding 25%. Of the 1081 prescriptions, the most frequent non-conformity was failure to write generic names (35.5%), followed by the failure to record patient's weight (16.4%), pharmacist's name (14.3%), duration of therapy (9.1%), and the use of inappropriate abbreviations (6.0%). Initially, 100% of prescriptions did not conform to the guidelines, but within a period of three months, this came down to 40%. A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

  9. Air Emissions Sources, Charts and Maps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Air Emissions provides (1) interactive charts supporting national, state, or county charts, (2) county maps of criteria air pollutant emissions for a state, and (3)...

  10. Making SPC easier with zone control charts

    International Nuclear Information System (INIS)

    Lanning, B.

    1995-01-01

    The zone control chart is a simple, easy to learn statistical process control (SPC) tool that can be applied to any process where the data are normally distributed. Several Shewhart runs rules are incorporated into a simple scoring system, with a single rule to determine when a process is out of control. Zone charts have average run lengths (ARLs) for detecting shifts in the process mean which, for most cases, are uniformly better than the standard control charts. This paper presents the simplified methodology behind the zone control chart

  11. Areva - 2011 Reference document

    International Nuclear Information System (INIS)

    2011-01-01

    After having indicated the person responsible of this document and the legal account auditors, and provided some financial information, this document gives an overview of the different risk factors existing in the company: law risks, industrial and environmental risks, operational risks, risks related to large projects, market and liquidity risks. Then, after having recalled the history and evolution of the company and the evolution of its investments over the last five years, it proposes an overview of Areva's activities on the markets of nuclear energy and renewable energies, of its clients and suppliers, of its strategy, of the activities of its different departments. Other information are provided: company's flow chart, estate properties (plants, equipment), an analysis of its financial situation, its research and development policy, the present context, profit previsions or estimations, management organization and operation

  12. Guideline implementation in clinical practice: Use of statistical process control charts as visual feedback devices

    Directory of Open Access Journals (Sweden)

    Fahad A Al-Hussein

    2009-01-01

    Conclusions: A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

  13. Google Charts Testing | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Google Charts Testing. The following item is a demo of Google GeoChart. Please note that geo chart can only recognize country name or city name rather than location or address (that is google my map's expertise). Additionally, Geo chart does support title and legend. To render geo chart properly, please get a ...

  14. NOAA Seamless Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Seamless Raster Chart Server provides a seamless collarless mosaic of the NOAA Raster Navigational Charts (RNC). The RNC are a collection of approximately...

  15. Newly diagnosed exudative age-related macular degeneration treated with pegaptanib sodium monotherapy in US community-based practices: medical chart review study

    Directory of Open Access Journals (Sweden)

    Xu Xiao

    2010-02-01

    Full Text Available Abstract Background Studies have shown that early detection and treatment of neovascular age-related macular degeneration (NV-AMD can delay vision loss and blindness. The objective of this study was to evaluate the efficacy/safety of intravitreal pegaptanib sodium monotherapy in treatment-naïve subjects with newly diagnosed NV-AMD and to gain insight into characteristics of lesions treated in community-based practices. Methods From seven private US practices, charts were retrospectively reviewed on 73 subjects with previously untreated subfoveal choroidal NV-AMD treated with their first dose of pegaptanib monotherapy on/after 4/1/2005 through 6/5/2006, receiving ≥4 treatments at 6-week intervals over 21 weeks. Primary endpoint: mean visual acuity (VA change from baseline to month 6. Results 75% of lesions were occult, and 82% were subfoveal. From baseline to month 6, mean VA change was -0.68 lines; 58% and 16% gained ≥0 and ≥3 lines of VA, and 70% were responders ( Conclusion Pegaptanib is effective in real-world patients with treatment-naïve NV-AMD in uncontrolled community-based retina practices.

  16. 16 CFR 1025.33 - Production of documents and things.

    Science.gov (United States)

    2010-01-01

    ... Section 1025.33 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL RULES OF PRACTICE FOR... (including writings, drawings, graphs, charts, photographs, phono-records, and any other data compilation..., custody, or control of the party upon whom the request is served, or (2) To permit entry upon designated...

  17. prepare_taxa_charts.py: A Python program to automate generation of publication ready taxonomic pie chart images from QIIME.

    Science.gov (United States)

    Lakhujani, Vijay; Badapanda, Chandan

    2017-06-01

    QIIME (Quantitative Insights Into Microbial Ecology) is one of the most popular open-source bioinformatics suite for performing metagenome, 16S rRNA amplicon and Internal Transcribed Spacer (ITS) data analysis. Although, it is very comprehensive and powerful tool, it lacks a method to provide publication ready taxonomic pie charts. The script plot_taxa_summary . py bundled with QIIME generate a html file and a folder containing taxonomic pie chart and legend as separate images. The images have randomly generated alphanumeric names. Therefore, it is difficult to associate the pie chart with the legend and the corresponding sample identifier. Even if the option to have the legend within the html file is selected while executing plot_taxa_summary . py , it is very tedious to crop a complete image (having both the pie chart and the legend) due to unequal image sizes. It requires a lot of time to manually prepare the pie charts for multiple samples for publication purpose. Moreover, there are chances of error while identifying the pie chart and legend pair due to random alphanumeric names of the images. To bypass all these bottlenecks and make this process efficient, we have developed a python based program, prepare_taxa_charts . py , to automate the renaming, cropping and merging of taxonomic pie chart and corresponding legend image into a single, good quality publication ready image. This program not only augments the functionality of plot_taxa_summary . py but is also very fast in terms of CPU time and user friendly.

  18. Chart Audit and Chart Stimulated Recall as Methods of Needs Assessment in Continuing Professional Health Education.

    Science.gov (United States)

    Affleck, Louise; Jennett, Penny

    1998-01-01

    Chart audit (assessment of patient medical records) is a cost-effective continuing-education needs-assessment method. Chart stimulated recall, in which physicians' memory of particular cases is stimulated by records, potentially increases content validity and exploration of clinical reasoning as well as the context of clinical decisions. (SK)

  19. Qualities of dental chart recording and coding.

    Science.gov (United States)

    Chantravekin, Yosananda; Tasananutree, Munchulika; Santaphongse, Supitcha; Aittiwarapoj, Anchisa

    2013-01-01

    Chart recording and coding are the important processes in the healthcare informatics system, but there were only a few reports in the dentistry field. The objectives of this study are to study the qualities of dental chart recording and coding, as well as the achievement of lecture/workshop on this topic. The study was performed by auditing the patient's charts at the TU Dental Student Clinic from July 2011-August 2012. The chart recording mean scores ranged from 51.0-55.7%, whereas the errors in the coding process were presented in the coder part more than the doctor part. The lecture/workshop could improve the scores only in some topics.

  20. Inclusion of extremes of prematurity in ventricular index centile charts.

    Science.gov (United States)

    Boyle, M; Shim, R; Gnanasekaran, R; Tarrant, A; Ryan, S; Foran, A; McCallion, N

    2015-06-01

    To assess the relationship between ventricular index (VI) measurements and postmenstrual age in preterm infants and to generate centile charts and normal ranges for frontal horn ratio (FHR) for a large contemporary cohort of preterm infants. A retrospective cohort study of 253 infants with birth gestation less than 32 weeks admitted between January 2009 and December 2011 to a tertiary NICU in Ireland. A total of 816 cranial ultrasounds were reviewed. Data collected were grouped according to postmenstrual age at the time of scan from 23 weeks to 45 weeks. Median values for VI show a general trend to increase with gestation. FHR did not significantly change with postmenstrual age at scan with a median value of 0.31. There is a slight increase in VI as gestation at the time of scans increases. These results provide the basis for updated centile charts which we propose for current practice.

  1. The making of Andersen’s liquefaction chart

    OpenAIRE

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    2017-01-01

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response.The process of obtaining the original chart has been improved. Algorithm based approximation is introduced. Pore pressure dependent ultimate bearing capacity normalization factor is introduced to normalize the chart.

  2. Comparison of reading speed with 3 different log-scaled reading charts.

    Science.gov (United States)

    Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini

    2014-01-01

    A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age=22.98±1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200±30wpm, 196±28wpm and 194±31wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t=-0.73, p=0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t=-0.97, p=0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  3. Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review.

    Science.gov (United States)

    Marincic, Patricia Z; Hardin, Amie; Salazar, Maria V; Scott, Susan; Fan, Shirley X; Gaillard, Philippe R

    2017-08-01

    Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT. Retrospective chart review. A random sample of 100 charts was chosen from the electronic medical records of patients with type 2 diabetes completing DSME and individualized MNT, June 2013 to 2014. Data were extracted on body mass index (calculated as kg/m 2 ), weight, hemoglobin A1c, blood glucose, and lipids. Mixed-model analysis of variance was used to determine differences between means for continuous variables; McNemar's tests and γ-statistic trend analysis were used to assess frequency of patients reaching glycemic targets. Significant weight loss was observed from baseline (94.3±21.1 kg) to end of program (91.7±21.2 kg [-1.6±3.9 kg]; P0.05). Significant hemoglobin A1c reduction was observed from baseline (8.74%±2.30%) to end of program (6.82%±1.37% [-1.92%±2.25%]; Phemoglobin A1c targets (≤7.0%) vs 27% at baseline (P=0.008). When stratified by diet alone and diet plus drug therapy, patients exhibited a 1.08%±1.20% (Phemoglobin A1c, respectively. Triglycerides decreased from baseline 181.6±75.5 mg/dL (2.0±0.9 mmol/L) to 115.8±48.1 mg/dL (1.3±0.5mmol/L) (P=0.023). High-density lipoprotein increased from 41.4±12.4 mg/dL (1.1±0.3 mmol/L) to 47.3±12.4 mg/dL (1.2±0.3 mmol/L) (P=0.007). Retrospective chart review provides an operational model for abstracting existing patient outcome data subsequent to registered dietitian nutritionist interventions. In support of universal reimbursement and patient access to DSME with supplemental individualized

  4. HydroHillChart – Francis module. Software used to Calculate the Hill Chart of the Francis Hydraulic Turbines

    Directory of Open Access Journals (Sweden)

    Dorian Nedelcu

    2015-07-01

    Full Text Available The paper presents the Hydro Hill Chart - Francis module application, used to calculate the hill chart of the Pelton, Francis and Kaplan hydraulic turbine models, by processing the data measured on the stand. After describing the interface and menu, the input data is graphically presented and the universal characteristic for measuring scenarios ao=const. and n11=const is calculated. Finally, the two calculated hill charts are compared through a graphical superimposition of the isolines.

  5. CBMA [Chartae Burgundiae Medii Aevi] – VI. Les chartes bourguignonnes sous Philologic

    OpenAIRE

    Eliana Magnani et Marie-José Gasse-Grandjean

    2011-01-01

    Depuis l’été 2010, les chartes bourguignonnes réunies dans la base des CBMA peuvent être interrogées librement sur internet avec le logiciel Philologic [http://www.artehis-cbma.eu/]. Il s’agit, actuellement, du seul corpus diplomatique étendu permettant, entre autres, la recherche de cooccurrences, un affichage par mot-clé, par distribution chronologique et par fréquence, qui incitent aux nouvelles lectures des documents, à la comparaison des pratiques scripturaires et de leur diffusion ou à ...

  6. Seasonal ARMA-based SPC charts for anomaly detection: Application to emergency department systems

    KAUST Repository

    Kadri, Farid; Harrou, Fouzi; Chaabane, Sondè s; Sun, Ying; Tahon, Christian

    2015-01-01

    Monitoring complex production systems is primordial to ensure management, reliability and safety as well as maintaining the desired product quality. Early detection of emergent abnormal behaviour in monitored systems allows pre-emptive action to prevent more serious consequences, to improve system operations and to reduce manufacturing and/or service costs. This study reports the design of a new methodology for the detection of abnormal situations based on the integration of time-series analysis models and statistical process control (SPC) tools for the joint development of a monitoring system to help supervising of the behaviour of emergency department services (EDs). The monitoring system developed is able to provide early alerts in the event of abnormal situations. The seasonal autoregressive moving average (SARMA)-based exponentially weighted moving average (EWMA) anomaly detection scheme proposed was successfully applied to the practical data collected from the database of the paediatric emergency department (PED) at Lille regional hospital centre, France. The method developed utilizes SARMA as a modelling framework and EWMA for anomaly detection. The EWMA control chart is applied to the uncorrelated residuals obtained from the SARMA model. The detection results of the EWMA chart are compared with two other commonly applied residual-based tests: a Shewhart individuals chart and a Cumulative Sum (CUSUM) control chart.

  7. Seasonal ARMA-based SPC charts for anomaly detection: Application to emergency department systems

    KAUST Repository

    Kadri, Farid

    2015-10-22

    Monitoring complex production systems is primordial to ensure management, reliability and safety as well as maintaining the desired product quality. Early detection of emergent abnormal behaviour in monitored systems allows pre-emptive action to prevent more serious consequences, to improve system operations and to reduce manufacturing and/or service costs. This study reports the design of a new methodology for the detection of abnormal situations based on the integration of time-series analysis models and statistical process control (SPC) tools for the joint development of a monitoring system to help supervising of the behaviour of emergency department services (EDs). The monitoring system developed is able to provide early alerts in the event of abnormal situations. The seasonal autoregressive moving average (SARMA)-based exponentially weighted moving average (EWMA) anomaly detection scheme proposed was successfully applied to the practical data collected from the database of the paediatric emergency department (PED) at Lille regional hospital centre, France. The method developed utilizes SARMA as a modelling framework and EWMA for anomaly detection. The EWMA control chart is applied to the uncorrelated residuals obtained from the SARMA model. The detection results of the EWMA chart are compared with two other commonly applied residual-based tests: a Shewhart individuals chart and a Cumulative Sum (CUSUM) control chart.

  8. Transmission Line Adapted Analytical Power Charts Solution

    Science.gov (United States)

    Sakala, Japhet D.; Daka, James S. J.; Setlhaolo, Ditiro; Malichi, Alec Pulu

    2017-08-01

    The performance of a transmission line has been assessed over the years using power charts. These are graphical representations, drawn to scale, of the equations that describe the performance of transmission lines. Various quantities that describe the performance, such as sending end voltage, sending end power and compensation to give zero voltage regulation, may be deduced from the power charts. Usually required values are read off and then converted using the appropriate scales and known relationships. In this paper, the authors revisit this area of circle diagrams for transmission line performance. The work presented here formulates the mathematical model that analyses the transmission line performance from the power charts relationships and then uses them to calculate the transmission line performance. In this proposed approach, it is not necessary to draw the power charts for the solution. However the power charts may be drawn for the visual presentation. The method is based on applying derived equations and is simple to use since it does not require rigorous derivations.

  9. Chart of the nuclides - Strasbourg 1990

    International Nuclear Information System (INIS)

    Antony, M.S.

    1991-01-01

    Data were compiled for a nuclide chart over the last two years. The compilation is complete to the end of September 1990. The chart includes about 30000 data. Decay modes are represented by colours. Announcement capabilities and prices are given. (G.P.) 3 refs

  10. Obtaining the Andersen's chart, triangulation algorithm

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation or stabilizing soil response. The process of obtaining the original chart has...

  11. 49 CFR 236.718 - Chart, dog.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  12. An observational study of the accuracy and completeness of an anesthesia information management system: recommendations for documentation system changes.

    Science.gov (United States)

    Wilbanks, Bryan A; Moss, Jacqueline A; Berner, Eta S

    2013-08-01

    Anesthesia information management systems must often be tailored to fit the environment in which they are implemented. Extensive customization necessitates that systems be analyzed for both accuracy and completeness of documentation design to ensure that the final record is a true representation of practice. The purpose of this study was to determine the accuracy of a recently installed system in the capture of key perianesthesia data. This study used an observational design and was conducted using a convenience sample of nurse anesthetists. Observational data of the nurse anesthetists'delivery of anesthesia care were collected using a touch-screen tablet computer utilizing an Access database customized observational data collection tool. A questionnaire was also administered to these nurse anesthetists to assess perceived accuracy, completeness, and satisfaction with the electronic documentation system. The major sources of data not documented in the system were anesthesiologist presence (20%) and placement of intravenous lines (20%). The major sources of inaccuracies in documentation were gas flow rates (45%), medication administration times (30%), and documentation of neuromuscular function testing (20%)-all of the sources of inaccuracies were related to the use of charting templates that were not altered to reflect the actual interventions performed.

  13. PSA applications. Good practices and documentation

    International Nuclear Information System (INIS)

    Dewailly, J.; Magne, L.

    1997-10-01

    In this paper, it is shown what the condensed documentation of the main strategic choices and technical assumptions related to a PSA could contain: how to select the internal and external initiating events, how the detail the plant configuration and the general organization of the plant and operating staff, how to highlight the assumptions related to physical models, etc. The proposals in this documentation are based on the R and D D's experience with PSA (construction of PSA models, use of PSA models for operation or maintenance, PSA tools). This document also presents different types of rules or recommendations related to PSA modelling for various applications involved in nuclear power plant operating. Finally, the paper stresses the main difficulties encountered (appropriate use of uncertainties, communication of PSA results to non-specialist users) and it also outlines some prospects for the future. (author)

  14. U.S. Pacific Command > Organization > Organization Chart

    Science.gov (United States)

    Responsibility USPACOM Previous Commanders Organization Organization Chart Media News Flickr Photos Video Directory Media Inquiries Home : Organization : Organization Chart About DoD DoD Careers Join the Military

  15. Smart Book Charts

    Science.gov (United States)

    Chinnapongse, Ronald L.

    2015-01-01

    Smart book charts for TPSM: Heatshield for Extreme Entry Environment Technology (HEEET), Conformal Ablative TPS (CA-TPS), 3D Woven Multifunctional Ablative TPS (3D MAT), and Adaptable, Deployable, Entry and Placement Technology (ADEPT).

  16. Chart of the nuclides

    International Nuclear Information System (INIS)

    Yoshizawa, Y.; Horiguchi, T.; Yamada, M.

    1980-01-01

    In this chart, four colors are use to classify nuclides according to their half-lives. The different symbols are also to show the decay modes and their percentage in each nuclide. Four tables are provided on the back of the chart. Table 1 is the ordinary periodic Table. Table 2 provides fundamental constants used for nuclear physics. Tables 3 lists the physical constants (mean density, ionization potential, melting point, and boiling point) of all elements. Table 4 provides the gamma-ray intensity standards. Half-lives, energy, relative intensity, and intensity per decay are list for 33 nuclides. (J.P.N.)

  17. 47 CFR 73.333 - Engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Engineering charts. 73.333 Section 73.333 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES FM Broadcast Stations § 73.333 Engineering charts. This section consists of the following Figures 1, 1a, 2, and...

  18. Two-dimensional phase fraction charts

    International Nuclear Information System (INIS)

    Morral, J.E.

    1984-01-01

    A phase fraction chart is a graphical representation of the amount of each phase present in a system as a function of temperature, composition or other variable. Examples are phase fraction versus temperature charts used to characterize specific alloys and as a teaching tool in elementary texts, and Schaeffler diagrams used to predict the amount of ferrite in stainless steel welds. Isothermal-transformation diagrams (TTT diagrams) are examples that give phase (or microconstituent) amount versus temperature and time. The purpose of this communication is to discuss the properties of two-dimensional phase fraction charts in more general terms than have been reported before. It is shown that they can represent multi-component, multiphase equilibria in a way which is easier to read and which contains more information than the isotherms and isopleths of multi-component phase diagrams

  19. Barograms / Barograph Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Barograms are weekly rectangular charts recording barometric pressure at a given station. The barograph is an instrument that makes a continuous pen and ink trace of...

  20. 15 CFR 738.3 - Commerce Country Chart structure.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Commerce Country Chart structure. 738.3 Section 738.3 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade... COMMERCE CONTROL LIST OVERVIEW AND THE COUNTRY CHART § 738.3 Commerce Country Chart structure. (a) Scope...

  1. Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

    Science.gov (United States)

    Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

    2013-08-01

    The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. The effects of parameter estimation on minimizing the in-control average sample size for the double sampling X bar chart

    Directory of Open Access Journals (Sweden)

    Michael B.C. Khoo

    2013-11-01

    Full Text Available The double sampling (DS X bar chart, one of the most widely-used charting methods, is superior for detecting small and moderate shifts in the process mean. In a right skewed run length distribution, the median run length (MRL provides a more credible representation of the central tendency than the average run length (ARL, as the mean is greater than the median. In this paper, therefore, MRL is used as the performance criterion instead of the traditional ARL. Generally, the performance of the DS X bar chart is investigated under the assumption of known process parameters. In practice, these parameters are usually estimated from an in-control reference Phase-I dataset. Since the performance of the DS X bar chart is significantly affected by estimation errors, we study the effects of parameter estimation on the MRL-based DS X bar chart when the in-control average sample size is minimised. This study reveals that more than 80 samples are required for the MRL-based DS X bar chart with estimated parameters to perform more favourably than the corresponding chart with known parameters.

  3. Quality and correlates of medical record documentation in the ambulatory care setting

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-12-01

    Full Text Available Abstract Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83 but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75. Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of

  4. A PIP chart for nuclear plant safety

    International Nuclear Information System (INIS)

    Suzuki, Tatsujiro; Yamaoka, Taiji

    1992-01-01

    While it is known that social and political aspects of nuclear safety issues are important, little study has been done on identifying the breadth of stakeholders whose policies have important influences over nuclear plant safety in a comprehensive way. The objectives of this study are to develop a chart that visually identifies important stakeholders and their policies and illustrates these influences in a hierarchical representation so that the relationship between stakeholders and nuclear safety will be better understood. This study is based on a series of extensive interviews with major stakeholders, such as nuclear plant managers, corporate planning vice presidents, state regulators, news media, and public interest groups, and focuses on one US nuclear power plant. Based on the interview results, the authors developed a conceptual policy influence paths (PIP) chart. The PIP chart illustrates the hierarchy of influence among stakeholders. The PIP chart is also useful in identifying possible stakeholders who can be easily overlooked without the PIP chart. In addition, it shows that influence flow is circular rather than linear in one direction

  5. Language Ideology or Language Practice? An Analysis of Language Policy Documents at Swedish Universities

    Science.gov (United States)

    Björkman, Beyza

    2014-01-01

    This article presents an analysis and interpretation of language policy documents from eight Swedish universities with regard to intertextuality, authorship and content analysis of the notions of language practices and English as a lingua franca (ELF). The analysis is then linked to Spolsky's framework of language policy, namely language…

  6. Medical documentation: part of the solution, or part of the problem? A narrative review of the literature on the time spent on and value of medical documentation.

    Science.gov (United States)

    Clynch, Neil; Kellett, John

    2015-04-01

    Even though it takes up such a large part of all clinicians' working day the medical literature on documentation and its value is sparse. Medline searches combining the terms medical records, documentation, time, and value or efficacy or benefit yielded only 147 articles. This review is based on the relevant articles selected from this search and additional studies gathered from the personal experience of the authors and their colleagues. Documentation now occupies a quarter to half of doctors' time yet much of the information collected is of dubious or unproven value. Most medical records departments still use the traditional paper chart, and there is considerable debate on the benefits of electronic medical records (EMRs). Although EMRs contains a lot more information than a paper record clinicians do not find it easy to getting useful information out of them. Unlike the paper chart narrative is difficult to enter into most EMRs so that they do not adequately communicate the patient's "story" to clinicians. Recent innovations have the potential to address these issues. Although documentation is widespread throughout the health care industry there has been almost no formal research into its value, on how to enhance its value, or on whether the time spent on it has negative effects on patient care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. A paediatric X-ray exposure chart

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)

    2014-09-15

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  8. Evaluation of statistical control charts for on-line radiation monitoring

    International Nuclear Information System (INIS)

    Hughes, L.D.; DeVol, T.A.

    2008-01-01

    Statistical control charts are presented for the evaluation of time series radiation counter data from flow cells used for monitoring of low levels of 99 TcO 4 - in environmental solutions. Control chart methods consisted of the 3-sigma (3σ) chart, the cumulative sum (CUSUM) chart, and the exponentially weighted moving average (EWMA) chart. Each method involves a control limit based on the detector background which constitutes the detection limit. Both the CUSUM and EWMA charts are suitable to detect and estimate sample concentration requiring less solution volume than when using a 3? control chart. Data presented here indicate that the overall accuracy and precision of the CUSUM method is the best. (author)

  9. Are primary care practitioners in Barbados following hypertension guidelines? - a chart audit

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2010-11-01

    Full Text Available Abstract Background About 55% of the population 40 to 80 years of age in Barbados is hypertensive. The quality of hypertension primary care compared to available practice guidelines is uncertain. Findings Charts of hypertensive and diabetic patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all hypertensive patients ≥ 40 years of age were then selected and processes of care and blood pressure (BP maintenance 343 charts of hypertensive patients (170 public, and 173 private were audited. Patients had the following characteristics: mean age 64 years, female gender 63%, mean duration of diagnosis 9.1 years, and diabetes diagnosed 58%. Patients had an average of 4.7 clinic visits per year, 70% were prescribed a thiazide diuretic, 42% a calcium channel blocker, 40% an angiotensin receptor blocker, and 19% a beta blocker. Public patients compared to private patients were more likely to be female (73% vs. 52%, p Conclusions Improvements are needed in following guidelines for basic interventions such as body mass assessment, accurate BP measurement, use of thiazide diuretics and lifestyle advice. BP control is inadequate.

  10. Stocking chart for upland central hardwoods

    Science.gov (United States)

    Martin E. Dale; Donald E. Hilt

    1989-01-01

    The upland hardwoods stocking chart, introduced by Gingrich in 1967, has become one of the forest manager's most useful tools. The chart allows you to determine the condition of the present stand in relation to a stocking standard. The stocking of a stand is extremely helpful in prescribing various silvicultural treatments such as intermediate thinnings,...

  11. Practical challenges related to point of care testing

    Directory of Open Access Journals (Sweden)

    Julie L.V. Shaw

    2016-04-01

    Full Text Available Point of care testing (POCT refers to laboratory testing that occurs near to the patient, often at the patient bedside. POCT can be advantageous in situations requiring rapid turnaround time of test results for clinical decision making. There are many challenges associated with POCT, mainly related to quality assurance. POCT is performed by clinical staff rather than laboratory trained individuals which can lead to errors resulting from a lack of understanding of the importance of quality control and quality assurance practices. POCT is usually more expensive than testing performed in the central laboratory and requires a significant amount of support from the laboratory to ensure the quality testing and meet accreditation requirements.Here, specific challenges related to POCT compliance with accreditation standards are discussed along with strategies that can be used to overcome these challenges. These areas include: documentation of POCT orders, charting of POCT results as well as training and certification of individuals performing POCT. Factors to consider when implementing connectivity between POCT instruments and the electronic medical record are also discussed in detail and include: uni-directional versus bidirectional communication, linking patient demographic information with POCT software, the importance of positive patient identification and considering where to chart POCT results in the electronic medical record. Keywords: Point of care Testing, Laboratory accreditation, Medical directive, Results documentation, Electronic Medical Record, Transcription error, Connectivity, Positive patient identification

  12. Square chart of nuclides with the best coordinates

    International Nuclear Information System (INIS)

    Wang Yuying

    2001-01-01

    It analyzes upper limiting feature of even Z=60-82 in different charts of nuclides. It has illustrated that the break line of upper limiting Z=60-82 in the chart of nucleus with proton number Z and neutron number N, parameters Z and H (=N-Z), two new parameters S(=2Z-N) and H, and parameters K (=S-H) and H, in proper order, it shows that the break line trends from the left lower to the right upper, the line alternates with horizontal and vertical, and the line trends from the right lower to the left upper. Here it finds that the square chart of nuclides places the middle among these charts. It shows that nuclei distribution is concentrated, so are scope of whole region of nuclides in the different charts of nuclides

  13. Color Charts, Esthetics, and Subjective Randomness

    Science.gov (United States)

    Sanderson, Yasmine B.

    2012-01-01

    Color charts, or grids of evenly spaced multicolored dots or squares, appear in the work of modern artists and designers. Often the artist/designer distributes the many colors in a way that could be described as "random," that is, without an obvious pattern. We conduct a statistical analysis of 125 "random-looking" art and design color charts and…

  14. A new Snellen's visual acuity chart with 'Indian' numerals.

    OpenAIRE

    Al-Salem, M

    1987-01-01

    'Indian' numerals, which are popular among the Arab population, were used to devise a new Snellen's visual acuity chart. The new chart has the advantages of a reading chart. It keeps the patient's interest, does not miss alexic patients, and is quicker to perform. It is also devoid of the many disadvantages of a kinetic response chart (the capital E letter or Landolt's broken rings), especially that of the limited option of test objects.

  15. Karlsruhe nuclide chart - new 9. edition 2015

    Energy Technology Data Exchange (ETDEWEB)

    Soti, Zsolt [European Commission, Joint Research Centre (JRC), Institute for Transuranium Elements (ITU), Postfach 2340, DE-76125 Karlsruhe, (Germany); Magill, Joseph; Pfennig, Gerda; Derher, Raymond [Nucleonica GmbH, c/o European Commission, Postfach 2340, DE-76125 Karlsruhe, (Germany)

    2015-07-01

    Following the success of the 8. Edition of the Karlsruhe Nuclide Chart 2012, a new edition is planned for 2015. Since the 2012 edition, more than 100 nuclides have been discovered and about 1400 nuclides have been updated. In summary, the new 9. edition contains decay and radiation data on approximately 3230 ground state nuclides and 740 isomers from 118 chemical elements. The accompanying booklet provides a detailed explanation of the nuclide box structure used in the Chart. An expanded section contains many additional nuclide decay schemes to aid the user to interpret the highly condensed information in the nuclide boxes. The booklet contains - in addition to the latest values of the physical constants and physical properties - a periodic table of the elements, tables of new and updated nuclides, and a difference chart showing the main changes in the Chart graphically. (authors)

  16. Karlsruhe nuclide chart - new 9. edition 2015

    International Nuclear Information System (INIS)

    Soti, Zsolt; Magill, Joseph; Pfennig, Gerda; Derher, Raymond

    2015-01-01

    Following the success of the 8. Edition of the Karlsruhe Nuclide Chart 2012, a new edition is planned for 2015. Since the 2012 edition, more than 100 nuclides have been discovered and about 1400 nuclides have been updated. In summary, the new 9. edition contains decay and radiation data on approximately 3230 ground state nuclides and 740 isomers from 118 chemical elements. The accompanying booklet provides a detailed explanation of the nuclide box structure used in the Chart. An expanded section contains many additional nuclide decay schemes to aid the user to interpret the highly condensed information in the nuclide boxes. The booklet contains - in addition to the latest values of the physical constants and physical properties - a periodic table of the elements, tables of new and updated nuclides, and a difference chart showing the main changes in the Chart graphically. (authors)

  17. Using UML and Petri nets for visualization of business document flow

    Directory of Open Access Journals (Sweden)

    Ivana Rábová

    2012-01-01

    Full Text Available The article deals with two principles of business workflow modeling, Petri nets and UML notation, that are the acceptable approaches to business modeling and can be used also for business documents workflow. The special type of Petri nets, WF-nets and UML activity diagrams are used in this article and both modeling ways are presented on the concrete business workflow and then there are presented and specified their advantage and disadvantage for business documents flows. At beginning it is explained the word workflow in context business documents, its features, principles and using in business environment. After that it is clarified that the UML is OMG’s most-used specification, and the way the world models not only application structure, behavior, and architecture, but also business process, workflows and data structure. Activity diagram UML is good way to show how different workflows in the business are managed, how they start, go and stop. Diagrams also show many different decision paths that can be taken from start to finish. State charts can be used as a detail the transitions or changes of states when documents can go through in the business. They show how a documents moves from one state to another and the rules that govern that change. Petri-nets offer a graphical notation for stepwise processes that include choice, iteration, and concurrent execution. Unlike UML Petri nets have an exact mathematical definition of their execution semantics, with a well-developed mathematical theory for process analysis. In the article there are modeled a special type of Petri nets, the WF-nets. The practical part of article incorporates two models of concrete business documents workflows presented in these notations, their comparison and recommendation for using these diagrams in business process management.

  18. 13. Project Management Documentation and Communications

    DEFF Research Database (Denmark)

    Kampf, Constance Elizabeth

    2014-01-01

    This chapter discusses the relationship between documentation and communication practices in organizational contexts.......This chapter discusses the relationship between documentation and communication practices in organizational contexts....

  19. Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting.

    Science.gov (United States)

    Gardiner, Paula; Filippelli, Amanda C; Kabbara, Karim; Lin, Steven C; Sadikova, Ekaterina; Kaptchuk, Ted J; Kemper, Kathi

    2015-10-01

    Little is known about the feasibility of online education in improving communication and documentation of dietary supplements (DS) among clinicians. This prospective educational study included clinicians at an urban teaching hospital. The curriculum included video streams, didactics, and interactive case presentations to discuss (1) DS safety and effectiveness, (2) cultural competency, (3) managing DS in a hospital setting, and (4) DS adverse events. Participants were surveyed, at baseline and after training, about DS knowledge, confidence, communication, and documentation practices. Thirty-nine of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean DS knowledge test score increased after the curriculum (p online curriculum is an effective tool for presenting DS education to clinicians with the goal of improving clinicians' knowledge, confidence, and documentation practices about DS.

  20. Tactile acuity charts: a reliable measure of spatial acuity.

    Science.gov (United States)

    Bruns, Patrick; Camargo, Carlos J; Campanella, Humberto; Esteve, Jaume; Dinse, Hubert R; Röder, Brigitte

    2014-01-01

    For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds.

  1. Memory-type control charts for monitoring the process dispersion

    NARCIS (Netherlands)

    Abbas, N.; Riaz, M.; Does, R.J.M.M.

    2014-01-01

    Control charts have been broadly used for monitoring the process mean and dispersion. Cumulative sum (CUSUM) and exponentially weighted moving average (EWMA) control charts are memory control charts as they utilize the past information in setting up the control structure. This makes CUSUM and

  2. National Forecast Charts

    Science.gov (United States)

    code. Press enter or select the go button to submit request Local forecast by "City, St" or Prediction Center on Twitter NCEP Quarterly Newsletter WPC Home Analyses and Forecasts National Forecast to all federal, state, and local government web resources and services. National Forecast Charts

  3. A New Attribute Control Chart using Multiple Dependent State Repetitive Sampling

    KAUST Repository

    Aldosari, Mansour Sattam; Aslam, Muhammad; Jun, Chi-Hyuck

    2017-01-01

    In this manuscript, a new attribute control chart using multiple dependent state repetitive sampling is designed. The operational procedure and structure of the proposed control chart is given. The required measures to determine the average run length (ARL) for in-control and out-of-control processes are given. Tables of ARLs are reported for various control chart parameters. The proposed control chart is more sensitive in detecting a small shift in the process as compared to the existing attribute control charts. The simulation study shows the efficiency of the proposed chart over the existing charts. An example is given for the illustration purpose.

  4. A New Attribute Control Chart using Multiple Dependent State Repetitive Sampling

    KAUST Repository

    Aldosari, Mansour Sattam

    2017-03-25

    In this manuscript, a new attribute control chart using multiple dependent state repetitive sampling is designed. The operational procedure and structure of the proposed control chart is given. The required measures to determine the average run length (ARL) for in-control and out-of-control processes are given. Tables of ARLs are reported for various control chart parameters. The proposed control chart is more sensitive in detecting a small shift in the process as compared to the existing attribute control charts. The simulation study shows the efficiency of the proposed chart over the existing charts. An example is given for the illustration purpose.

  5. HydroHillChart – Pelton module. Software used to Calculate the Hill Chart of the Pelton Hydraulic Turbines

    OpenAIRE

    Dorian Nedelcu; Adelina Bostan; Florin Peris-Bendu

    2015-01-01

    The paper presents the HydroHillChart - Pelton module application, used to calculate the hill chart of the Pelton hydraulic turbine models, by processing the data measured on the stand. In addition, the tools offered by the application such as: interface, menu, input data, numerical and graphical results, etc. are described.

  6. Screening efficacy of a simplified logMAR chart

    Directory of Open Access Journals (Sweden)

    Naganathan Muthuramalingam

    2016-04-01

    Aim: This study evaluates the efficacy of a simplified logMAR chart, designed for VA testing over the conventional Snellen chart, in a school-based vision-screening programme. Methods: We designed a simplified logMAR chart by employing the principles of the Early Treatment Diabetic Retinopathy Study (ETDRS chart in terms of logarithmic letter size progression, inter-letter spacing, and inter-line spacing. Once the simplified logMAR chart was validated by students in the Elite school vision-screening programme, we set out to test the chart in 88 primary and middle schools in the Tiruporur block of Kancheepuram district in Tamil Nadu. One school teacher in each school was trained to screen a cross-sectional population of 10 354 primary and secondary school children (girls: 5488; boys: 4866 for VA deficits using a new, simplified logMAR algorithm. An experienced paediatric optometrist was recruited to validate the screening methods and technique used by the teachers to collect the data. Results: The optometrist screened a subset of 1300 school children from the total sample. The optometrist provided the professional insights needed to validate the clinical efficacy of the simplified logMAR algorithm and verified the reliability of the data collected by the teachers. The mean age of children sampled for validation was 8.6 years (range: 9–14 years. The sensitivity and the specificity of the simplified logMAR chart when compared to the standard logMAR chart were found to be 95% and 98%, respectively. Kappa value was 0.97. Sensitivity of the teachers’ screening was 66.63% (95% confidence interval [CI]: 52.73–77.02 and the specificity was 98.33% (95% CI: 97.49–98.95. Testing of VA was done under substandard illumination levels in 87% of the population. A total of 10 354 children were screened, 425 of whom were found to have some form of visual and/or ocular defect that was identified by the teacher or optometrist. Conclusion: The simplified logMAR testing algorithm

  7. Automatic Extraction of High-Resolution Rainfall Series from Rainfall Strip Charts

    Science.gov (United States)

    Saa-Requejo, Antonio; Valencia, Jose Luis; Garrido, Alberto; Tarquis, Ana M.

    2015-04-01

    Soil erosion is a complex phenomenon involving the detachment and transport of soil particles, storage and runoff of rainwater, and infiltration. The relative magnitude and importance of these processes depends on a host of factors, including climate, soil, topography, cropping and land management practices among others. Most models for soil erosion or hydrological processes need an accurate storm characterization. However, this data are not always available and in some cases indirect models are generated to fill this gap. In Spain, the rain intensity data known for time periods less than 24 hours back to 1924 and many studies are limited by it. In many cases this data is stored in rainfall strip charts in the meteorological stations but haven't been transfer in a numerical form. To overcome this deficiency in the raw data a process of information extraction from large amounts of rainfall strip charts is implemented by means of computer software. The method has been developed that largely automates the intensive-labour extraction work based on van Piggelen et al. (2011). The method consists of the following five basic steps: 1) scanning the charts to high-resolution digital images, 2) manually and visually registering relevant meta information from charts and pre-processing, 3) applying automatic curve extraction software in a batch process to determine the coordinates of cumulative rainfall lines on the images (main step), 4) post processing the curves that were not correctly determined in step 3, and 5) aggregating the cumulative rainfall in pixel coordinates to the desired time resolution. A colour detection procedure is introduced that automatically separates the background of the charts and rolls from the grid and subsequently the rainfall curve. The rainfall curve is detected by minimization of a cost function. Some utilities have been added to improve the previous work and automates some auxiliary processes: readjust the bands properly, merge bands when

  8. The making of Andersen’s liquefaction chart

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response.The process of obtaining the original chart has been...

  9. 47 CFR 73.699 - TV engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false TV engineering charts. 73.699 Section 73.699 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Television Broadcast Stations § 73.699 TV engineering charts. This section consists of the following Figures...

  10. Chart of nuclides relating to neutron activation

    International Nuclear Information System (INIS)

    Okada, Minoru

    1981-09-01

    This chart is for frequent use in the prediction of the product species of neutron activation. The first edition of the chart has been made in 1976 after the repeated trial preparation. It has the following good points. (1) Any letter in chart is as large as one can read easily. [This condition has been obtained by the selection of items to be shown in chart. They are the name (the symbol of element, mass number, and half-life) of nuclide or of isomer, and the type of decay.]. (2) Decay product has been shown indirectly for branchings with two-step decay via short-lived daughter in an excited state. [This matter has been realized by use of the new mode of indication.] (3) Nuclides shown in chart are (a) naturally occurring nuclides and (b) nuclides formed from naturally occurring nuclides through one of the following reactions: (n, γ), (n, n'), (n, p), (n, α), (n, 2n), (n, pn), (n, 3n), (n, αn), (n, t), (n, 3 He), (n, 2p), and (n, γ)(n, γ). In the revision of the first edition, some modes of indication have become a little simpler, and the isomers of shorter half-lives (0.1 - 1 μs) have been added. (author)

  11. Control chart applications in healthcare: a literature review

    Science.gov (United States)

    Suman, Gaurav; Prajapati, DeoRaj

    2018-05-01

    The concept of Statistical process control (SPC) was given by the physicist Walter Shewhart in order to improve the industrial manufacturing. The SPC was firstly applied in laboratory and after then shifted to patient level in hospitals. As there is more involvement of human in healthcare, the chances of errors are also more. SPC i.e., control chart can help in determining the source of errors by identifying the special and common causes of variations. This paper presents the review of literature on the application of SPC and control chart in healthcare sector. Forty articles are selected out of 142 potentially relevant searched studies. Selected studies are categorised into eight departments. Literature survey shows that most of work on control chart applications in healthcare is carried out in Surgery, Emergency and Epidemiology departments. US, UK and Australia are the main customers where maximum amount of work was done. The US is the country where control chart in healthcare sector have been used at regular interval. This shows the gap of deploying control chart in different departments and different countries as well. The CUSUM and EWMA chart came into picture in healthcare sector after 2008 and are used at regular interval.

  12. Nuclear industry chart

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    As part of a survey on Switzerland a pull-out organisation chart is presented of the nuclear industry showing Swiss government bodies and industrial concerns. Their interests, connections with each other and their associations with international and other national organizations and firms are indicated. (U.K.)

  13. Tactile acuity charts: a reliable measure of spatial acuity.

    Directory of Open Access Journals (Sweden)

    Patrick Bruns

    Full Text Available For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds.

  14. Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes.

    Science.gov (United States)

    Anhøj, Jacob; Olesen, Anne Vingaard

    2014-01-01

    A run chart is a line graph of a measure plotted over time with the median as a horizontal line. The main purpose of the run chart is to identify process improvement or degradation, which may be detected by statistical tests for non-random patterns in the data sequence. We studied the sensitivity to shifts and linear drifts in simulated processes using the shift, crossings and trend rules for detecting non-random variation in run charts. The shift and crossings rules are effective in detecting shifts and drifts in process centre over time while keeping the false signal rate constant around 5% and independent of the number of data points in the chart. The trend rule is virtually useless for detection of linear drift over time, the purpose it was intended for.

  15. Documentation of Ethnoveterinary Practices for Mastitis in Dairy Animals in Pakistan

    Directory of Open Access Journals (Sweden)

    S. M. Raihan Dilshad, N. U. Rehman*, Nazir Ahmad and A. Iqbal1

    2010-07-01

    Full Text Available This study was aimed to document the ethnoveterinary practices (EVPs used for the control and treatment of mastitis in cattle and buffaloes in the Sargodha district, Pakistan. The information was collected using rapid and participatory rural appraisal techniques through interviews and focused group discussions with 217 traditional veterinary healers (TVHs over a period of 16 months from September 2005 to December 2006. Thus, 25 different plant species belonging to 20 different families were documented from the study area for the treatment and prophylaxis of mastitis in bovines (cattle and bubalines (dairy buffalo, Bubalus bubalis. The most frequently reported (≥10 times plant species were Capsicum annuum L. (n = 32, Lepidium sativum L. (n =31, Allium sativum L. (n = 28, Sesamum indicum L. (n = 24, Citrus limon (L. Burm. f (n = 22, Zingiber officinale Roscoe (n = 18, Citrullus colocynthis (L. Schrad (n = 18, Curcuma longa L. (n = 16, Cuminum cyminum L. (n = 14, Rosa indica L. (n = 13, Centratherum anthelmisticum L. (n = 12, Triticum aestivum L (n = 11, Nigella sativa L. (n = 11 and Peganum harmala L. (n = 11. All the documented plant species were indigenous to the study area. Materials other than plants used for the treatment of this problem included ammonium chloride. The richness of EVPs in the study area and extensive variation in the doses, methods of preparation, indications, and claims regarding efficacy of plants for mastitis merit controlled studies for their validation.

  16. HydroHillChart – Pelton module. Software used to Calculate the Hill Chart of the Pelton Hydraulic Turbines

    Directory of Open Access Journals (Sweden)

    Dorian Nedelcu

    2015-07-01

    Full Text Available The paper presents the HydroHillChart - Pelton module application, used to calculate the hill chart of the Pelton hydraulic turbine models, by processing the data measured on the stand. In addition, the tools offered by the application such as: interface, menu, input data, numerical and graphical results, etc. are described.

  17. Feeding by numbers: an ethnographic study of how breastfeeding women understand their babies' weight charts

    Directory of Open Access Journals (Sweden)

    Dykes Fiona

    2006-12-01

    Full Text Available Abstract Background Weighing breastfed babies has been the subject of some controversy as the previous international growth chart was largely based on data from infants fed infant formula. The concern that professionals may be misled by the charts into suggesting to mothers that they supplement unnecessarily was a major impetus for the World Health Organization's investment in a new growth chart. Evidence of interpretation in practice has been scant. Methods An ethnographic study was conducted in a town in the Northwest of England to investigate this issue. In the first phase, women and health visitors were observed in the well-child clinic during clinic sessions and breastfeeding group meetings. In the second phase, longitudinal interviews with 14 women were conducted. Each woman was interviewed up to three times in the first six months after the birth of her baby, with a total of 35 interviews. Results Mothers and health visitors focussed on weight gain with frequent weighing and attention to even minor fluctuations of the plotted line being evident. Women felt it important to ensure their baby's weight followed a centile, and preferred for this to be the fiftieth centile. Interventions included giving infant formula and solids as well as changing what the mother ate and drank. Women also described how they worried about their baby's weight. Little effective support by health professionals with breastfeeding technique was observed. Conclusion Babies were weighed more often than officially recommended, with weighing and plotting being at the core of each clinic visit. The plotted weight chart exerted a powerful influence on both women's and health visitors' understanding of the adequacy of breastfeeding. They appeared to rate the regular progression of weight gains along the chart centiles more highly than continued or exclusive breastfeeding. Thus weighing and visual charting of weight constituted a form of surveillance under the medical gaze

  18. 46 CFR 232.3 - Chart of accounts.

    Science.gov (United States)

    2010-10-01

    ... stated in any revision to generally accepted accounting principles, the meaning of the latter shall... UNIFORM FINANCIAL REPORTING REQUIREMENTS § 232.3 Chart of accounts. (a) Purpose of accounts. A contractor shall use this chart of accounts as a guide for preparing the financial statements and for other...

  19. 33 CFR 164.33 - Charts and publications.

    Science.gov (United States)

    2010-07-01

    ...) PORTS AND WATERWAYS SAFETY NAVIGATION SAFETY REGULATIONS § 164.33 Charts and publications. (a) Each vessel must have the following: (1) Marine charts of the area to be transited, published by the National... tables published by private entities using data provided by the National Ocean Service. (ii) Tidal...

  20. 21 CFR 886.1150 - Visual acuity chart.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Visual acuity chart. 886.1150 Section 886.1150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1150 Visual acuity chart. (a) Identification...

  1. Robust Control Charts for Time Series Data

    NARCIS (Netherlands)

    Croux, C.; Gelper, S.; Mahieu, K.

    2010-01-01

    This article presents a control chart for time series data, based on the one-step- ahead forecast errors of the Holt-Winters forecasting method. We use robust techniques to prevent that outliers affect the estimation of the control limits of the chart. Moreover, robustness is important to maintain

  2. [Growth charts: Impact on the prevalence of nutritional disorders].

    Science.gov (United States)

    Polo Martín, P; Abellan, J J; Nájar Godoy, M I; Álvarez de Laviada Mulero, T

    2015-05-01

    The references used to assess child growth in Spain are the graphs of the Orbegozo Foundation and the charts of the World Health Organization (WHO). The objective of this study is to analyze the differences between the two charts for weight, height and body mass index, and assess their relevance to identify growth or nutritional problems. The values of the extreme percentiles of height, weight and body mass index for each sex from 0 to 10 years in both charts are compared. For each value Absolute differences and Z scores are calculated for each value. To evaluate the impact on the prevalence of the various nutritional or growth disorders the location of the value of the respective percentiles of in each of the charts were assessed. Significant differences were observed between the 3th percentile of height and weight, 97th of weight, and 85th and 97th of body mass index. Marked differences were observed for the extreme values of body mass index. During the first years, the Orbegozo charts overestimate the prevalence of malnutrition (between 2% and 19% depending on age and sex) compared to the WHO charts. In subsequent ages Orbegozo underestimates WHO between 0.7% and 2.89%. Orbegozo underestimates the prevalence of overweight (between 2.5% and 14.8%) compared to the WHO charts. The 97th percentile of Body mass index in the Orbegozo charts corresponds in most cases with WHO percentiles above 99.99%. The two charts analyzed have significant differences from a clinical and the public health point of view, in the estimation of overweight/obesity and malnutrition. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  3. Adherence to the Australian National Inpatient Medication Chart: the efficacy of a uniform national drug chart on improving prescription error.

    Science.gov (United States)

    Atik, Alp

    2013-10-01

    In 2006, the National Inpatient Medication Chart (NIMC) was introduced as a uniform medication chart in Australian public hospitals with the aim of reducing prescription error. The rate of regular medication prescription error in the NIMC was assessed. Data was collected using the NIMC Audit Tool and analyzed with respect to causes of error per medication prescription and per medication chart. The following prescription requirements were assessed: date, generic drug name, route of administration, dose, frequency, administration time, indication, signature, name and contact details. A total of 1877 medication prescriptions were reviewed. 1653 prescriptions (88.07%) had no contact number, 1630 (86.84%) did not have an indication, 1230 and 675 (35.96%) used a drug's trade name. Within 261 medication charts, all had at least one entry, which did not include an indication, 258 (98.85%) had at least one entry, which did not have a contact number and 200 (76.63%) had at least one entry, which used a trade name. The introduction of a uniform national medication chart is a positive step, but more needs to be done to address the root causes of prescription error. © 2012 John Wiley & Sons Ltd.

  4. Model documentation of assessment and nursing diagnosis in the practice of nursing care management for nursing students

    OpenAIRE

    A. Aziz Alimul Hidayat; M. Kes

    2015-01-01

    Model documentation of assessment and nursing diagnosis in the practice of nursing care management is an integration model in nursing care records, especially records nursing assessment and diagnosis in one format. This model can reduce the duration of the recording in nursing care, and make it easier for students to understand the nursing diagnosis, so that nursing interventions more effective. The purpose of this paper was to describes the form integration documentation of nursing assessmen...

  5. 32 CFR 728.93 - Chart of adjuncts.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Chart of adjuncts. 728.93 Section 728.93 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of...

  6. Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.

    Science.gov (United States)

    Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

    2010-10-01

    General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.

  7. Improvement of WWW chart of the nuclides interface

    International Nuclear Information System (INIS)

    Okamoto, Tsutomu; Minato, Futoshi; Iwamoto, Osamu; Koura, Hiroyuki

    2016-03-01

    The booklet 'chart of the nuclides' is issued every 4 years since 1976 from Nuclear Data Center, Japan Atomic Energy Agency. The chart of the nuclides for WWW (World Wide Web) was developed in 1999 in order to be available from the Internet browser. The Internet connection speeds, browser functions and JavaScript libraries has, however, progressed at present compared with the Internet technology in those days. In connection with the release of the 2014 edition of the chart of the nuclides, the interface of the WWW chart of the nuclides has been improved by introducing new Internet technologies aiming at enhancing convenience on accessibilities via browsers. We introduced a scrolling screen that would make capabilities of easy screen movement on a map with the addition of the drag scrolling function. Considering smart phone access, the light-weight edition which introduced automatic switch was prepared. The new system results in reduction in access time and usefulness in mobile environment. The method of making figures of the chart was reconsidered due to addition of new decay schemes to the 2014 edition. SVG (Scalable Vector Graphics) was adopted so as to make figures easily. It is concluded that the accessibilities of WWW chart of the nuclides are substantially improved from the previous version by introducing the new technologies. (author)

  8. Dental Charting. Learning Activities, Unit Tests, Progress Chart, and Work Sheet.

    Science.gov (United States)

    Texas Univ., Austin. Center for Occupational Curriculum Development.

    These materials are part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. These student materials, designed to be used with the Dental Charting Student Manual, consist of learning activities, unit…

  9. Weldability charts for constructional steels

    International Nuclear Information System (INIS)

    Ion, J C; Ashby, M F

    2012-01-01

    The weldability of materials is still a poorly understood concept; a quantitative assessment remains elusive. The variables associated with welding are reduced here into two groups - processing parameters and material properties - from which two characteristic indices are defined and used as the basis of weldability charts. For the case of constructional steels, a carbon equivalent characterises both heat affected zone hardenability and the maximum hardness developed after solid state phase transformations. The welding process is characterised by its energy input. A mathematical model is used to establish relationships between the indices, which are displayed on charts as contours of microstructure and hardness.

  10. CDC Child Growth Charts

    Data.gov (United States)

    U.S. Department of Health & Human Services — CDC child growth charts consist of a series of percentile curves that illustrate the distribution of selected body measurements in U.S. children. Pediatric growth...

  11. Pain Management Practices in a Pediatric Emergency Room (PAMPER) Study: interventions with nurses.

    Science.gov (United States)

    Le May, Sylvie; Johnston, C Celeste; Choinière, Manon; Fortin, Christophe; Kudirka, Denise; Murray, Louise; Chalut, Dominic

    2009-08-01

    Children's pain in emergency departments (EDs) is poorly managed by nurses, despite evidence that pain is one of the most commonly presenting complaints of children attending the ED. Our objectives were 2-fold: to verify if tailored educational interventions with emergency pediatric nurses would improve nurses' knowledge of pain management and nurses' pain management practices (documentation of pain, administration of analgesics, nonpharmacological interventions). This intervention study with a pre-post design (baseline, immediately after the intervention [T-2], and 6 months after intervention [T-3]) used a sample of nurses (N = 50) and retrospective chart reviews of children (N = 450; 150 charts reviewed each at baseline, T-2, and T-3) who presented themselves in the ED with a diagnosis known to generate moderate to severe pain (burns, acute abdominal pain, deep lacerations, fracture, sprain). Principal outcomes: nurses' knowledge of pain management (Pediatric Nurses Knowledge and Attitudes Survey [PNKAS] on pain) and nurses' clinical practices of pain management (Pain Management Experience Evaluation [PMEE]). Response rate on the PNKAS was 84% (42/50) at baseline and 50% (21/42) at T-2. Mean scores on PNKAS were 28.2 (SD, 4.9; max, 42.0) at baseline and 31.0 (SD, 4.6) at T-2. Results from paired t test showed significant difference between both times (t = -3.129, P = 0.005). Nurses who participated in the capsules improved their documentation of pain from baseline (59.3%) to T-2 (80.8%; chi = 12.993, P nurses increased their nonpharmacological interventions from baseline (16.7%) to T-3 (31.9%; chi = 8.623, P = 0.003). Finally, we obtained significant differences on pain documentation between the group of nurses who attended at least 1 capsule and the group of nurses who did not attend any capsule at both times (T-2 and T-3; chi = 20.424, P nurses' knowledge of pain management and some of the practices over time. We believe that an intervention tailored to nurses

  12. Visualizing a Procedure with Nassi-Schneiderman Charts.

    Science.gov (United States)

    Weiss, Edmond H.

    1990-01-01

    Argues that Nassi-Schneiderman (NS) charts, when used to diagram human procedures, can eliminate prose ambiguities. Asserts that these devices provide most of the advantages of decision tables and trees. Suggests using NS charts in testing the logic and completeness of traditional procedures, or even in place of many traditional publications. (SG)

  13. Development and clinical application of a color pediatric visual acuity chart

    Directory of Open Access Journals (Sweden)

    Shu-Guo Yin

    2014-12-01

    Full Text Available AIM: To introduce a new color pediatric visual acuity chart and its clinical application.METHODS:The color pediatric visual acuity chart was designed based on principle of visual angle. The optotype on the color chart had graphics. The progression rate of optotype size between 2 lines was 10(101/2 and 1.2589. A regular geometric progression of optotype sizes and distribution was employed to arrange 8 lines with 11 optotype on the color chart. The testing distance was 3m. The visual acuity score could be recorded as logarithm of the minimum angle of resolution notation or decimal notation. The reliability of naked distant measurements with this new chart was tested in one eye of 100 children(4 ~6 years oldtaking the Chinese national standard logarithm visual acuity chart standard. RESULTS: The color pediatric visual acuity chart and logarithmic chart controls, visual acuity test results that in the two groups had no significant difference(t=1.2671, P>0.05. Two sets of vision data existed positive correlation(r=0.924, PCONCLUSION:Children are easier to accept used new color pediatric visual acuity chart to inspect vision. New chart is reliability and apply to children's vision screening.

  14. Comparison of customised growth charts v. standard population

    African Journals Online (AJOL)

    pregnant diabetic population using population-based growth charts and customised growth charts. Methods. ... Of the patients, 44 had type 1, 66 type 2 and 173 gestational diabetes. The growth of .... with diabetic ketoacidosis, of whom one.

  15. Statistical process control charts for attribute data involving very large sample sizes: a review of problems and solutions.

    Science.gov (United States)

    Mohammed, Mohammed A; Panesar, Jagdeep S; Laney, David B; Wilson, Richard

    2013-04-01

    The use of statistical process control (SPC) charts in healthcare is increasing. The primary purpose of SPC is to distinguish between common-cause variation which is attributable to the underlying process, and special-cause variation which is extrinsic to the underlying process. This is important because improvement under common-cause variation requires action on the process, whereas special-cause variation merits an investigation to first find the cause. Nonetheless, when dealing with attribute or count data (eg, number of emergency admissions) involving very large sample sizes, traditional SPC charts often produce tight control limits with most of the data points appearing outside the control limits. This can give a false impression of common and special-cause variation, and potentially misguide the user into taking the wrong actions. Given the growing availability of large datasets from routinely collected databases in healthcare, there is a need to present a review of this problem (which arises because traditional attribute charts only consider within-subgroup variation) and its solutions (which consider within and between-subgroup variation), which involve the use of the well-established measurements chart and the more recently developed attribute charts based on Laney's innovative approach. We close by making some suggestions for practice.

  16. Finding charts for southern IRAS galaxies

    International Nuclear Information System (INIS)

    Sutherland, W.J.; Maddox, S.J.; Saunders, W.

    1991-01-01

    Using the APM Galaxy Survey, we have generated a collection of finding charts for 4614 sources with non-stellar colours in the IRAS Faint Source Catalogue south of δ= -17.5 o . Over 90 per cent of the sources are reliably identified with an optical object, and we provide 1-arcsec positions and B J magnitudes for these. We will provide paper copies of the charts on request, at a small charge to cover photocopying costs. (author)

  17. The European chart of territorial planning

    International Nuclear Information System (INIS)

    1998-01-01

    In this chapter the European chart of territorial planning is included. This European chart contains next chapters: Introduction; The mission of the territorial planning; The basic aims; Realization of aims of the territorial planning; The confirmation of the European co-operation. In the Appendix the Specific aims: (1) The village territory; (2) The urban territory; (3) The boundary territory; (4) The mountain territory; (5) The structurally weak territory; (6) The decaying territory; (7) The coastal territories and islands

  18. Documentation of ethnoveterinary practices used in family poultry in Botswana

    Directory of Open Access Journals (Sweden)

    John Cassius Moreki

    2013-02-01

    Full Text Available Aim: To document the use of indigenous plants used by family poultry rearers to treat and control diseases and parasites in 15 villages of Botswana. Materials and Methods: A total of 1000 family poultry rearers in 15 villages were interviewed using a structured questionnaire. Data were also collected through direct observation, village walks, interview of passers-by, group interviews, and meetings with key informants (i.e., traditional leaders, extension agents and chairpersons of village development committees. Results: The ethnoveterinary practices in 15 villages of Botswana were identified and documented. Nineteen plant species representing 15 families were used by family poultry rearers to treat and control poultry diseases and parasites. Most frequently used plants were from Fabaceae, Asteraceae and Liliaceae. Both human and veterinary medications (e.g., vicks, disprin and Compral tablets, blue stones, potassium permanganate, veterinary drugs and vaccines were used in health management. Sixty-six percent of the respondents said they used traditional remedies to control and treat diseases, 19% did not use vaccines or remedies, 2% used vaccines while 13% used drugs to control and treat diseases. Conclusions: Ethnoveterinary medicine predominates in family poultry healthcare. Scientific investigations should be carried out to ascertain the effectiveness of identified plant species used in health management of family poultry. [Vet World 2013; 6(1.000: 18-21

  19. An Exponentially Weighted Moving Average Control Chart for Bernoulli Data

    DEFF Research Database (Denmark)

    Spliid, Henrik

    2010-01-01

    of the transformation is given and its limit for small values of p is derived. Control of high yield processes is discussed and the chart is shown to perform very well in comparison with both the most common alternative EWMA chart and the CUSUM chart. The construction and the use of the proposed EWMA chart......We consider a production process in which units are produced in a sequential manner. The units can, for example, be manufactured items or services, provided to clients. Each unit produced can be a failure with probability p or a success (non-failure) with probability (1-p). A novel exponentially...... weighted moving average (EWMA) control chart intended for surveillance of the probability of failure, p, is described. The chart is based on counting the number of non-failures produced between failures in combination with a variance-stabilizing transformation. The distribution function...

  20. Teaching about Modern Germany: Instructional Materials for the Social Studies Classroom. Correlation Charts Indicating Content and Skills Addressed by Each Lesson.

    Science.gov (United States)

    Goethe House, New York, NY.

    This instructional booklet for the social studies classroom is a companion to a series about modern day Germany. The materials describe the documents in the series and present correlation charts for content and skills: (1) "A Kid Like Me across the Sea"; (2) "Communities and Regions"; (3) "Overview of Germany"; (4)…

  1. Customized versus population-based birth weight charts for the detection of neonatal growth and perinatal morbidity in a cross-sectional study of term neonates.

    Science.gov (United States)

    Carberry, Angela E; Raynes-Greenow, Camille H; Turner, Robin M; Jeffery, Heather E

    2013-10-15

    Customized birth weight charts that incorporate maternal characteristics are now being adopted into clinical practice. However, there is controversy surrounding the value of these charts in the prediction of growth and perinatal outcomes. The objective of this study was to assess the use of customized charts in predicting growth, defined by body fat percentage, and perinatal morbidity. A total of 581 term (≥37 weeks' gestation) neonates born in Sydney, Australia, in 2010 were included. Body fat percentage measurements were taken by using air displacement plethysmography. Objective composite measurements of perinatal morbidity were used to identify neonates who had poor outcomes; these data were extracted from medical records. The value of customized charts was assessed by calculating positive predictive values, negative predictive values, and odds ratios with 95% confidence intervals. Customized versus population-based charts did not improve the prediction of either low body fat percentage (59% vs. 66% positive predictive value and 87% vs. 89% negative predictive value, respectively) or high body fat percentage (48% vs. 53% positive predictive value and 90% vs. 89% negative predictive value, respectively). Customized charts were not better than population-based charts at predicting perinatal morbidity (for customized charts, odds ratio = 1.02, 95% confidence interval: 1.01, 1.04; for population-based charts, odds ratio = 1.03, 95% confidence interval: 1.01, 1.05) per percentile decrease in birth weight. Customized birth weight charts do not provide significant improvements over population-based charts in predicting neonatal growth and morbidity.

  2. Great Lakes Ice Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Charts show ice extent and concentration three times weekly during the ice season, for all lakes except Ontario, from the 1973/74 ice season through the 2001/2002...

  3. Chesapeake Highway Advisories Routing Traffic, Chart, Business Plan

    Science.gov (United States)

    1996-10-01

    THE BUSINESS PLAN IS ORGANIZED INTO FOUR MAJOR SECTIONS. THE FIRST SECTION IS INTRODUCTORY IN NATURE AND PROVIDES BACKGROUND INFORMATION ON ITS AND THE CHART PROGRAM IN MARYLAND. IT INCLUDES THE CHART MISSION, GOALS AND OBJECTIVES, AS WELL AS OVERVIE...

  4. Compliance of NHS dental practice websites in Wales before and after the introduction of the GDC document 'Principles of ethical advertising'.

    Science.gov (United States)

    Budd, M L; Davies, M; Dewhurst, R; Atkin, P A

    2016-06-10

    Objectives To evaluate the compliance of NHS dental practice websites in Wales, UK, with the 2012 GDC document Principles of ethical advertising, before its introduction (2011) and again after its introduction (2014).Methods All practices in Wales with an NHS contract and dental practice website were identified. The content of the website was evaluated to determine if it complied with the principles outlined in the 2012 GDC document Principles of Ethical Advertising.Results Twenty-five percent of the 446 practices sampled in 2011 had a website, compared to 44% of the 436 practices sampled in 2014. The principles best complied with were; displaying the name, geographic address, and telephone number of the practice (100% for both years). None of the websites compared the qualifications or skills of its practitioners to others, therefore 100% complied with this principle. Displaying team members' professional qualification and the country from which this is obtained was fairly well represented; 92% and 61% respectively in 2014; an improvement from only 50% and 49% respectively in 2011. Principles worst complied with were displaying the GDC's address (3% 2011; 9% 2014) or link to the GDC website (11% 2011; 7% 2014) and details of the practice complaints procedure (1% 2011; 5% 2014). Overall, no practice complied with all of the compulsory principles.Conclusion In both 2011 and 2014 no practice website was compliant with all the principles outlined in the 2012 GDC document Principles of ethical advertising. Reflecting results from previous studies, this study showed that compliance is slowly improving, yet over 4 years after the introduction of the mandatory principles, it remains that no practice website is 100% compliant.

  5. A Combined Control Chart for Identifying Out–Of–Control Points in Multivariate Processes

    Directory of Open Access Journals (Sweden)

    Marroquín–Prado E.

    2010-10-01

    Full Text Available The Hotelling's T2 control chart is widely used to identify out–of–control signals in multivariate processes. However, this chart is not sensitive to small shifts in the process mean vec tor. In this work we propose a control chart to identify out–of–control signals. The proposed chart is a combination of Hotelling's T2 chart, M chart proposed by Hayter et al. (1994 and a new chart based on Principal Components. The combination of these charts identifies any type and size of change in the process mean vector. Us ing simulation and the Average Run Length (ARL, the performance of the proposed control chart is evaluated. The ARL means the average points within control before an out–of–control point is detected, The results of the simulation show that the proposed chart is more sensitive that each one of the three charts individually

  6. Examination of Routine Use of Prenatal Weight Gain Charts as a Communication Tool for Providers.

    Science.gov (United States)

    Aguilera, Marijo; Sidebottom, Abbey C; McCool, Brigitte R

    2017-10-01

    Objectives In 2009 the IOM revised prenatal weight gain guidelines. The primary purpose of this pilot study was to assess if provider education and use of prenatal weight gain charts to track weight gain and counsel patients was associated with better patient and provider knowledge and communication about the guidelines. Methods A prospective non-randomized study conducted in four OB practices (two control, two intervention). Data sources included provider surveys (n = 16 intervention, 21 control), patient surveys (n = 332), and medical records. Intervention clinics received provider education on the IOM guidelines and used patient education materials and prenatal weight gain charts to track weight gain and as a counseling tool. Comparison clinics received no education and did not use the charts or patient education information. Results More patients at intervention clinics (92.3%) reported that a provider gave them advice about weight gain, compared to patients from comparison clinics (66.4%) (p gain (83.1 vs. 64.3%, p = 0.007). Intervention clinic patients were more likely to have knowledge of the guidelines indicated by 72.3% reporting a target weight gain amount within the guidelines versus 50.4% of comparison patients (p gain charts resulted in higher patient reported communication about weight gain from their provider, higher patient satisfaction with those discussions, and better knowledge of the appropriate target weight gain goals.

  7. 47 CFR 73.599 - NCE-FM engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false NCE-FM engineering charts. 73.599 Section 73.599 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Noncommercial Educational FM Broadcast Stations § 73.599 NCE-FM engineering charts. This...

  8. Repeatability of an automated Landolt C test, compared with the early treatment of diabetic retinopathy study (ETDRS) chart testing.

    Science.gov (United States)

    Ruamviboonsuk, Paisan; Tiensuwan, Montip; Kunawut, Catleya; Masayaanon, Patcharapim

    2003-10-01

    To evaluate the repeatability of visual acuity scores from the automated test and compare them with the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Instrument validation study based on a model of repeatability study in two observations. SMETHODS: a prospective, clinic-based, comparative study. A total of 206 participants without ocular diseases and refractive errors in their right eyes were randomly enrolled in the automated group in which 107 participants performed the automated test and the ETDRS group in which 99 participants read the ETDRS chart. All participants were tested with only their right eyes without corrections at 4 meters and came back to have the same tests 1 week later. The automated test used the Landolt rings as optotypes and was conducted by a low-ended personal computer with a 15-inch monitor and a wireless keyboard. The "letter" score calculated by counting every correct response to optotypes, and the "threshold curve" score interpreted from the optotype size at the midpoint of a visual acuity threshold curve. The 95% confidence interval of test-retest of visual acuity scores from the automated test are comparable to the ETDRS chart (.143 compared with.125 for letter scores,.145 compared with.122 for threshold curve scores). The score repeatabilities, calculated from the standard deviations of test-retest, from the automated test are also comparable to the ETDRS chart (.201 compared with.177 for letter scores,.206 compared with.172 for threshold curve scores). All comparisons demonstrated no statistical difference (P >.05). The automated testing system in this study enables practical measuring visual acuity by the Landolt rings. The system's repeatability, which is comparable to the ETDRS chart, supports its role as an alternative tool for measuring outcome in new clinical research. Its ability to practically generate visual acuity threshold curves may also be useful in future clinical research studies.

  9. Birth-weight charts and immigrant populations: A critical review.

    Science.gov (United States)

    Urquia, Marcelo L; Sørbye, Ingvil K; Wanigaratne, Susitha

    2016-04-01

    There is an increasing body of literature focusing on differences in newborn size between different population subgroups defined by racial, ethnic, and immigration status. The interpretation of these differences as pathological or as merely reflecting normal variability is not straightforward and may have consequences for the provision of obstetric and neonatal care to minority populations. In this review, we critically assess some methodological issues affecting the assessment of newborn size and their potential implications for minority populations. In particular, we discuss the pros and cons of different types of newborn birth-weight (BW) charts (i.e., single local population-based references, minority-specific references, and a single international standard) to determine abnormal newborn size, with emphasis on immigrant populations. We conclude that size alone is not enough to inform clinical decisions and that all newborn size charts should be used as screening tools, not as diagnostic tools. Parental minority status may be regarded as a marker and used to further inquire about individual risk factors, particularly among immigrants who may not have a complete medical history in the new country. Finally, we outline areas for further research and recommendations for clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. On the Mathematics behind the CUSUM Control Charts

    DEFF Research Database (Denmark)

    Madsen, Henrik

    1998-01-01

    This paper describes the mathematics behind CUSUM control charts. An introduction to CUSUM charts is found in (Madsen 1998).CUSUM charts are well suited for checking a measuring system in operation for any departure from some target or specified values. In general they can be used for:- detecting...... a drift (or shift in the level) of the measuring system, and- detecting a change of the precision of the measuring system.In both cases the CUSUM procedure contains methods for estimating the shift such that maintenance (e.g. recalibration) can take place.The CUSUM procedure is described in ISO/CD 7871...

  11. A near-vision chart for children aged 3-5 years old:new designs and clinical applications

    Directory of Open Access Journals (Sweden)

    Yang-Qing Huang

    2014-06-01

    .CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age. It can be applied in routine clinical practice.

  12. Using color management in color document processing

    Science.gov (United States)

    Nehab, Smadar

    1995-04-01

    Color Management Systems have been used for several years in Desktop Publishing (DTP) environments. While this development hasn't matured yet, we are already experiencing the next generation of the color imaging revolution-Device Independent Color for the small office/home office (SOHO) environment. Though there are still open technical issues with device independent color matching, they are not the focal point of this paper. This paper discusses two new and crucial aspects in using color management in color document processing: the management of color objects and their associated color rendering methods; a proposal for a precedence order and handshaking protocol among the various software components involved in color document processing. As color peripherals become affordable to the SOHO market, color management also becomes a prerequisite for common document authoring applications such as word processors. The first color management solutions were oriented towards DTP environments whose requirements were largely different. For example, DTP documents are image-centric, as opposed to SOHO documents that are text and charts centric. To achieve optimal reproduction on low-cost SOHO peripherals, it is critical that different color rendering methods are used for the different document object types. The first challenge in using color management of color document processing is the association of rendering methods with object types. As a result of an evolutionary process, color matching solutions are now available as application software, as driver embedded software and as operating system extensions. Consequently, document processing faces a new challenge, the correct selection of the color matching solution while avoiding duplicate color corrections.

  13. Negative Binomial charts for monitoring high-quality processes

    NARCIS (Netherlands)

    Albers, Willem/Wim

    Good control charts for high quality processes are often based on the number of successes between failures. Geometric charts are simplest in this respect, but slow in recognizing moderately increased failure rates p. Improvement can be achieved by waiting until r > 1 failures have occurred, i.e. by

  14. 48 CFR 252.245-7000 - Government-furnished mapping, charting, and geodesy property.

    Science.gov (United States)

    2010-10-01

    ... mapping, charting, and geodesy property. 252.245-7000 Section 252.245-7000 Federal Acquisition Regulations..., charting, and geodesy property. As prescribed in 245.107-70, use the following clause: Government-Furnished Mapping, Charting, and Geodesy Property (DEC 1991) (a) Definition—Mapping, charting, and geodesy (MC&G...

  15. Development of disease-specific growth charts in Turner syndrome and Noonan syndrome

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Isojima

    2017-12-01

    Full Text Available Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.

  16. Development of disease-specific growth charts in Turner syndrome and Noonan syndrome.

    Science.gov (United States)

    Isojima, Tsuyoshi; Yokoya, Susumu

    2017-12-01

    Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.

  17. The effectiveness of robust RMCD control chart as outliers’ detector

    Science.gov (United States)

    Darmanto; Astutik, Suci

    2017-12-01

    A well-known control chart to monitor a multivariate process is Hotelling’s T 2 which its parameters are estimated classically, very sensitive and also marred by masking and swamping of outliers data effect. To overcome these situation, robust estimators are strongly recommended. One of robust estimators is re-weighted minimum covariance determinant (RMCD) which has robust characteristics as same as MCD. In this paper, the effectiveness term is accuracy of the RMCD control chart in detecting outliers as real outliers. In other word, how effectively this control chart can identify and remove masking and swamping effects of outliers. We assessed the effectiveness the robust control chart based on simulation by considering different scenarios: n sample sizes, proportion of outliers, number of p quality characteristics. We found that in some scenarios, this RMCD robust control chart works effectively.

  18. Charting Transnational Native American Studies

    Directory of Open Access Journals (Sweden)

    Hsinya Huang

    2012-06-01

    Full Text Available Introduction to the Special Forum entitled "Charting Transnational Native American Studies: Aesthetics, Politics, Identity," edited by Hsinya Huang, Philip J. Deloria, Laura M. Furlan, and John Gamber

  19. Slavery Service Accounting Practices in Brazil: A Bibliographic and Document Analysis

    Directory of Open Access Journals (Sweden)

    Adriana Rodrigues Silva

    2014-12-01

    Full Text Available This study focuses on the social and economic aspects and institutional relationships that determined a unique pattern of inequality. We aim to examine the particular role of accounting as a practice used to dehumanize an entire class of people. The primary purpose of this study is not to examine slavery's profitability but rather to identify how accounting practices served slavery. A qualitative research method is applied in this study. Regarding technical procedures, this study makes use of bibliographic and documentary sources. For the purpose of this investigation, and in accordance with bibliographic and documentary research methods, we analyze scientific articles, books and documents from the Brazilian National Archive, the Brazilian Historic and Geographic Institute and the Brazilian National Library Foundation. In light of what was discovered through the study's development, we can consider accounting as a tool that is more active than passive and, therefore, as a tool that was used to support the slave regime. In essence, accounting was used to convert a human's qualitative attributes into a limited number of categories (age, gender, race, through which slaves were differentiated and monetized to facilitate commercial trafficking. We believe that accounting practices facilitated slave trading, conversion and exploitation, procedures that completely ignored qualitative and human dimensions of slavery. Opportunities for future studies on accounting in the slave period, as is the case of other oppressive regimes, are infinite, especially in the case of Brazil.

  20. Quality Control Charts in Large-Scale Assessment Programs

    Science.gov (United States)

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying

    2011-01-01

    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  1. 46 CFR 109.565 - Charts and nautical publications.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 109.565 Section 109... OPERATIONS Miscellaneous § 109.565 Charts and nautical publications. The master or person in charge of a self...) Notices to mariners. (f) Tide Tables. (g) Current Tables. (h) All other nautical publications necessary. 1...

  2. Multiple sclerosis documentation system (MSDS): moving from documentation to management of MS patients.

    Science.gov (United States)

    Ziemssen, Tjalf; Kempcke, Raimar; Eulitz, Marco; Großmann, Lars; Suhrbier, Alexander; Thomas, Katja; Schultheiss, Thorsten

    2013-09-01

    The long disease duration of multiple sclerosis and the increasing therapeutic options require a individualized therapeutic approach which should be carefully documented over years of observation. To switch from MS documentation to an innovative MS management, new computer- and internet-based tools could be implemented as we could demonstrate with the novel computer-based patient management system "multiple sclerosis management system 3D" (MSDS 3D). MSDS 3D allows documentation and management of visit schedules and mandatory examinations via defined study modules by integration of data input from various sources (patients, attending physicians and MS nurses). It provides forms for the documentation of patient visits as well as clinical and diagnostic findings. Information can be collected via interactive touch screens. Specific modules allow the management of highly efficacious treatments as natalizumab or fingolimod. MSDS can be used to transfer the documented data to databases as, e.g. the registry of the German MS society or REGIMS. MSDS has already been implemented successfully in clinical practice and is currently being evaluated in a multicenter setting. High-quality management and documentation are crucial for improvements in clinical practice and research work.

  3. An Assessment of Statistical Process Control-Based Approaches for Charting Student Evaluation Scores

    Science.gov (United States)

    Ding, Xin; Wardell, Don; Verma, Rohit

    2006-01-01

    We compare three control charts for monitoring data from student evaluations of teaching (SET) with the goal of improving student satisfaction with teaching performance. The two charts that we propose are a modified "p" chart and a z-score chart. We show that these charts overcome some of the shortcomings of the more traditional charts…

  4. Monitoring a PVC batch process with multivariate statistical process control charts

    NARCIS (Netherlands)

    Tates, A. A.; Louwerse, D. J.; Smilde, A. K.; Koot, G. L. M.; Berndt, H.

    1999-01-01

    Multivariate statistical process control charts (MSPC charts) are developed for the industrial batch production process of poly(vinyl chloride) (PVC). With these MSPC charts different types of abnormal batch behavior were detected on-line. With batch contribution plots, the probable causes of these

  5. Development of gamma exposure chart (Selenium-75) for Industrial Radiography Application

    International Nuclear Information System (INIS)

    Sapizah Rahim; Shaharudin Sayuti; Noorhazleena Azaman

    2011-01-01

    Radiographic exposure can be determined by either trial exposure, reference to previous data or using exposure chart. Without previous data, exposure chart is the easiest and economic way to achieve correct exposure. It will minimize re-shoot and time. This paper presents the development of gamma exposure chart for Selenium-75 source. Film radiography method has been chosen for this development using steel step wedge blocks. Agfa Structurix D7 films have been used during the exposure and the optical density of the films was measured by using X-Rite densitometer. Method of development of the chart is explained. The chart is tested on pipe and welded plate test sample and the results are discussed. (author)

  6. ELECTRICAL POWER SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    M. Maniyar

    2004-06-22

    The purpose of this revision of the System Description Document (SDD) is to establish requirements that drive the design of the electrical power system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience are design engineers. This type of SDD leads and follows the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential to performing the design process. This SDD follows the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to this system are obtained from ''Project Functional and Operational Requirements'' (F&OR) (Siddoway, 2003). Other requirements to support the design process have been taken from higher level requirements documents such as ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), the fire hazards analyses, and the preclosure safety analysis. The above mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canori and Leitner 2003) requirements. This SDD includes several appendices with supporting information. Appendix B lists key system charts, diagrams, drawings, and lists; and Appendix C is a list of system procedures.

  7. A computer-controlled conformal radiotherapy system. IV: Electronic chart

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; McShan, Daniel L.; Matrone, Gwynne M.; Weaver, Tamar A.; Lewis, James D.; Kessler, Marc L.

    1995-01-01

    Purpose: The design and implementation of a system for electronically tracking relevant plan, prescription, and treatment data for computer-controlled conformal radiation therapy is described. Methods and Materials: The electronic charting system is implemented on a computer cluster coupled by high-speed networks to computer-controlled therapy machines. A methodical approach to the specification and design of an integrated solution has been used in developing the system. The electronic chart system is designed to allow identification and access of patient-specific data including treatment-planning data, treatment prescription information, and charting of doses. An in-house developed database system is used to provide an integrated approach to the database requirements of the design. A hierarchy of databases is used for both centralization and distribution of the treatment data for specific treatment machines. Results: The basic electronic database system has been implemented and has been in use since July 1993. The system has been used to download and manage treatment data on all patients treated on our first fully computer-controlled treatment machine. To date, electronic dose charting functions have not been fully implemented clinically, requiring the continued use of paper charting for dose tracking. Conclusions: The routine clinical application of complex computer-controlled conformal treatment procedures requires the management of large quantities of information for describing and tracking treatments. An integrated and comprehensive approach to this problem has led to a full electronic chart for conformal radiation therapy treatments

  8. Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form

    Science.gov (United States)

    Moragianni, Vasiliki A.; Hacker, Michele R.; Craparo, Frank J.

    2013-01-01

    Objective Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution’s obstetrical record in August 2003. Methods A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form. The two groups were compared in terms of obstetric characteristics, neonatal outcomes and documentation components. Results Charts that included the standardized delivery form were more likely to contain documentation of estimated fetal weight (82.7% vs. 39.0% without the form, Pdystocia, and second stage duration. Conclusions Inclusion of a standardized form in the delivery record improves the rate of documentation of both shoulder dystocia-specific and general delivery components. PMID:22017330

  9. Application of CUSUM charts to detect lameness in a milking robot

    DEFF Research Database (Denmark)

    Pastell, Matti; Madsen, Henrik

    2008-01-01

    shown that the weight distribution between limbs changes when cow get lame. In this paper we suggest CUSUM charts to automatically detect lameness based on the measurements. CUSUM charts are statistical based control charts and are well suited for checking a measuring system in operation for any...

  10. The Usage of Time Series Control Charts for Financial Process Analysis

    Directory of Open Access Journals (Sweden)

    Kovářík Martin

    2012-09-01

    Full Text Available We will deal with financial proceedings of the company using methods of SPC (Statistical Process Control, specifically through time series control charts. The paper will outline the intersection of two disciplines which are econometrics and statistical process control. The theoretical part will discuss the methodology of time series control charts and in the research part there will be this methodology demonstrated in three case studies. The first study will focus on the regulation of simulated financial flows for a company by CUSUM control chart. The second study will involve the regulation of financial flows for a heteroskedastic financial process by EWMA control chart. The last case study of our paper will be devoted to applications of ARIMA, EWMA and CUSUM control charts in the financial data that are sensitive to the mean shifting while calculating the autocorrelation in the data. In this paper, we highlight the versatility of control charts not only in manufacturing but also in managing the financial stability of cash flows.

  11. Growth charts for Australian children with achondroplasia.

    Science.gov (United States)

    Tofts, Louise; Das, Sandeep; Collins, Felicity; Burton, Karen L O

    2017-08-01

    Achondroplasia is an autosomal dominant disorder, the most common genetic cause of short stature in humans. Reference curves for head circumference, weight, height, and BMI are needed in clinical practice but none exist for the Australian population. This study aimed to produce head circumference, height, weight, and BMI reference percentile curves for Australian children and adolescents with achondroplasia. Measurements of head circumference, height and weight taken at clinical visits were retrospectively extracted from the electronic medical record. Age was corrected for prematurity. Patients were excluded from head circumference analysis if they had significant neurosurgical complications and from the weight and BMI analysis when they had a clinical diagnosis of overweight. Measurements were available on 138 individuals (69 males and 69 females) taken between 1970 and 2015, with over 50% collected since 2005. A total of 3,352 data points were available. The LMS method was used to produce growth charts with estimated centiles (10, 25, 50, 75, and 90th) separately for males and females. For females birth weight was 3 kg (2.5-3.5 kg), birth length 48 cm (44-50 cm) and head circumference 37.5 cm (36-39 cm), adult height was 125 cm (116-132 cm), weight 42 kg (34-54 kg), and head circumference 58 cm (55.5-60.5 cm) all 50th centile (10-90th). For males birth weight was 3.5 kg (3-4 kg), length 49 cm (46-52 cm) and head circumference 38.5 cm (36-41 cm), adult height was 134 cm (125-141 cm), weight 41 kg (24.5-57 kg) and head circumference 61 cm (58-64 cm). The curves are similar to previously published reference data from the USA and have expected population wide variation from curves from an Argentinian population. Despite limitations of our curves for adolescents (12 years and older) due to data paucity, these Australian growth charts for children and adolescents with achondroplasia will be a useful reference in clinical

  12. Unfair commercial practices in european and czech legal regulations and in practice of the courts

    OpenAIRE

    Štouračová, Vanda

    2010-01-01

    The bachelor thesis deals with charting of unfair commercial practices on consumer. Initially there are described unfair commercial practices in legal regulations of EU and Czech Republic and distinguished into misleading and agressive practices. There is also included description of misleading advertising. Besides unfair commercial practices there are described businessunlike commercial practices boundaring with legal regulations. Lastly there are stated chosen European and Czech court decis...

  13. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    Roy, S.

    2004-01-01

    The purpose of this revision of the System Design Description (SDD) is to establish requirements that drive the design of the electrical support system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience/users are design engineers. This type of SDD both ''leads'' and ''trails'' the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD trails the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to electrical support systems are obtained from the ''Project Functional and Operational Requirements'' (F andOR) (Siddoway 2003). Other requirements to support the design process have been taken from higher-level requirements documents such as the ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), and fire hazards analyses. The above-mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canon and Leitner 2003) requirements. This SDD contains several appendices that include supporting information. Appendix B lists key system charts, diagrams, drawings, and lists, and Appendix C includes a list of system procedures

  14. Blinded with Science or Informed by Charts? A Replication Study

    OpenAIRE

    Dragicevic , Pierre; Jansen , Yvonne

    2018-01-01

    International audience; We provide a reappraisal of Tal and Wansink's study "Blinded with Science" , where seemingly trivial charts were shown to increase belief in drug efficacy, presumably because charts are associated with science. Through a series of four replications conducted on two crowdsourcing platforms, we investigate an alternative explanation, namely, that the charts allowed participants to better assess the drug's efficacy. Considered together, our experiments suggest that the ch...

  15. Inland Electronic Navigational Charts (IENC)

    Data.gov (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — These Inland Electronic Navigational Charts (IENCs) were developed from available data used in maintenance of Navigation channels. Users of these IENCs should be...

  16. NOAA Electronic Navigational Charts (ENC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey (OCS) has been involved in the development of a NOAA Electronic Navigational Chart (NOAA ENC) suite to support the marine transportation...

  17. System Behaviour Charts Inform an Understanding of Biodiversity Recovery

    Directory of Open Access Journals (Sweden)

    Simon A. Black

    2015-01-01

    Full Text Available Practitioners working with species and ecosystem recovery typically deal with the complexity of, on one hand, lack of data or data uncertainties and, on the other hand, demand for critical decision-making and intervention. The control chart methods of commercial and industrial and environmental monitoring can complement an ecological understanding of wildlife systems including those situations which incorporate human activities and land use. Systems Behaviour Charts are based upon well-established control chart methods to provide conservation managers with an approach to using existing data and enable insight to aid timely planning of conservation interventions and also complement and stimulate research into wider scientific and ecological questions. When the approach is applied to existing data sets in well-known wildlife conservation cases, the subsequent Systems Behaviour Charts and associated analytical criteria demonstrate insights which would be helpful in averting problems associated with each case example.

  18. Detecting SYN flood attacks via statistical monitoring charts: A comparative study

    KAUST Repository

    Bouyeddou, Benamar

    2017-12-14

    Accurate detection of cyber-attacks plays a central role in safeguarding computer networks and information systems. This paper addresses the problem of detecting SYN flood attacks, which are the most popular Denial of Service (DoS) attacks. Here, we compare the detection capacity of three commonly monitoring charts namely, a Shewhart chart, a Cumulative Sum (CUSUM) control chart and exponentially weighted moving average (EWMA) chart, in detecting SYN flood attacks. The comparison study is conducted using the publicly available benchmark datasets: the 1999 DARPA Intrusion Detection Evaluation Datasets.

  19. The use of principal components and univariate charts to control multivariate processes

    Directory of Open Access Journals (Sweden)

    Marcela A. G. Machado

    2008-04-01

    Full Text Available In this article, we evaluate the performance of the T² chart based on the principal components (PC X chart and the simultaneous univariate control charts based on the original variables (SU charts or based on the principal components (SUPC charts. The main reason to consider the PC chart lies on the dimensionality reduction. However, depending on the disturbance and on the way the original variables are related, the chart is very slow in signaling, except when all variables are negatively correlated and the principal component is wisely selected. Comparing the SU , the SUPC and the T² charts we conclude that the SU X charts (SUPC charts have a better overall performance when the variables are positively (negatively correlated. We also develop the expression to obtain the power of two S² charts designed for monitoring the covariance matrix. These joint S² charts are, in the majority of the cases, more efficient than the generalized variance chart.Neste artigo, avaliamos o desempenho do gráfico de T² baseado em componentes principais (gráfico PC e dos gráficos de controle simultâneos univariados baseados nas variáveis originais (gráfico SU X ou baseados em componentes principais (gráfico SUPC. A principal razão para o uso do gráfico PC é a redução de dimensionalidade. Entretanto, dependendo da perturbação e da correlação entre as variáveis originais, o gráfico é lento em sinalizar, exceto quando todas as variáveis são negativamente correlacionadas e a componente principal é adequadamente escolhida. Comparando os gráficos SU X, SUPC e T² concluímos que o gráfico SU X (gráfico SUPC tem um melhor desempenho global quando as variáveis são positivamente (negativamente correlacionadas. Desenvolvemos também uma expressão para obter o poder de detecção de dois gráficos de S² projetados para controlar a matriz de covariâncias. Os gráficos conjuntos de S² são, na maioria dos casos, mais eficientes que o gr

  20. Gulf of Mexico IFR Aeronautical Chart Index - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The IFR Enroute Aeronautical Chart series is designed to meet the needs of users who require a digital version chart. This is the visual index to the charts for the...

  1. Proposed colour banded early warning observation charts for South ...

    African Journals Online (AJOL)

    Introduction of a colour banded observation chart should be combined with a clear communication strategy. The process should be used to change the organisational culture to be more proactive in initiating early intervention to reduce the burden of unintended complications. Keywords: Observation chart; Physiology; ...

  2. Computer programs to make a Chart of the nuclides for WWW

    International Nuclear Information System (INIS)

    Nakagawa, Tsuneo; Katakura, Jun-ichi; Horiguchi, Takayoshi

    1999-06-01

    Computer programs to make a chart of the nuclides for World Wide Web (WWW) have been developed. The programs make a data file for WWW chart of the nuclides from a data file containing nuclide information in the format similar to ENSDF, by filling unknown half-lives with calculated ones. Then, the WWW chart of the nuclides in the gif format is created from the data file. The programs to make html files and image map files, to select a chart of selected nuclides, and to show various information of nuclides are included in the system. All the programs are written in C language. This report describes the formats of files, the programs and 1998 issue of Chart of the Nuclides made by means of the present programs. (author)

  3. Constructing an exposure chart: step by step (based on standard procedures)

    International Nuclear Information System (INIS)

    David, Jocelyn L; Cansino, Percedita T.; Taguibao, Angileo P.

    2000-01-01

    An exposure chart is very important in conducting radiographic inspection of materials. By using an accurate exposure chart, an inspector is able to avoid a trial and error way of determining correct time to expose a specimen, thereby producing a radiograph that has an acceptable density based on a standard. The chart gives the following information: x-ray machine model and brand, distance of the x-ray tube from the film, type and thickness of intensifying screens, film type, radiograph density, and film processing conditions. The methods of preparing an exposure chart are available in existing radiographic testing manuals. These described methods are presented in step by step procedures, covering the actual laboratory set-up, data gathering, computations, and transformation of derived data into Characteristic Curve and Exposure Chart

  4. Growth charts for children with Ellis–van Creveld syndrome

    Science.gov (United States)

    Eilers, Paul H. C.; Lawrence, Kate; Hennekam, Raoul C. M.; Versteegh, Florens G. A.

    2010-01-01

    Ellis–van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlier review of growth data in EvC, a database of EvC patients, and from recent literature. To model the growth charts, the GAMLSS package for the R statistical program was used. Height of EvC patients was compared to healthy children using Dutch growth charts. Data are presented both on a scale for age and on a scale for the square root of age. Compared to healthy Dutch children, mean height standard deviation score values for male and female EvC patients were −3.1 and −3.0, respectively. The present growth charts should be useful in the follow-up of EvC patients. Most importantly, early detection of growth hormone deficiency, known to occur in EvC, will be facilitated. PMID:20830486

  5. Growth charts for children with Ellis-van Creveld syndrome.

    Science.gov (United States)

    Verbeek, Sabine; Eilers, Paul H C; Lawrence, Kate; Hennekam, Raoul C M; Versteegh, Florens G A

    2011-02-01

    Ellis-van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlier review of growth data in EvC, a database of EvC patients, and from recent literature. To model the growth charts, the GAMLSS package for the R statistical program was used. Height of EvC patients was compared to healthy children using Dutch growth charts. Data are presented both on a scale for age and on a scale for the square root of age. Compared to healthy Dutch children, mean height standard deviation score values for male and female EvC patients were -3.1 and -3.0, respectively. The present growth charts should be useful in the follow-up of EvC patients. Most importantly, early detection of growth hormone deficiency, known to occur in EvC, will be facilitated.

  6. WE-AB-201-02: TPS Commissioning and QA: A Process Orientation and Application of Control Charts

    International Nuclear Information System (INIS)

    Sharpe, M.

    2015-01-01

    . The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations

  7. WE-AB-201-02: TPS Commissioning and QA: A Process Orientation and Application of Control Charts

    Energy Technology Data Exchange (ETDEWEB)

    Sharpe, M. [The Princess Margaret Cancer Centre - UHN (Canada)

    2015-06-15

    . The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.

  8. Control charts for location based on different sampling schemes

    NARCIS (Netherlands)

    Mehmood, R.; Riaz, M.; Does, R.J.M.M.

    2013-01-01

    Control charts are the most important statistical process control tool for monitoring variations in a process. A number of articles are available in the literature for the X̄ control chart based on simple random sampling, ranked set sampling, median-ranked set sampling (MRSS), extreme-ranked set

  9. Three-Dimensional Nuclear Chart--Understanding Nuclear Physics and Nucleosynthesis in Stars

    Science.gov (United States)

    Koura, Hiroyuki

    2014-01-01

    Three-dimensional (3D) nuclear charts were created using toy blocks, which represent the atomic masses per nucleon number and the total half-lives for each nucleus in the entire region of the nuclear mass. The bulk properties of the nuclei can be easily understood by using these charts. Subsequently, these charts were used in outreach activities…

  10. Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2011-06-01

    Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

  11. Changing Landscapes in Documentation Efforts: Civil Society Documentation of Serious Human Rights Violations

    Directory of Open Access Journals (Sweden)

    Brianne McGonigle Leyh

    2017-04-01

    Full Text Available Wittingly or unwittingly, civil society actors have long been faced with the task of documenting serious human rights violations. Thirty years ago, such efforts were largely organised by grassroots movements, often with little support or funding from international actors. Sharing information and best practices was difficult. Today that situation has significantly changed. The purpose of this article is to explore the changing landscape of civil society documentation of serious human rights violations, and what that means for standardising and professionalising documentation efforts. Using the recent Hisséne Habré case as an example, this article begins by looking at how civil society documentation can successfully influence an accountability process. Next, the article touches upon barriers that continue to impede greater documentation efforts. The article examines the changing landscape of documentation, focusing on technological changes and the rise of citizen journalism and unofficial investigations, using Syria as an example, as well as on the increasing support for documentation efforts both in Syria and worldwide. The changing landscape has resulted in the proliferation of international documentation initiatives aimed at providing local civil society actors guidelines and practical assistance on how to recognise, collect, manage, store and use information about serious human rights violations, as well as on how to minimise the risks associated with the documentation of human rights violations. The recent initiatives undertaken by international civil society, including those by the Public International Law & Policy Group, play an important role in helping to standardise and professionalise documentation work and promote the foundational principles of documentation, namely the ‘do no harm’ principle, and the principles of informed consent and confidentiality. Recognising the drawback that greater professionalisation may bring, it

  12. 14 CFR Section 3 - Chart of Balance Sheet Accounts

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Chart of Balance Sheet Accounts Section 3 Section 3 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION... Balance Sheet Classifications Section 3 Chart of Balance Sheet Accounts [See footnotes at end of table...

  13. Toward developing a standardized Arabic continuous text reading chart.

    Science.gov (United States)

    Alabdulkader, Balsam; Leat, Susan Jennifer

    Near visual acuity is an essential measurement during an oculo-visual assessment. Short duration continuous text reading charts measure reading acuity and other aspects of reading performance. There is no standardized version of such chart in Arabic. The aim of this study is to create sentences of equal readability to use in the development of a standardized Arabic continuous text reading chart. Initially, 109 Arabic pairs of sentences were created for use in constructing a chart with similar layout to the Colenbrander chart. They were created to have the same grade level of difficulty and physical length. Fifty-three adults and sixteen children were recruited to validate the sentences. Reading speed in correct words per minute (CWPM) and standard length words per minute (SLWPM) was measured and errors were counted. Criteria based on reading speed and errors made in each sentence pair were used to exclude sentence pairs with more outlying characteristics, and to select the final group of sentence pairs. Forty-five sentence pairs were selected according to the elimination criteria. For adults, the average reading speed for the final sentences was 166 CWPM and 187 SLWPM and the average number of errors per sentence pair was 0.21. Childrens' average reading speed for the final group of sentences was 61 CWPM and 72 SLWPM. Their average error rate was 1.71. The reliability analysis showed that the final 45 sentence pairs are highly comparable. They will be used in constructing an Arabic short duration continuous text reading chart. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  14. Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.

    Science.gov (United States)

    Narayanan, Jaishree; Dobrin, Sofia; Choi, Janet; Rubin, Susan; Pham, Anna; Patel, Vimal; Frigerio, Roberta; Maurer, Darryck; Gupta, Payal; Link, Lourdes; Walters, Shaun; Wang, Chi; Ji, Yuan; Maraganore, Demetrius M

    2017-01-01

    Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index. The tools summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments. The tools provide Best Practices Advisories and other clinical decision support when appropriate. The tools prompt enrollment in a DNA biobanking study. We have thus far enrolled 231 patients for initial visits and are starting our first annual follow-up visits and provide a brief description of our cohort. We are sharing these EMR tools and captured data with other epilepsy clinics as part of a Neurology Practice Based Research Network, and are using the tools to conduct pragmatic trials using subgroup-based adaptive designs. © 2016 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

  15. Borehole DC-12 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-12. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  16. Borehole DC-14 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-14. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  17. Borehole DC-15 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-15. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  18. Subtle Nonlinearity in Popular Album Charts

    Science.gov (United States)

    Bentley, R. Alexander; Maschner, Herbert D. G.

    Large-scale patterns of culture change may be explained by models of self organized criticality, or alternatively, by multiplicative processes. We speculate that popular album activity may be similar to critical models of extinction in that interconnected agents compete to survive within a limited space. Here we investigate whether popular music albums as listed on popular album charts display evidence of self-organized criticality, including a self-affine time series of activity and power-law distributions of lifetimes and exit activity in the chart. We find it difficult to distinguish between multiplicative growth and critical model hypotheses for these data. However, aspects of criticality may be masked by the selective sampling that a "Top 200" listing necessarily implies.

  19. Monitoring and documentation of side effects from depot antipsychotic medication: an interdisciplinary audit of practice in a regional mental health service.

    LENUS (Irish Health Repository)

    Cleary, A

    2012-01-01

    The aim of this audit was to review current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. Following a review of the literature on best practice internationally, an evidence based audit tool was adapted. A sample of 60 case files, care plans and prescriptions were audited between January and May 2010. This represented 31% of the total number of service users receiving depot injections in the mental health service region (n=181). The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only 5 (8%) case notes examined had documentation recorded describing the condition of the injection site and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded, and only 3 (5%) of case notes had documented that information on the depot injection and side effects was given. In 57 (95%) of case notes no documentation of recorded information on the depot and on side effects was given. Documentation of physical observations and tests revealed that 58% of cases had full blood count, liver function tests, thyroid function tests and fasting lipids recorded. All other tests (i.e. temperature, pulse, respirations, blood pressure, ECG) were recorded in less than 50% of cases. Prolactin levels were not recorded in any case. The lack of written consent was partly attributed to lack of recording of consent. The failure to monitor and record some\\r\

  20. Practical challenges related to point of care testing.

    Science.gov (United States)

    Shaw, Julie L V

    2016-04-01

    Point of care testing (POCT) refers to laboratory testing that occurs near to the patient, often at the patient bedside. POCT can be advantageous in situations requiring rapid turnaround time of test results for clinical decision making. There are many challenges associated with POCT, mainly related to quality assurance. POCT is performed by clinical staff rather than laboratory trained individuals which can lead to errors resulting from a lack of understanding of the importance of quality control and quality assurance practices. POCT is usually more expensive than testing performed in the central laboratory and requires a significant amount of support from the laboratory to ensure the quality testing and meet accreditation requirements. Here, specific challenges related to POCT compliance with accreditation standards are discussed along with strategies that can be used to overcome these challenges. These areas include: documentation of POCT orders, charting of POCT results as well as training and certification of individuals performing POCT. Factors to consider when implementing connectivity between POCT instruments and the electronic medical record are also discussed in detail and include: uni-directional versus bidirectional communication, linking patient demographic information with POCT software, the importance of positive patient identification and considering where to chart POCT results in the electronic medical record.

  1. Overgeneration from Solar Energy in California. A Field Guide to the Duck Chart

    Energy Technology Data Exchange (ETDEWEB)

    Denholm, Paul [National Renewable Energy Lab. (NREL), Golden, CO (United States); O' Connell, Matthew [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brinkman, Gregory [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jorgenson, Jennie [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-11-01

    In 2013, the California Independent System Operator published the 'duck chart,' which shows a significant drop in mid-day net load on a spring day as solar photovoltaics (PV) are added to the system. The chart raises concerns that the conventional power system will be unable to accommodate the ramp rate and range needed to fully utilize solar energy, particularly on days characterized by the duck shape. This could result in 'overgeneration' and curtailed renewable energy, increasing its costs and reducing its environmental benefits. This paper explores the duck chart in detail, examining how much PV might need to be curtailed if additional grid flexibility measures are not taken, and how curtailment rates can be decreased by changing grid operational practices. It finds that under "business-as-usual"" types of assumptions and corresponding levels of grid flexibility in California, solar penetrations as low as 20% of annual energy could lead to marginal curtailment rates that exceed 30%. However, by allowing (or requiring) distributed PV and storage (including new installations that are part of the California storage mandate) to provide grid services, system flexibility could be greatly enhanced. Doing so could significantly reduce curtailment and allow much greater penetration of variable generation resources. Overall, the work described in this paper points to the need to fully integrate distributed resources into grid system planning and operations to allow maximum use of the solar resource.

  2. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    S. Roy

    2004-06-24

    The purpose of this revision of the System Design Description (SDD) is to establish requirements that drive the design of the electrical support system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience/users are design engineers. This type of SDD both ''leads'' and ''trails'' the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD trails the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to electrical support systems are obtained from the ''Project Functional and Operational Requirements'' (F&OR) (Siddoway 2003). Other requirements to support the design process have been taken from higher-level requirements documents such as the ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), and fire hazards analyses. The above-mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canon and Leitner 2003) requirements. This SDD contains several appendices that include supporting information. Appendix B lists key system charts, diagrams, drawings, and lists, and Appendix C includes a list of system procedures.

  3. Overview of the consortium of hospitals advancing research on tobacco (chart

    Directory of Open Access Journals (Sweden)

    Riley William T

    2012-08-01

    Full Text Available Abstract Background The Consortium of Hospitals Advancing Research on Tobacco (CHART is a network of six projects and a research coordinating unit funded by the National Heart, Lung, and Blood Institute, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institutes of Health (NIH Office of Behavioral and Social Science Research. The CHART projects will assess the effectiveness and cost-effectiveness of smoking cessation interventions initiated during hospitalization and continued post-discharge. Methods/design Along with a seventh project funded previously under the NIH Challenge grants, the CHART projects will assess smoking cessation strategies delivered to approximately 10,000 hospitalized smokers across a geographically diverse group of nearly 20 private, public, academic, and community hospitals. The CHART research coordinating unit at Kaiser Permanente Center for Health Research provides organizational and data coordination support, facilitating the development of common measures for combining data from multiple CHART projects. Discussion The targeted enrollment in CHART, if achieved, will represent the largest, most diverse pooled dataset of hospitalized smokers receiving smoking cessation assistance, and is designed to contribute to the dissemination and implementation of smoking cessation interventions provided by hospital systems.

  4. Arctic Sea Ice Charts from Danish Meteorological Institute, 1893 - 1956

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — From 1893 to 1956, the Danish Meteorological Institute (DMI) created charts of observed and inferred sea ice extent for each summer month. These charts are based on...

  5. 46 CFR 97.05-5 - Charts and nautical publications.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 97.05-5 Section 97.05... OPERATIONS Notice to Mariners and Aids to Navigation § 97.05-5 Charts and nautical publications. As... tables; (g) Current tables; and (h) All other nautical publications necessary. 1 1 For United States...

  6. Improving nurse documentation and record keeping in stoma care.

    Science.gov (United States)

    Law, Lesley; Akroyd, Karen; Burke, Linda

    Evidence suggests that nurse documentation is often inconsistent and lacks a coherent and standardized approach. This article reports on research into the use of nurse documentation on a stoma care ward in a large London hospital, and explores the factors that may affect the process of record keeping by nursing staff. This study uses stoma care as a case study to explore the role of documentation on the ward, focusing on how this can be improved. It is based on quantitative and qualitative methods. The medical notes of 56 patients were analysed and in addition, focus groups with a number of nurses were undertaken. Quantitative findings indicate that although 80% of patients had a chart filed in their medical notes, only a small portion of the form was completed by nursing staff. Focus group findings indicate that this is because forms lacked standardization and because the language used was often ambiguous. Staff also felt that such documentation was not viewed by other nurses and so, was not effective in improving patient care. As a result of this study, significant improvements have been made to documentation used on the stoma care ward. This is an important exploration of record keeping within nursing in the context of the Nursing and Midwifery Council's emphasis on the importance of documentation in achieving effective patient outcomes.

  7. Documentation of torture victims, assessment of the start procedure for medico-legal documentation.

    Science.gov (United States)

    Mandel, Lene; Worm, Lise

    2007-01-01

    A Pilot Study was performed at the Rehabilitation and Research Centre for Torture Victims (RCT) in Copenhagen in order to explore the possibilities for adding a medico-legal documentation component to the rehabilitation of torture victims already taking place. It describes the process and results on implementing medico-legal documentation in a rehabilitative setting. A modified version of the Guidelines in the Istanbul Protocol was developed on the basis of the review of literature and current practices described in "Documentation of torture victims, implementation of medico-legal protocols". The modified guidelines were tested on five clients. The aim was twofold: 1) To assess the client's attitude towards the idea of adding a documentation component to the rehabilitation process and: 2) To assess the practical circumstances of implementing the Istanbul Protocol in the everyday life of a rehabilitation centre. Results show that all five clients were positive towards the project and found comfort in being able to contribute to the fight against impunity. Also, the Pilot Study demonstrated that a large part of the medico-legal documentation was already obtained in the rehabilitation process. It was however not accessible due to lack of systematization and a data registering system. There are thus important synergies in collecting data for rehabilitation and documentation but a joint database system is necessary to realize these synergies.

  8. Translation of clinical practice guidelines for childhood obesity prevention in primary care mobilizes a rural Midwest community.

    Science.gov (United States)

    Gibson, S Jo

    2016-03-01

    The purpose of this project was to implement clinic system changes that support evidence-based guidelines for childhood obesity prevention. Adherence rates for prevention and screening of children in a rural Midwest primary care setting were used to measure the success of the program. Retrospective chart reviews reflected gaps in current practice and documentation. An evidence-based toolkit for childhood obesity prevention was used to implement clinic system changes for the identified gaps. The quality improvement approach proved to be effective in translating knowledge of obesity prevention guidelines into rural clinic practices with significant improvements in documentation of prevention measures that may positively impact the childhood obesity epidemic. Primary care providers, including nurse practitioners (NPs), are at the forefront of diagnosing, educating, and counseling children and families on obesity prevention and need appropriate resources and tools to deliver premier care. The program successfully demonstrated how barriers to practice, even with the unique challenges in a rural setting, can be overcome. NPs fulfill a pivotal primary care role and can provide leadership that may positively impact obesity prevention in their communities. ©2015 American Association of Nurse Practitioners.

  9. Areva reference document 2007; Areva document de reference 2007

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains also information on the markets, market shares and competitive position of the AREVA group. Content: 1 - Person responsible for the reference document and persons responsible for auditing the financial statements; 2 - Information pertaining to the transaction (not applicable); 3 - General information on the company and its share capital: Information on Areva, Information on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; 4 - Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts 140 Principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and Development programs, Intellectual Property and Trademarks, Risk and insurance; 5 - Assets financial position financial performance: Analysis of and comments on the group's financial position and performance, Human Resources report, Environmental report, Consolidated financial statements 2007, Notes to the consolidated financial statements, Annual financial statements 2007, Notes to the corporate financial statements; 6 - Corporate governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Ordinary General Meeting of Shareholders of April 17, 2008; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2007, Outlook; Glossary; table of concordance.

  10. Areva, reference document 2006; Areva, document de reference 2006

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains information on the markets, market shares and competitive position of the AREVA group. Content: - 1 Person responsible for the reference document and persons responsible for auditing the financial statements; - 2 Information pertaining to the transaction (Not applicable); - 3 General information on the company and its share capital: Information on AREVA, on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; - 4 Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts, The principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and development programs, intellectual property and trademarks, Risk and insurance; - 5 Assets - Financial position - Financial performance: Analysis of and comments on the group's financial position and performance, 2006 Human Resources Report, Environmental Report, Consolidated financial statements, Notes to the consolidated financial statements, AREVA SA financial statements, Notes to the corporate financial statements; 6 - Corporate Governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Combined General Meeting of Shareholders of May 3, 2007; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2006, Outlook; 8 - Glossary; 9 - Table of concordance.

  11. Assessing the Effect of an Educational Intervention on Nurses' and Patient Care Assistants' Comprehension and Documentation of Functional Ability in Pediatric Patients with Sickle Cell Disease.

    Science.gov (United States)

    Bernier, Katherine M; Strobel, Megan; Lucas, Ruth

    2018-04-13

    In 2014, the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) was developed to investigate patient's self-rated functional ability during times of acute pain in the inpatient clinical setting. Although it has great potential, the application of this tool has not been made a standard of care. The purpose of this multiple methods study was to determine if, through an educational intervention, hospital staff could consistently document the YAPFAQ in children with sickle cell disease (SCD) during a vaso-occlusive episode. Twenty-two staff members participated in an educational intervention and semi-structured group discussions. Pre/post surveys measured knowledge of the YAPFAQ before and after the intervention. Group discussions were recorded, transcribed verbatim, and analyzed for thematic clusters. Retrospective chart reviews of children with SCD were reviewed for YAPFAQ documentation frequency before and after the intervention. Staff knowledge of who completes the YAPFAQ increased after the intervention, (pcontinues to hold high potential for directing nursing care, but requires staff investment for clinical practice change. A seamless integration between nursing education and translation through EHR is recommended as technology continues to integrate into nursing practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. 46 CFR 26.03-4 - Charts and nautical publications.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Charts and nautical publications. 26.03-4 Section 26.03... Operating Requirements § 26.03-4 Charts and nautical publications. (a) As appropriate for the intended... navigation possible; (2) “U.S. Coast Pilot” or similar publication; (3) Coast Guard light list; (4) Tide...

  13. Safe Minimum Internal Temperature Chart

    Science.gov (United States)

    ... Internal Temperature Chart Safe steps in food handling, cooking, and storage are essential in preventing foodborne illness. You can't see, smell, or taste harmful bacteria that may cause illness. In every step of food preparation, follow the four guidelines to keep food safe: ...

  14. Geo structural chart of Uruguay. Scale 1/2.000.000

    International Nuclear Information System (INIS)

    Preciozzi, F.; Spoturno, F.; Heinzen, W.

    1979-01-01

    This work is about the Geo-Structural Chart of Uruguay , Esca le 1 / 2,000,000. The geological information synthesis in the country, obtained from: published geological work or whose information is registered by laboratory work and geophysical surveys. This Chart will allow an overview of the degree of geological knowledge of Uruguay, restricted to the limits imposed by the scale of this work. The realization of this Chart included a thorough and careful compilation, critical analysis, standardization and interpretation of all geological and geophysical maps available in the country

  15. HOTELLING'S T2 CONTROL CHARTS BASED ON ROBUST ESTIMATORS

    Directory of Open Access Journals (Sweden)

    SERGIO YÁÑEZ

    2010-01-01

    Full Text Available Under the presence of multivariate outliers, in a Phase I analysis of historical set of data, the T 2 control chart based on the usual sample mean vector and sample variance covariance matrix performs poorly. Several alternative estimators have been proposed. Among them, estimators based on the minimum volume ellipsoid (MVE and the minimum covariance determinant (MCD are powerful in detecting a reasonable number of outliers. In this paper we propose a T 2 control chart using the biweight S estimators for the location and dispersion parameters when monitoring multivariate individual observations. Simulation studies show that this method outperforms the T 2 control chart based on MVE estimators for a small number of observations.

  16. Time contour expression of limited range phenomena on stack chart; Jugo chart jo deno kyokuchi gensho jikan contour

    Energy Technology Data Exchange (ETDEWEB)

    Kametani, T

    1997-05-27

    Time contour expression of limited range phenomena on stack chart is examined for further improvement on the result of the ultimate interpretation in the seismic reflection survey. The policy is made clear from the beginning that local phenomena are to be discussed, and data prior CMP stacking is interpreted in detail. For this purpose, it is effective to make use of the time contour expression in the midpoint-offset plane simultaneously with the CMP and COP panels. For the review of data prior to CMP stacking, it is convenient to use the CMP (CDP) stacking chart in which the data is arranged methodically. In this chart, all the channels which are crude data prior to stacking are plotted on midpoint-offset coordinates, which plane is called the MOD (Midpoint Offset Domain) panel. Various panels can be chosen unrestrictedly, and their mutual relations can be easily grasped. When data points are given a time axis, they can be expressed in a time contour. Studies are conducted about the underground structure, multiple reflection paths divided by it, and characteristics of detour reflection attributable to faults. 4 refs., 9 figs.

  17. A design chart for long vacuum pipes and shells

    International Nuclear Information System (INIS)

    Krempetz, K.; Grimson, J.; Kelly, P.

    1986-01-01

    This paper presents a design chart to aid designers in the selection of a wall thickness for long cylindrical shells having atmospheric pressure outside the shell and a pressure less than atmospheric inside the shell. The chart indicates a conservative value for the minimum wall thickness for a given shell diameter and material when the shell is completely evacuated

  18. 46 CFR 78.05-5 - Charts and nautical publications.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Charts and nautical publications. 78.05-5 Section 78.05... Notice to Mariners and Aids to Navigation § 78.05-5 Charts and nautical publications. As appropriate for... publications necessary. 1 1 For United States vessels in or on the navigable waters of the United States, see...

  19. Borehole DC-6 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart for Borehole DC-6 identifies the basic stratigraphy and preliminary hydrologic test results. This borehole was cored for obtaining stratigraphic data and only that portion within the Grande Ronde formation remains open for hydrologic testing. The upper two formations were cased and cemented off

  20. About the National Forecast Chart

    Science.gov (United States)

    code. Press enter or select the go button to submit request Local forecast by "City, St" or Prediction Center on Twitter NCEP Quarterly Newsletter WPC Home Analyses and Forecasts National Forecast to all federal, state, and local government web resources and services. The National Forecast Charts

  1. Data analytics and parallel-coordinate materials property charts

    Science.gov (United States)

    Rickman, Jeffrey M.

    2018-01-01

    It is often advantageous to display material properties relationships in the form of charts that highlight important correlations and thereby enhance our understanding of materials behavior and facilitate materials selection. Unfortunately, in many cases, these correlations are highly multidimensional in nature, and one typically employs low-dimensional cross-sections of the property space to convey some aspects of these relationships. To overcome some of these difficulties, in this work we employ methods of data analytics in conjunction with a visualization strategy, known as parallel coordinates, to represent better multidimensional materials data and to extract useful relationships among properties. We illustrate the utility of this approach by the construction and systematic analysis of multidimensional materials properties charts for metallic and ceramic systems. These charts simplify the description of high-dimensional geometry, enable dimensional reduction and the identification of significant property correlations and underline distinctions among different materials classes.

  2. Development of a fetal weight chart using serial trans-abdominal ultrasound in an East African population

    DEFF Research Database (Denmark)

    Schmiegelow, Christentze; Scheike, Thomas; Oesterholt, Mayke

    2012-01-01

    OBJECTIVE: To produce a fetal weight chart representative of a Tanzanian population, and compare it to weight charts from Sub-Saharan Africa and the developed world. METHODS: A longitudinal observational study in Northeastern Tanzania. Pregnant women were followed throughout pregnancy with serial...... trans-abdominal ultrasound. All pregnancies with pathology were excluded and a chart representing the optimal growth potential was developed using fetal weights and birth weights. The weight chart was compared to a chart from Congo, a chart representing a white population, and a chart representing...... a white population but adapted to the study population. The prevalence of SGA was assessed using all four charts. RESULTS: A total of 2193 weight measurements from 583 fetuses/newborns were included in the fetal weight chart. Our chart had lower percentiles than all the other charts. Most importantly...

  3. Interactive Financial Charts- Agency Financial Reports

    Data.gov (United States)

    General Services Administration — For a visual depiction of GSA's Balance Sheet and Statement of Net Cost, please use the interactive charts to view the financial results for fiscal years 2007-2013.

  4. Development of mild steel exposure chart for neutron radiography application

    International Nuclear Information System (INIS)

    Hafizal Yazid; Rafhayudi Jamro; Hishamuddin Husain; Muhammad Rawi Mohd Zin; Razali Kassim; Abd Aziz Mohamed; Azali Muhammad

    2004-01-01

    A neutron radiography exposure chart for mild steel was developed to facilitate the determination of exposure time when producing neutron radiographs for any given mild steel thickness. A mild steel sample in the form of step wedge (1-10 mm thick) was exposed to thermal neutron using Direct technique. This technique involves exposing x-ray film-Gadolinium converter housed in one film cassette simultaneously to thermal neutron beam. Gadolinium converters with thickness of 0.025 mm and 0.5 mm were used to observe the effect of converter thickness on radiographic density and exposure time. Collected radiographic density data is then calculated based on manufacturer's film characteristic chart and finally exposure chart for mild steel was plotted. This chart could later be used as a guide for estimating exposure time for any given sample thickness providing other conditions are similar (material, film processing, neutron flux, film density and converter thickness). (Author)

  5. Cartographic Rules and Differences in Nautical Data Visualization on Paper and Electronic Nautical Charts

    Directory of Open Access Journals (Sweden)

    Tea Duplančić Leder

    2013-04-01

    Full Text Available This paper aims to present cartographic rules for the production of paper and electronic navigational charts and main differences in compilation, visualisation and representation of nautical information. Major differences between paper nautical charts and ENC are visualisation of nautical data: colour mixing, resolution of represented nautical objects, human control of display representation and fonts and signatures and chart content are described. It is concluded that electronic navigational charts have many advantages and few shortcomings to paper navigational charts.

  6. Person-centred care in nursing documentation.

    LENUS (Irish Health Repository)

    Broderick, Margaret C

    2012-12-07

    BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation

  7. Statistical Control Charts: Performances of Short Term Stock Trading in Croatia

    Directory of Open Access Journals (Sweden)

    Dumičić Ksenija

    2015-03-01

    Full Text Available Background: The stock exchange, as a regulated financial market, in modern economies reflects their economic development level. The stock market indicates the mood of investors in the development of a country and is an important ingredient for growth. Objectives: This paper aims to introduce an additional statistical tool used to support the decision-making process in stock trading, and it investigate the usage of statistical process control (SPC methods into the stock trading process. Methods/Approach: The individual (I, exponentially weighted moving average (EWMA and cumulative sum (CUSUM control charts were used for gaining trade signals. The open and the average prices of CROBEX10 index stocks on the Zagreb Stock Exchange were used in the analysis. The statistical control charts capabilities for stock trading in the short-run were analysed. Results: The statistical control chart analysis pointed out too many signals to buy or sell stocks. Most of them are considered as false alarms. So, the statistical control charts showed to be not so much useful in stock trading or in a portfolio analysis. Conclusions: The presence of non-normality and autocorellation has great impact on statistical control charts performances. It is assumed that if these two problems are solved, the use of statistical control charts in a portfolio analysis could be greatly improved.

  8. A critical review of the hypothesis of a medieval origin for portolan charts

    NARCIS (Netherlands)

    Nicolai, R.

    2014-01-01

    Portolan charts are nautical charts, which appear suddenly in the thirteenth century Mediterranean world, without any discernable development path or predecessors. These charts are remarkable for the high degree of realism and accuracy with which they render the coastlines of their core coverage

  9. Robust control charts in industrial production of olive oil

    Science.gov (United States)

    Grilo, Luís M.; Mateus, Dina M. R.; Alves, Ana C.; Grilo, Helena L.

    2014-10-01

    Acidity is one of the most important variables in the quality analysis and characterization of olive oil. During the industrial production we use individuals and moving range charts to monitor this variable, which is not always normal distributed. After a brief exploratory data analysis, where we use the bootstrap method, we construct control charts, before and after a Box-Cox transformation, and compare their robustness and performance.

  10. Bilgi ve Belge Hizmetlerinde Mükemmeli Yakalamak: Örnekedinme / Benchmarking Practices in the Information and Documentation Centers

    Directory of Open Access Journals (Sweden)

    Mesut Kurulgan

    2007-04-01

    Full Text Available Prior to 1980’s most of the Information and Documentation Centers(IDC had adopted customer satisfaction as the quality criterion of their services. During the 80’s IDC’s became aware of Total QualityManagement as one of the primary influencing factors in increasing the efficiency of information services and began its implementation. For over 20 years they have been using instruments and processes toimprove services offered to users. One of these is benchmarking.Different benchmarking processes such as those of competitive,cooperative, internal, quantitative and qualitative types were all utilized by IDC’s. This study briefly explains the benchmarking process and examines various practices of benchmarking in Information and Documentation Centers in the World and in Turkey.

  11. Dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses.

    Science.gov (United States)

    Zhang, Xiang; Loda, Justin B; Woodall, William H

    2017-07-20

    For a patient who has survived a surgery, there could be several levels of recovery. Thus, it is reasonable to consider more than two outcomes when monitoring surgical outcome quality. The risk-adjusted cumulative sum (CUSUM) chart based on multiresponses has been developed for monitoring a surgical process with three or more outcomes. However, there is a significant effect of varying risk distributions on the in-control performance of the chart when constant control limits are applied. To overcome this disadvantage, we apply the dynamic probability control limits to the risk-adjusted CUSUM charts for multiresponses. The simulation results demonstrate that the in-control performance of the charts with dynamic probability control limits can be controlled for different patient populations because these limits are determined for each specific sequence of patients. Thus, the use of dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses allows each chart to be designed for the corresponding patient sequence of a surgeon or a hospital and therefore does not require estimating or monitoring the patients' risk distribution. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  12. SU-F-T-96: A New Paradigm of Weekly Chart Checking for Radiation Therapy Clinics

    International Nuclear Information System (INIS)

    Tan, J; Pompos, A; Jiang, S; Yan, Y

    2016-01-01

    Purpose: To put forth an innovative clinical paradigm for weekly chart checking so that treatment status is periodically checked accurately and efficiently. This study also aims to help optimize the chart checking clinical workflow in a busy radiation therapy clinic. Methods: It is mandated by the Texas Administrative code to check patient charts of radiation therapy once a week or every five fractions, however it varies drastically among institutions in terms of when and how it is done. Some do it every day, but a lot of efforts are wasted on opening ineligible charts; some do it on a fixed day but the distribution of intervals between subsequent checks is not optimal. To establish an optimal chart checking procedure, a new paradigm was developed to achieve 1) charts are checked more accurately and more efficiently; 2) charts are checked on optimal days without any miss; 3) workload is evened out throughout a week when multiple physicists are involved. All active charts will be accessed by querying the R&V system. Priority is assigned to each chart based on the number of days before the next due date followed by sorting and workload distribution steps. New charts are also taken into account when distributing the workload so it is reasonably even throughout the week. Results: Our clinical workflow became more streamlined and smooth. In addition, charts get checked in a more timely fashion so that errors would get caught earlier should they occur. Conclusion: We developed a new weekly chart checking diagram. It helps physicists check charts in a timely manner, saves their time in busy clinics, and consequently reduces possible errors.

  13. SU-F-T-96: A New Paradigm of Weekly Chart Checking for Radiation Therapy Clinics

    Energy Technology Data Exchange (ETDEWEB)

    Tan, J; Pompos, A; Jiang, S; Yan, Y [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: To put forth an innovative clinical paradigm for weekly chart checking so that treatment status is periodically checked accurately and efficiently. This study also aims to help optimize the chart checking clinical workflow in a busy radiation therapy clinic. Methods: It is mandated by the Texas Administrative code to check patient charts of radiation therapy once a week or every five fractions, however it varies drastically among institutions in terms of when and how it is done. Some do it every day, but a lot of efforts are wasted on opening ineligible charts; some do it on a fixed day but the distribution of intervals between subsequent checks is not optimal. To establish an optimal chart checking procedure, a new paradigm was developed to achieve 1) charts are checked more accurately and more efficiently; 2) charts are checked on optimal days without any miss; 3) workload is evened out throughout a week when multiple physicists are involved. All active charts will be accessed by querying the R&V system. Priority is assigned to each chart based on the number of days before the next due date followed by sorting and workload distribution steps. New charts are also taken into account when distributing the workload so it is reasonably even throughout the week. Results: Our clinical workflow became more streamlined and smooth. In addition, charts get checked in a more timely fashion so that errors would get caught earlier should they occur. Conclusion: We developed a new weekly chart checking diagram. It helps physicists check charts in a timely manner, saves their time in busy clinics, and consequently reduces possible errors.

  14. Nuclear industry chart no. 21 - France

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    A fold-out chart shows the relationship between the government bodies and industrial concerns. Nuclear power plant orders under the 1970-84 programme are tabulated. A directory is included of national bodies, firms and establishments. (U.K.)

  15. Areva reference document 2007; Areva document de reference 2007

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains also information on the markets, market shares and competitive position of the AREVA group. Content: 1 - Person responsible for the reference document and persons responsible for auditing the financial statements; 2 - Information pertaining to the transaction (not applicable); 3 - General information on the company and its share capital: Information on Areva, Information on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; 4 - Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts 140 Principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and Development programs, Intellectual Property and Trademarks, Risk and insurance; 5 - Assets financial position financial performance: Analysis of and comments on the group's financial position and performance, Human Resources report, Environmental report, Consolidated financial statements 2007, Notes to the consolidated financial statements, Annual financial statements 2007, Notes to the corporate financial statements; 6 - Corporate governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Ordinary General Meeting of Shareholders of April 17, 2008; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2007, Outlook; Glossary; table of

  16. Areva, reference document 2006; Areva, document de reference 2006

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains information on the markets, market shares and competitive position of the AREVA group. Content: - 1 Person responsible for the reference document and persons responsible for auditing the financial statements; - 2 Information pertaining to the transaction (Not applicable); - 3 General information on the company and its share capital: Information on AREVA, on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; - 4 Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts, The principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and development programs, intellectual property and trademarks, Risk and insurance; - 5 Assets - Financial position - Financial performance: Analysis of and comments on the group's financial position and performance, 2006 Human Resources Report, Environmental Report, Consolidated financial statements, Notes to the consolidated financial statements, AREVA SA financial statements, Notes to the corporate financial statements; 6 - Corporate Governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Combined General Meeting of Shareholders of May 3, 2007; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2006, Outlook; 8 - Glossary; 9 - Table of concordance.

  17. [Development and integration of the Oncological Documentation System ODS].

    Science.gov (United States)

    Raab, G; van Den Bergh, M

    2001-08-01

    To simplify clinical routine and to improve medical quality without exceeding the existing resources. Intensifying communication and cooperation between all institutions of patients' health care. The huge amount of documentation work of physicians can no longer be done without modern tools of paperless data processing. The development of ODS was a tight cooperation between physician and technician which resulted in a mutual understanding and led to a high level of user convenience. - At present all cases of gynecology, especially gynecologic oncology can be documented and processed by ODS. Users easily will adopt the system as data entry within different program areas follows the same rules. In addition users can choose between an individual input of data and assistants guiding them through highly specific areas of documentation. ODS is a modern, modular structured and very fast multiuser database environment for in- and outpatient documentation. It automatically generates a lot of reports for clinical day to day business. Statistical routines will help the user reflecting his work and its quality. Documentation of clinical trials according to the GCP guidelines can be done by ODS using the internet or offline datasharing. As ODS is the synthesis of a computer based patient administration system and an oncological documentation database, it represents the basis for the construction of the electronical patient chart as well as the digital documentation of clinical trials. The introduction of this new technology to physicians and nurses has to be done slowly and carefully, in order to increase motivation and to improve the results.

  18. An Application of Geospatial Information Systems (GIS) Technology to Anatomic Dental Charting

    OpenAIRE

    Bartling, William C.; Schleyer, Titus K.L.

    2003-01-01

    Historically, an anatomic dental chart is a compilation of color-coded symbols and numbers used within a template, either paper or computerized, to create a graphic record of a patient’s oral health status. This poster depicts how Geospatial Information System (GIS) technology can be used to create an accurate, current anatomic dental chart that contains detailed information not present in current charting systems.

  19. A COMPARISON OF SOME ROBUST BIVARIATE CONTROL CHARTS FOR INDIVIDUAL OBSERVATIONS

    Directory of Open Access Journals (Sweden)

    Moustafa Omar Ahmed Abu - Shawiesh

    2014-06-01

    Full Text Available This paper proposed and considered some bivariate control charts to monitor individual observations from a statistical process control. Usual control charts which use mean and variance-covariance estimators are sensitive to outliers. We consider the following robust alternatives to the classical Hoteling's T2: T2MedMAD, T2MCD, T2MVE a simulation study has been conducted to compare the performance of these control charts. Two real life data are analyzed to illustrate the application of these robust alternatives.

  20. News from the Library: The 8th edition Karlsruhe nuclide chart has been released

    CERN Multimedia

    CERN Library

    2012-01-01

    The 8th edition of the Karlsruhe Nuclide Chart contains new data not found in the 7th edition.   Since 1958, the well-known Karlsruhe Nuclide Chart has provided scientists with structured, valuable information on the half-lives, decay modes and energies of radioactive nuclides. The chart is used in many disciplines in physics (health physics, radiation protection, nuclear and radiochemistry, astrophysics, etc.) but also in the life and earth sciences (biology, medicine, agriculture, geology, etc.). The 8th edition of the Karlsruhe Nuclide Chart contains new data on 737 nuclides not found in the 7th edition. In total, nuclear data on 3847 experimentally observed ground states and isomers are presented. A new web-based version of this chart is in the final stages of development for use within the Nucleonica Nuclear Science Portal - a portal for which CERN has an institutional license. The chart is also available in paper format.   If you want to buy a paper version of the chart, ple...

  1. Handbook of thermodynamic tables and charts

    International Nuclear Information System (INIS)

    Raznjevic, K.

    1976-01-01

    A compilation of thermodynamic and thermophysical tables and charts is presented. Numerical values are cited in both technical and SI units. Solid, liquid, vapor, and gaseous forms of organic and inorganic materials are included. 12 figures, 137 tables

  2. Development of recommended practices and guidance documents for upstream oil and gas flow measurement

    Energy Technology Data Exchange (ETDEWEB)

    Dahl, Eivind; Scheers, Lex; Ting, Frank; Letton, Chip

    2005-07-01

    As first stated in the Introduction, improvements in multiphase flow meters during the last 15 years have resulted in their increased usage in upstream oil and gas applications, especially in difficult offshore locations both topside and deep subsea. To address user needs for information and standardization in the area, documentation has recently been created under the auspices of the NFOGM, API, and ISO. Our intent here was to familiarize potential users with the three new documents, which should be helpful in a number of respects, e.g., (a) distribution of best knowledge and operational practices on the subject, (b) provision of a common language for discussing multiphase flow, and (c) accounting for the requirements of governing regulatory authorities. At this stage of completion of NFOGM, API, and ISO reports, a natural question arises as to what the future holds for another round of flow measurement documentation. Candidate areas include: 1) In Situ Verification of Multiphase Flow Meters. 2) Wet Gas Flow Measurement. 3) Flare Gas Meters. 4) Virtual Metering. 5) Composition and Phase Behavior Issues In Measurement. 6) Flow Measurement Uncertainty. Addressing certain of these is already being proposed in several possible venues, among which are (1) the DeepStar Consortium, (2) a JIP for investigating total system (meter + flowline + separator) uncertainty organized by a group at Tulsa University, and (3) a program for development of drilling and production capabilities in ultradeep water to be sponsored by the US Department of Energy. The creation of the three documents discussed in this paper demonstrates the benefits that strong international cooperation can achieve in producing standardization documents, ensuring their true global input and acceptance. On the other hand, it should also be questioned why two or more documents are required, which are the result of much duplication of effort. For example, although there are differences between API RP86 and the

  3. Reliability of FAMACHA© chart for the evaluation of anaemia in ...

    African Journals Online (AJOL)

    The reliability of FAMACHA© chart for identifying anaemic goats was compared with Packed Cell Volume (PCV). The colour of the lower eyelids was graded with FAMACHA© chart based on FAMACHA© scores (FS) of 1-5. The animals were scored from severely anaemic (white or FS 5) through moderately anaemic (pink or ...

  4. Toward a New Brewing Control Chart for the 21st Century.

    Science.gov (United States)

    Melrose, John; Roman-Corrochano, Borja; Montoya-Guerra, Marcela; Bakalis, Serafim

    2018-04-23

    This paper describes new results from a base model of brewing from a bed of packed coffee grains. The model solves for the diffusion of soluble species out of a distribution of particles into the flow through the bed pore space. It requires a limited set of input parameters. It gives a simple picture of the basic physics of coffee brewing and sets out a set of reduced variables for this process. The importance of bed extraction efficiency is elucidated. A coffee brewing control chart has been widely used to describe the region of ideal coffee brewing for some 50 years. A new chart is needed, however, one that connects actual brewing conditions (weight, flow rate, brew time, grind, etc.) to the yield and strength of brews. The paper shows a new approach to brewing control charts, including brew time and bed extraction efficiency as control parameters. Using the base model, an example chart will be given for a particular grind ratio of coarse to fine particles, and an "espresso regime" will be picked out. From such a chart yield, volume and strength of a brew can be read off at will.

  5. A simulation training evaluation method for distribution network fault based on radar chart

    Directory of Open Access Journals (Sweden)

    Yuhang Xu

    2018-01-01

    Full Text Available In order to solve the problem of automatic evaluation of dispatcher fault simulation training in distribution network, a simulation training evaluation method based on radar chart for distribution network fault is proposed. The fault handling information matrix is established to record the dispatcher fault handling operation sequence and operation information. The four situations of the dispatcher fault isolation operation are analyzed. The fault handling anti-misoperation rule set is established to describe the rules prohibiting dispatcher operation. Based on the idea of artificial intelligence reasoning, the feasibility of dispatcher fault handling is described by the feasibility index. The relevant factors and evaluation methods are discussed from the three aspects of the fault handling result feasibility, the anti-misoperation correctness and the operation process conciseness. The detailed calculation formula is given. Combining the independence and correlation between the three evaluation angles, a comprehensive evaluation method of distribution network fault simulation training based on radar chart is proposed. The method can comprehensively reflect the fault handling process of dispatchers, and comprehensively evaluate the fault handling process from various angles, which has good practical value.

  6. Application of machine learning and expert systems to Statistical Process Control (SPC) chart interpretation

    Science.gov (United States)

    Shewhart, Mark

    1991-01-01

    Statistical Process Control (SPC) charts are one of several tools used in quality control. Other tools include flow charts, histograms, cause and effect diagrams, check sheets, Pareto diagrams, graphs, and scatter diagrams. A control chart is simply a graph which indicates process variation over time. The purpose of drawing a control chart is to detect any changes in the process signalled by abnormal points or patterns on the graph. The Artificial Intelligence Support Center (AISC) of the Acquisition Logistics Division has developed a hybrid machine learning expert system prototype which automates the process of constructing and interpreting control charts.

  7. Validation of Computed Radiography (CR) Exposure Chart for Stainless Steel and Aluminium

    International Nuclear Information System (INIS)

    Nassir, M.A.; Khairul Anuar Mohd Salleh; Arshad Yassin

    2015-01-01

    Computed radiography (CR) is a technique that is currently used to complement the conventional radiography in Non Destructive Testing (NDT). With CR, phosphorous base imaging plate (IP) is used to acquire digital radiographic images. The degree of absorption by the IP is proportional to the intensity of the dose received. The IP stores latent image which subsequently digitized by the CR reader. Prior to radiography exposure, the radiation dosage is determined by referring to the exposure chart. Exposure chart is one of the most important tools for achieving acceptable quality radiographs. Therefore, it is important to have a reliable and accurate exposure chart. The aim of this study is to test and validate exposure charts that were developed based on the statistical analysis of the digital radiographic grey values. The charts produced were for stainless steel and aluminum. According to EN 14784-2:2005, acceptable normalized signal-to-noise ratio (SNR N ) for testing class A and class B shall have minimum 70 and 120 respectively. (author)

  8. Application of Special Cause Control Charts to Green Sand Process

    Directory of Open Access Journals (Sweden)

    Perzyk M.

    2015-12-01

    Full Text Available Statistical Process Control (SPC based on the well known Shewhart control charts, is widely used in contemporary manufacturing industry, including many foundries. However, the classic SPC methods require that the measured quantities, e.g. process or product parameters, are not auto-correlated, i.e. their current values do not depend on the preceding ones. For the processes which do not obey this assumption the Special Cause Control (SCC charts were proposed, utilizing the residual data obtained from the time-series analysis. In the present paper the results of application of SCC charts to a green sand processing system are presented. The tests, made on real industrial data collected in a big iron foundry, were aimed at the comparison of occurrences of out-of-control signals detected in the original data with those appeared in the residual data. It was found that application of the SCC charts reduces numbers of the signals in almost all cases It is concluded that it can be helpful in avoiding false signals, i.e. resulting from predictable factors.

  9. AMDIS and CHART update. 1

    International Nuclear Information System (INIS)

    Murakami, I.; Kato, T.; Igarashi, A.

    2002-10-01

    A working group for updating atomic and molecular collision data in the NIFS database AMDIS (electron scattering) and CHART (ion scattering) has been organized. This group has searched and reviewed literatures for collecting relevant atomic data with are to be included into the database. This is a summary report of the activities of this working group. (author)

  10. Using an electronic medical record to improve communication within a prenatal care network.

    Science.gov (United States)

    Bernstein, Peter S; Farinelli, Christine; Merkatz, Irwin R

    2005-03-01

    In 2002, the Institute of Medicine called for the introduction of information technologies in health care settings to improve quality of care. We conducted a review of hospital charts of women who delivered before and after the implementation of an intranet-based computerized prenatal record in an inner-city practice. Our objective was to assess whether the use of this record improved communication among the outpatient office, the ultrasonography unit, and the labor floor. The charts of patients who delivered in August 2002 and August 2003 and received their prenatal care at the Comprehensive Family Care Center at Montefiore Medical Center were analyzed. Data collected included the presence of a copy of the prenatal record in the hospital chart, the date of the last documented prenatal visit, and documentation of any prenatal ultrasonograms performed. Forty-three charts in each group were available for review. The prenatal chart was absent in 16% of the charts of patients from August 2002 compared with only 2% in August 2003 charts (P intranet-based prenatal chart significantly improves communication among providers.

  11. SNF AGING SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    L.L. Swanson

    2005-04-06

    The purpose of this system description document (SDD) is to establish requirements that drive the design of the spent nuclear fuel (SNF) aging system and associated bases, which will allow the design effort to proceed. This SDD will be revised at strategic points as the design matures. This SDD identifies the requirements and describes the system design, as it currently exists, with emphasis on attributes of the design provided to meet the requirements. This SDD is an engineering tool for design control; accordingly, the primary audience and users are design engineers. This SDD is part of an iterative design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD follows the design with regard to the description of the system. The description provided in the SDD reflects the current results of the design process. Throughout this SDD, the term aging cask applies to vertical site-specific casks and to horizontal aging modules. The term overpack is a vertical site-specific cask that contains a dual-purpose canister (DPC) or a disposable canister. Functional and operational requirements applicable to this system were obtained from ''Project Functional and Operational Requirements'' (F&OR) (Curry 2004 [DIRS 170557]). Other requirements that support the design process were taken from documents such as ''Project Design Criteria Document'' (PDC) (BSC 2004 [DES 171599]), ''Site Fire Hazards Analyses'' (BSC 2005 [DIRS 172174]), and ''Nuclear Safety Design Bases for License Application'' (BSC 2005 [DIRS 171512]). The documents address requirements in the ''Project Requirements Document'' (PRD) (Canori and Leitner 2003 [DIRS 166275]). This SDD includes several appendices. Appendix A is a Glossary; Appendix B is a list of key system charts

  12. SNF AGING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    L.L. Swanson

    2005-01-01

    The purpose of this system description document (SDD) is to establish requirements that drive the design of the spent nuclear fuel (SNF) aging system and associated bases, which will allow the design effort to proceed. This SDD will be revised at strategic points as the design matures. This SDD identifies the requirements and describes the system design, as it currently exists, with emphasis on attributes of the design provided to meet the requirements. This SDD is an engineering tool for design control; accordingly, the primary audience and users are design engineers. This SDD is part of an iterative design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD follows the design with regard to the description of the system. The description provided in the SDD reflects the current results of the design process. Throughout this SDD, the term aging cask applies to vertical site-specific casks and to horizontal aging modules. The term overpack is a vertical site-specific cask that contains a dual-purpose canister (DPC) or a disposable canister. Functional and operational requirements applicable to this system were obtained from ''Project Functional and Operational Requirements'' (F andOR) (Curry 2004 [DIRS 170557]). Other requirements that support the design process were taken from documents such as ''Project Design Criteria Document'' (PDC) (BSC 2004 [DES 171599]), ''Site Fire Hazards Analyses'' (BSC 2005 [DIRS 172174]), and ''Nuclear Safety Design Bases for License Application'' (BSC 2005 [DIRS 171512]). The documents address requirements in the ''Project Requirements Document'' (PRD) (Canori and Leitner 2003 [DIRS 166275]). This SDD includes several appendices. Appendix A is a Glossary; Appendix B is a list of key system charts, diagrams, drawings, lists and additional supporting information; and Appendix C is a list of

  13. Historical Map & Chart Collection of NOAA's Nautical Charts, Hydrographic Surveys, Topographic Surveys, Geodetic Surveys, City Plans, and Civil War Battle Maps Starting from the mid 1700's

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Historical Map and Chart Collection of the Office of Coast Survey contains over 20000 historical maps and charts from the mid 1700s through the late 1900s. These...

  14. The Energy Chart'93

    International Nuclear Information System (INIS)

    Shervashidze, N.

    1993-01-01

    The Energy Chart'93 is developed with respect to forthcoming restructuring of energy sector in Bulgaria and contains its main directions for both short- and long-term periods. The priorities are given to: energy supply, stabilization of the existing units, ecological development, domestic energy sources, atomic energy, gas energy, utilization of the available hydrological potential. The leading role of legislation in this area is also pointed out, as well as the regulating function of the Committee of Energy. (author)

  15. Understanding Charts and Graphs.

    Science.gov (United States)

    1987-07-28

    Farenheit degrees, which have no Onaturalo zero ); finally, ratio scales have numbers that are ordered so that the magnitudes of differences are important and...system. They have to do with the very nature of how marks serve as meaningful symbols. In the ideal case, a chart or graph will be absolutely unambiguous...and these laws comprise this principle (see Stevens, 1974). Absolute discriminability: A minimal magnitude of a mark is necessary for it to be detected

  16. Gaps in patient care practices to prevent hospital-acquired delirium.

    Science.gov (United States)

    Alagiakrishnan, Kannayiram; Marrie, Thomas; Rolfson, Darryl; Coke, William; Camicioli, Richard; Duggan, D'Arcy; Launhardt, Bonnie; Fisher, Bruce; Gordon, Debbie; Hervas-Malo, Marilou; Magee, Bernice; Wiens, Cheryl

    2009-10-01

    To evaluate the current patient care practices that address the predisposing and precipitating factors contributing to the prevention of hospital-acquired delirium in the elderly. Prospective cohort (observational) study. Patients 65 years of age and older who were admitted to medical teaching units at the University of Alberta Hospital in Edmonton over a period of 7 months and who were at risk of delirium. Medical teaching units at the University of Alberta. Demographic data and information on predisposing factors for hospital-acquired delirium were obtained for all patients. Documented clinical practices that likely prevent common precipitants of delirium were also recorded. Of the 132 patients enrolled, 20 (15.2%) developed hospital-acquired delirium. At the time of admission several predisposing factors were not documented (eg, possible cognitive impairment 16 [12%], visual impairment 52 [39.4%], and functional status of activities of daily living 99 [75.0%]). Recorded precipitating factors included catheter use, screening for dehydration, and medications. Catheters were used in 35 (26.5%) patients, and fluid intake-and-output charting assessed dehydration in 57 (43.2%) patients. At the time of admission there was no documentation of hearing status in 69 (52.3%) patients and aspiration risk in 104 (78.8%) patients. After admission, reorientation measures were documented in only 16 (12.1%) patients. Although all patients had brief mental status evaluations performed once daily, this was not noted to occur twice daily (which would provide important information about fluctuation of mental status) and there was no formal attention span testing. In this study, hospital-acquired delirium was also associated with increased mortality (P < .004), increased length of stay (P < .007), and increased institutionalization (P < .027). Gaps were noted in patient care practices that might contribute to hospital-acquired delirium and also in measures to identify the development

  17. Quality assurance in a radiation oncology unit: the chart round experience

    International Nuclear Information System (INIS)

    Fogarty, G.B.; Peters, L.J.; Hornby, C.; Ferguson, H.M.

    2001-01-01

    Quality assurance ensures that planned treatments eventuate. Programmes must include feedback loops to promptly correct any shortfall in predetermined standards. In March 1999, a weekly Chart Round was introduced to verify that certain items relevant to quality care were being completed for patients of the Head and Neck Radiotherapy Unit at the Peter MacCallum Cancer Institute. The experience was reviewed after 1 year and it was found that the initiation of Chart Rounds has assisted in raising the level of item completion from 80% to 99% in similar groups of patients treated before and after the initiation of the Chart Round. Initiation of the Chart Round has also provided a useful forum for in-house peer-review, education and effective real-time communication between medical and allied health personnel, all of which has further added to the quality of patient care. Copyright (2001) Blackwell Science Pty Ltd

  18. Chart Supplements - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The Chart Supplements are searchable by individual airport in PDF format. They contain data on public and joint use airports, seaplane bases, heliports, VFR airport...

  19. Design chart of optimum current leads

    International Nuclear Information System (INIS)

    Ishibashi, K.; Katase, A.; Maechata, K.

    1986-01-01

    The heat flow through current leads is one of major heat losses in a superconducting magnet system. To reduce the heat flow, current leads have been optimized in a complex way by varying such quantities as conductor length, cross-sectional area, heat transfer coefficient and cooling perimeter. Therefore, this study is made to simplify the design procedure, and to explain the general characteristics of the current leads. A new combined parameter which takes turbulent flow into account is introduced in the present work to enable us to draw a useful design chart. This chart gives, to a wide variety of current leads, detailed information about the optimum design-viz. geometric dimensions, heat flow into liquid helium, and pressure drop of the cooling gas. Change of the cross-sectional area along the conductor may improve the current lead performance. The effects of this area change are examined in detail

  20. Method of using of the Box-Cox transformation at the application of the xbar and s chart

    Directory of Open Access Journals (Sweden)

    Eftimie Nicolae

    2017-01-01

    Full Text Available The application of the most statistical process control techniques is based on the assumption that the distribution of the measurements is normal. However, there are many situations in practice when the process data distribution is not normal. In certain cases, the Box-Cox transformation can be used for converting the process data distribution into a normal distribution. Considering these aspects, the paper presents a method of application for the xbar and s chart that can be used in the case when the measurements distribution is not normal. The proposed method consists of the following stages: the testing of normality of the process data, the application of the Box-Cox transformation and the testing of normality of the transformed data. In the case when the distribution of the transformed data is normal, they are used at the application of the xbar and s control chart.

  1. Automatic exposure control systems designed to maintain constant image noise: effects on computed tomography dose and noise relative to clinically accepted technique charts.

    Science.gov (United States)

    Favazza, Christopher P; Yu, Lifeng; Leng, Shuai; Kofler, James M; McCollough, Cynthia H

    2015-01-01

    To compare computed tomography dose and noise arising from use of an automatic exposure control (AEC) system designed to maintain constant image noise as patient size varies with clinically accepted technique charts and AEC systems designed to vary image noise. A model was developed to describe tube current modulation as a function of patient thickness. Relative dose and noise values were calculated as patient width varied for AEC settings designed to yield constant or variable noise levels and were compared to empirically derived values used by our clinical practice. Phantom experiments were performed in which tube current was measured as a function of thickness using a constant-noise-based AEC system and the results were compared with clinical technique charts. For 12-, 20-, 28-, 44-, and 50-cm patient widths, the requirement of constant noise across patient size yielded relative doses of 5%, 14%, 38%, 260%, and 549% and relative noises of 435%, 267%, 163%, 61%, and 42%, respectively, as compared with our clinically used technique chart settings at each respective width. Experimental measurements showed that a constant noise-based AEC system yielded 175% relative noise for a 30-cm phantom and 206% relative dose for a 40-cm phantom compared with our clinical technique chart. Automatic exposure control systems that prescribe constant noise as patient size varies can yield excessive noise in small patients and excessive dose in obese patients compared with clinically accepted technique charts. Use of noise-level technique charts and tube current limits can mitigate these effects.

  2. Continuous hyperfractionated accelerated radiotherapy (chart) in localized cancer of the esophagus

    International Nuclear Information System (INIS)

    Powell, Melanie E.B.; Hoskin, Peter J.; Saunders, Michele I.; Foy, Christopher J.W.; Dische, Stanley

    1997-01-01

    Purpose: To assess the efficacy and toxicity of continuous hyperfractionated accelerated radiotherapy (CHART) in locoregional control compared with a historical group of patients treated with conventionally fractionated radical radiotherapy. Methods and Materials: Between 1985 and 1994, 54 patients with localized esophageal cancer were treated with CHART. Twenty-eight patients received CHART alone (54 Gy in 36 fractions over 12 consecutive days) and 15 were given intravenous mitomycin C and cisplatin on days 10 and 13, respectively. Eleven patients received 40.5 Gy in 27 fractions over 9 days, followed by a single high-dose-rate intraluminal brachytherapy insertion of 15 Gy at 1 cm. Results: Acute toxicity was well tolerated and dysphagia was improved in 35 patients (65%), with 28 (52%) eating a normal diet by week 12. This compares with an improvement in dysphagia score in 72% of the conventionally treated group. The median duration of relief of dysphagia was 7.8 months (range 0-41.4) in the CHART group compared with 5.5 months (range 0-48) in the controls. Strictures developed in 29 patients (61%) and 18 were confirmed on biopsy to be due to recurrent disease. Median survival was 12 months (range 0.5-112) in the CHART group and 15 months (range 3.6-56) in the control patients. Conclusion: CHART is well tolerated and achieves a high rate of local control. Palliation in the short overall treatment time of esophageal cancer is an advantage in these patients whose median survival is only 12 months

  3. Timing analysis of safety properties using fault trees with time dependencies and timed state-charts

    International Nuclear Information System (INIS)

    Magott, Jan; Skrobanek, Pawel

    2012-01-01

    Behavior in time domain is often crucial for safety critical systems. Standard fault trees cannot express time-dependent behavior. In the paper, timing analysis of safety properties using fault trees with time dependencies (FTTDs) and timed state-charts is presented. A new version of timed state-charts (TSCs) is also proposed. These state-charts can model the dynamics of technical systems, e.g. controllers, controlled objects, and people. In TSCs, activity and communication times are represented by time intervals. In the proposed approach the structure of FTTD is fixed by a human. Time properties of events and gates of FTTD are expressed by time intervals, and are calculated using TSCs. The minimal and maximal values of these time intervals of FTTD can be calculated by finding paths with minimal and maximal time lengths in TSCs, which is an NP-hard problem. In order to reduce the practical complexity of computing the FTTD time parameters, some reductions of TSCs are defined in the paper, such as sequential, alternative, loop (iteration), and parallel. Some of the reductions are intuitive, in case of others—theorems are required. Computational complexity of each reduction is not greater than linear in the size of reduced TSC. Therefore, the obtained results enable decreasing of the costs of FTTD time parameters calculation when system dynamics is expressed by TSCs. Case study of a railroad crossing with a controller that controls semaphores, gate, light-audio signal close to the gate will be analyzed.

  4. Planar Poincare chart - A planar graphic representation of the state of light polarization

    Science.gov (United States)

    Tedjojuwono, Ken K.; Hunter, William W., Jr.; Ocheltree, Stewart L.

    1989-01-01

    The planar Poincare chart, which represents the complete planar equivalence of the Poincare sphere, is proposed. The four sets of basic lines are drawn on two separate charts for the generalization and convenience of reading the scale. The chart indicates the rotation of the principal axes of linear birefringent material. The relationships between parameters of the two charts are given as 2xi-2phi (orientation angle of the major axis-ellipticity angle) pair and 2alpha-delta (angle of amplitude ratio-phase difference angle) pair. The results are useful for designing and analyzing polarization properties of optical components with birefringent properties.

  5. 46 CFR 201.42 - Subscription, authentication of documents.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Subscription, authentication of documents. 201.42 Section 201.42 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION POLICY, PRACTICE AND... Subscription, authentication of documents. (a) Documents filed shall be subscribed: (1) By the person or...

  6. OWL representation of the geologic timescale implementing stratigraphic best practice

    Science.gov (United States)

    Cox, S. J.

    2011-12-01

    The geologic timescale is a cornerstone of the earth sciences. Versions are available from many sources, with the following being of particular interest: (i) The official International Stratigraphic Chart (ISC) is maintained by the International Commission for Stratigraphy (ICS), following principles developed over the last 40 years. ICS provides the data underlying the chart as part of a specialized software package, and the chart itself as a PDF using the standard colours; (ii) ITC Enschede has developed a representation of the timescale as a thesaurus in SKOS, used in a Web Map Service delivery system; (iii) JPL's SWEET ontology includes a geologic timescale. This takes full advantage of the capabilities of OWL. However, each of these has limitations - The ISC falls down because of incompatibility with web technologies; - While SKOS supports multilingual labelling, SKOS does not adequately support timescale semantics, in particular since it does not include ordering relationships; - The SWEET version (as of version 2) is not fully aligned to the model used by ICS, in particular not recognizing the role of the Global Boundary Stratotype Sections and Point (GSSP). Furthermore, it is distributed as static documents, rather than through a dynamic API using SPARQL. The representation presented in this paper overcomes all of these limitations as follows: - the timescale model is formulated as an OWL ontology - the ontology is directly derived from the UML representation of the ICS best practice proposed by Cox & Richard [2005], and subsequently included as the Geologic Timescale package in GeoSciML (http://www.geosciml.org); this includes links to GSSPs as per the ICS process - key properties in the ontology are also asserted to be subProperties of SKOS properties (topConcept and broader/narrower relations) in order to support SKOS-based queries; SKOS labelling is used to support multi-lingual naming and synonyms - the International Stratigraphic Chart is implemented

  7. Designing business charts with Excel based on the standards of HICHERT SUCCESS

    CERN Document Server

    Gerths, Holger

    2014-01-01

    This e-book offers a comprehensive range of knowledge for creating professional business charts based on the concept of HICHERT®SUCCESS. Given this knowledge, the SUCCESS rules of designing good business charts can be followed easily. This training is based on one complex example. The tips and trick learned can be transferred to other Excel chart types easily. Contents: Introduction to the HICHERT®SUCCESS design rules.Tips and tricks for Excel 2003 and 2007/2010.Comprehensive trai

  8. A robust standard deviation control chart

    NARCIS (Netherlands)

    Schoonhoven, M.; Does, R.J.M.M.

    2012-01-01

    This article studies the robustness of Phase I estimators for the standard deviation control chart. A Phase I estimator should be efficient in the absence of contaminations and resistant to disturbances. Most of the robust estimators proposed in the literature are robust against either diffuse

  9. Nuclear industry chart no. 20 - Sweden

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    A folding chart is presented of the Swedish nuclear industry, which shows the government bodies, companies, utilities and other groups who participate in the nuclear field. Their special interests and activities and affiliations with each other and with international organisations are indicated. (U.K.)

  10. ICS International Chronostratigraphic Chart 2016/04

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Finney, S.C.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lowerboundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  11. ICS International Chronostratigraphic Chart 2017/02

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Harper, D.A.T.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lowerboundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  12. Imaginary Documentary: reflecting upon contemporary documental photography Documentário Imaginário: reflexões sobre a fotografia documental contemporânea

    Directory of Open Access Journals (Sweden)

    Kátia Hallak Lombardi

    2008-01-01

    Full Text Available This article pursues the idea of an Imaginary Documentary – a possible new inflexion on the practices of contemporary documental photography. The text establishes its theoretical foundations through a forthcoming approach of the discussions about documental photography to the concept of imaginary, by Gilbert Durand, and the notion of Imaginary Museum, by André Malraux. Photographers that are part of documental photography history are the elected objects in which we shall confront the potentialities of the Imaginary Documentary. Este artigo tem como propósito buscar a estruturação da idéia de Documentário Imaginário – uma possível inflexão na prática da fotografia documental contemporânea. O texto assenta suas bases teóricas por meio da aproximação de reflexões sobre a fotografia documental ao conceito de imaginário em Gilbert Durand e à noção de Museu Imaginário de André Malraux. Fotógrafos que fazem parte da história da fotografia documental são os objetos eleitos para aferir as potencialidades do Documentário Imaginário.

  13. Flaw evaluation charts

    International Nuclear Information System (INIS)

    Korosec, D.; Vojvodic Tuma, J.

    1999-01-01

    The structural integrity of the primary components in pressurized water reactor nuclear power plant is very important in the respect of safe and efficient operation. These components have to be subjected to periodic controls. In the light of fracture mechanics concept, the acceptance criteria for defects (flaws) are developed. Flaw evaluation procedure is necessary, to evaluate the defects regarding their acceptability for further operation. The objective of the flaw evaluation charts is to provide a series of simple graphs as decision maps. that immediate decision may be taken regarding the acceptability of a detected defects, on the basis of ASME Code XI criteria.(author)

  14. HRS Clinical Document Development Methodology Manual and Policies: Executive summary.

    Science.gov (United States)

    Indik, Julia H; Patton, Kristen K; Beardsall, Marianne; Chen-Scarabelli, Carol A; Cohen, Mitchell I; Dickfeld, Timm-Michael L; Haines, David E; Helm, Robert H; Krishnan, Kousik; Nielsen, Jens Cosedis; Rickard, John; Sapp, John L; Chung, Mina

    2017-10-01

    The Heart Rhythm Society (HRS) has been developing clinical practice documents in collaboration and partnership with other professional medical societies since 1996. The HRS formed a Scientific and Clinical Documents Committee (SCDC) with the sole purpose of managing the development of these documents from conception through publication. The SCDC oversees the process for developing clinical practice documents, with input and approval from the HRS Executive Committee and the Board of Trustees. As of May 2017, the HRS has produced more than 80 publications with other professional organizations. This process manual is produced to publicly and transparently declare the standards by which the HRS develops clinical practice documents, which include clinical practice guidelines, expert consensus statements, scientific statements, clinical competency statements, task force policy statements, and proceedings statements. The foundation for this process is informed by the Institute of Medicine's standards for developing trustworthy clinical practice guidelines; the new criteria from the National Guidelines Clearinghouse, effective June 2014; SCDC member discussions; and a review of guideline policies and methodologies used by other professional organizations. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  15. On the Use of Ashenhurst Decomposition Chart as an Alternative to ...

    African Journals Online (AJOL)

    ... the Ashenhurst decomposition chart is shown to be a mapping technique which solves this selection problem and enables the design of logic circuits with desirable attributes using multiplexers. The Ashenhurst decomposition chart also serves as a bridging technique between the map based and algorithmic based digital ...

  16. ICS International Chronostratigraphic Chart 2015/01

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Finney, S.C.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lower boundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  17. Growth charts of human development.

    Science.gov (United States)

    van Buuren, Stef

    2014-08-01

    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate score measuring global development. The relations between the indicators should be consistent with the Rasch model. If true, the D-score is a measure with interval scale properties, and allows for the calculation of meaningful differences both within and across age. The stage line diagram describes the natural development of ordinal indicators. The method models the transition probabilities between successive stages of the indicator as smoothly varying functions of age. The location of each stage is quantified by the mid-P-value. Both types of diagrams assist in identifying early and delayed development, as well as finding differences in tempo. The relevant techniques are illustrated to track global development during infancy and early childhood (0-2 years) and Tanner pubertal stages (8-21 years). New reference values for both applications are provided. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Proposal for internet-based Digital Dental Chart for personal dental identification in forensics.

    Science.gov (United States)

    Hanaoka, Yoichi; Ueno, Asao; Tsuzuki, Tamiyuki; Kajiwara, Masahiro; Minaguchi, Kiyoshi; Sato, Yoshinobu

    2007-05-03

    A dental chart is very useful as a standard source of evidence in the personal identification of bodies. However, the kind of dental chart available will often vary as a number of types of odontogram have been developed where the visual representation of dental conditions has relied on hand-drawn representation. We propose the Digital Dental Chart (DDC) as a new style of dental chart, especially for open investigations aimed at establishing the identity of unknown bodies. Each DDC is constructed using actual oral digital images and dental data, and is easy to upload onto an Internet website. The DDC is a more useful forensic resource than the standard types of dental chart in current use as it has several advantages, among which are its ability to carry a large volume of information and reproduce dental conditions clearly and in detail on a cost-effective basis.

  19. Application of a binomial cusum control chart to monitor one drinking water indicator

    Directory of Open Access Journals (Sweden)

    Elisa Henning

    2014-02-01

    Full Text Available The aim of this study is to analyze the use of a binomial cumulative sum chart (CUSUM to monitor the presence of total coliforms, biological indicators of quality of water supplies in water treatment processes. The sample series were monthly taken from a water treatment plant and were analyzed from 2007 to 2009. The statistical treatment of the data was performed using GNU R, and routines were created for the approximation of the upper limit of the binomial CUSUM chart. Furthermore, a comparative study was conducted to investigate whether there is a significant difference in sensitivity between the use of CUSUM and the traditional Shewhart chart, the most commonly used chart in process monitoring. The results obtained demonstrate that this study was essential for making the right choice in selecting a chart for the statistical analysis of this process.

  20. Scheme of collective services for the energy. Document under consultation; Schema de services collectifs de l'energie. Document soumis a la consultation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The energy policy is a major question of a government, for the economy and also for the environmental impact. This document aims at defining objectives in the context of the energy and the environment and its future in the next twenty years. It gives information and assistance to decision makers to manage the energy valorization and conservation. It includes five parts. The first part deals with the context, the stakes and forecast. The second and the third parts presents respectively the means for new actions and their control. The fourth part is an analysis of the regional contributions and the last part provides charts and maps. (A.L.B.)

  1. JDATAVIEWER – JAVA-Based Charting Library

    CERN Document Server

    Kruk, G

    2009-01-01

    The JDataViewer is a Java-based charting library developed at CERN, with powerful, extensible and easy to use function editing capabilities. Function edition is heavily used in Control System applications, but poorly supported in products available on the market. The JDataViewer enables adding, removing and modifying function points graphically (using a mouse) or by editing a table of values. Custom edition strategies are supported: developer can specify an algorithm that reacts to the modification of a given point in the function by automatically adapting all other points. The library provides all typical 2D plotting types (scatter, polyline, area, bar, HiLo, contour), as well as data point annotations and data indicators. It also supports common interactors to zoom and move the visible view, or to select and highlight function segments. A clear API is provided to configure and customize all chart elements (colors, fonts, data ranges ...) programmatically, and to integrate non-standard rendering types, inter...

  2. The use of control charts by laypeople and hospital decision-makers for guiding decision making.

    Science.gov (United States)

    Schmidtke, K A; Watson, D G; Vlaev, I

    2017-07-01

    Graphs presenting healthcare data are increasingly available to support laypeople and hospital staff's decision making. When making these decisions, hospital staff should consider the role of chance-that is, random variation. Given random variation, decision-makers must distinguish signals (sometimes called special-cause data) from noise (common-cause data). Unfortunately, many graphs do not facilitate the statistical reasoning necessary to make such distinctions. Control charts are a less commonly used type of graph that support statistical thinking by including reference lines that separate data more likely to be signals from those more likely to be noise. The current work demonstrates for whom (laypeople and hospital staff) and when (treatment and investigative decisions) control charts strengthen data-driven decision making. We present two experiments that compare people's use of control and non-control charts to make decisions between hospitals (funnel charts vs. league tables) and to monitor changes across time (run charts with control lines vs. run charts without control lines). As expected, participants more accurately identified the outlying data using a control chart than using a non-control chart, but their ability to then apply that information to more complicated questions (e.g., where should I go for treatment?, and should I investigate?) was limited. The discussion highlights some common concerns about using control charts in hospital settings.

  3. Examining Teachers' Behavioral Management Charts: A Comparison of Class Dojo and Paper-Pencil Methods

    Science.gov (United States)

    Krach, S. Kathleen; McCreery, Michael P.; Rimel, Hillary

    2017-01-01

    Many teachers report using behavioral management charts in their classrooms as a means of managing student behaviors, but little is known about exactly what behaviors teachers are charting, or specifically how. Misunderstanding over how real-world teachers maintain behavioral charts may cause miscommunication between the teacher and the school…

  4. Crude versus case-mix-adjusted control charts for safety monitoring in thyroid surgery.

    Science.gov (United States)

    Duclos, Antoine; Voirin, Nicolas; Touzet, Sandrine; Soardo, Pietro; Schott, Anne-Marie; Colin, Cyrille; Peix, Jean-Louis; Lifante, Jean-Christophe

    2010-12-01

    Patient-safety monitoring based on health-outcome indicators can lead to misinterpretation of changes in case mix. This study aimed to compare the detection of indicator variations between crude and case-mix-adjusted control charts using data from thyroid surgeries. The study population included each patient who underwent thyroid surgery in a teaching hospital from January 2006 to May 2008. Patient safety was monitored according to two indicators, which are immediately recognisable postoperative complications: recurrent laryngeal nerve palsy and hypocalcaemia. Each indicator was plotted monthly on a p-control chart using exact limits. The weighted κ statistic was calculated to measure the agreement between crude and case-mix-adjusted control charts. We evaluated the outcomes of 1405 thyroidectomies. The overall proportions of immediate recurrent laryngeal nerve palsy and hypocalcaemia were 7.4% and 20.5%, respectively. The proportion of agreement in the detection of indicator variations between the crude and case-mix-adjusted p-charts was 95% (95% CI 85% to 99%). The strength of the agreement was κ = 0.76 (95% CI 0.54 to 0.98). The single special cause of variation that occurred was only detected by the case-mix-adjusted p-chart. There was good agreement in the detection of indicator variations between crude and case-mix-adjusted p-charts. The joint use of crude and adjusted charts seems to be a reasonable approach to increase the accuracy of interpretation of variations in outcome indicators.

  5. Control Charts for Processes with an Inherent Between-Sample Variation

    Directory of Open Access Journals (Sweden)

    Eva Jarošová

    2018-06-01

    Full Text Available A number of processes to which statistical control is applied are subject to various effects that cause random changes in the mean value. The removal of these fluctuations is either technologically impossible or economically disadvantageous under current conditions. The frequent occurrence of signals in the Shewhart chart due to these fluctuations is then undesirable and therefore the conventional control limits need to be extended. Several approaches to the design of the control charts with extended limits are presented in the paper and applied on the data from a real production process. The methods assume samples of size greater than 1. The performance of the charts is examined using the operating characteristic and average run length. The study reveals that in many cases, reducing the risk of false alarms is insufficient.

  6. Embedding the shapes of regions of interest into a Clinical Document Architecture document.

    Science.gov (United States)

    Minh, Nguyen Hai; Yi, Byoung-Kee; Kim, Il Kon; Song, Joon Hyun; Binh, Pham Viet

    2015-03-01

    Sharing a medical image visually annotated by a region of interest with a remotely located specialist for consultation is a good practice. It may, however, require a special-purpose (and most likely expensive) system to send and view them, which is an unfeasible solution in developing countries such as Vietnam. In this study, we design and implement interoperable methods based on the HL7 Clinical Document Architecture and the eXtensible Markup Language Stylesheet Language for Transformation standards to seamlessly exchange and visually present the shapes of regions of interest using web browsers. We also propose a new integration architecture for a Clinical Document Architecture generator that enables embedding of regions of interest and simultaneous auto-generation of corresponding style sheets. Using the Clinical Document Architecture document and style sheet, a sender can transmit clinical documents and medical images together with coordinate values of regions of interest to recipients. Recipients can easily view the documents and display embedded regions of interest by rendering them in their web browser of choice. © The Author(s) 2014.

  7. NUCLIDES 2000: an electronic chart of the nuclides

    International Nuclear Information System (INIS)

    Galy, J.; Magill, J.

    2000-01-01

    Radionuclides have many applications in agriculture, medicine, industry and research. For basic information on such radioactive materials, the Chart of the Nuclides has proved to be an indispensable tool for obtaining data on radionuclides and working out qualitatively decay schemes and reaction paths. These Charts are, however, of limited use when one requires quantitative information on the decaying nuclide and its daughters. This was the motivation for the development of the NUCLIDES 2000 software package. The radioactive decay data used in NUCLIDES 2000 is based on the Joint Evaluated File (Jeff) version 2.2. The present version of the program contains decay data on approximately 2700 radionuclides. (authors)

  8. jsGraph and jsNMR—Advanced Scientific Charting

    Directory of Open Access Journals (Sweden)

    Norman Pellet

    2014-09-01

    Full Text Available The jsGraph library is a versatile javascript library that allows advanced charting to be rendered interactively in web browsers without relying on server-side image processing. jsGraph is released under the MIT license and is free of charge. While being highly customizable through an intuitive javascript API, jsGraph is optimized to render a large quantity of data in a short amount of time. jsGraphs can display line, scatter, contour or zone series. Examples can be consulted on the project home page [1]. Customization of the chart, its axis and its series is achieved through simple but comprehensive JSON configurations.

  9. Measuring the effects of acupuncture and homoeopathy in general practice: An uncontrolled prospective documentation approach

    Directory of Open Access Journals (Sweden)

    Walach Harald

    2004-03-01

    Full Text Available Abstract Background Despite the increasing demand for acupuncture and homoeopathy in Germany, little is known about the effects of these treatments in routine care. We set up a pragmatic documentation study in general practice funded within the scope of project launched by a German health insurer. Patients were followed-up for up to four years. Methods The aim of the project was to study the effects and benefits of acupuncture and/or homoeopathy, and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture and over 900 homoeopathy patients. As data sources, we used the documentation made available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36; these were complemented by questions concerning the patient's medical history and by questions on patient satisfaction. The health insurer provided us with data on work absenteeism. Results Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire SF-36 and about 1 point improvement on a rating scale of effects, given by doctors. Data on the treatment and the patients' and physicians' background suggests chronically ill patients treated by fairly regular schemes. Conclusion Since the results showed evidence of a subjective benefit for patients from acupuncture and homoeopathy, this may account for the increase in demand for these treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previously.

  10. Personal information documents for people with dementia: Healthcare staff 's perceptions and experiences.

    Science.gov (United States)

    Baillie, Lesley; Thomas, Nicola

    2018-01-01

    Person-centred care is internationally recognised as best practice for the care of people with dementia. Personal information documents for people with dementia are proposed as a way to support person-centred care in healthcare settings. However, there is little research about how they are used in practice. The aim of this study was to analyse healthcare staff 's perceptions and experiences of using personal information documents, mainly Alzheimer's Society's 'This is me', for people with dementia in healthcare settings. The method comprised a secondary thematic analysis of data from a qualitative study, of how a dementia awareness initiative affected care for people with dementia in one healthcare organisation. The data were collected through 12 focus groups (n = 58 participants) and 1 individual interview, conducted with a range of healthcare staff, both clinical and non-clinical. There are four themes presented: understanding the rationale for personal information documents; completing personal information documents; location for personal information documents and transfer between settings; impact of personal information documents in practice. The findings illuminated how healthcare staff use personal information documents in practice in ways that support person-centred care. Practical issues about the use of personal information documents were revealed and these may affect the optimal use of the documents in practice. The study indicated the need to complete personal information documents at an early stage following diagnosis of dementia, and the importance of embedding their use across care settings, to support communication and integrated care.

  11. Computing exact bundle compliance control charts via probability generating functions.

    Science.gov (United States)

    Chen, Binchao; Matis, Timothy; Benneyan, James

    2016-06-01

    Compliance to evidenced-base practices, individually and in 'bundles', remains an important focus of healthcare quality improvement for many clinical conditions. The exact probability distribution of composite bundle compliance measures used to develop corresponding control charts and other statistical tests is based on a fairly large convolution whose direct calculation can be computationally prohibitive. Various series expansions and other approximation approaches have been proposed, each with computational and accuracy tradeoffs, especially in the tails. This same probability distribution also arises in other important healthcare applications, such as for risk-adjusted outcomes and bed demand prediction, with the same computational difficulties. As an alternative, we use probability generating functions to rapidly obtain exact results and illustrate the improved accuracy and detection over other methods. Numerical testing across a wide range of applications demonstrates the computational efficiency and accuracy of this approach.

  12. Critical issues in an electronic documentation system.

    Science.gov (United States)

    Weir, Charlene R; Nebeker, Jonathan R

    2007-10-11

    The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs has instituted a medical record (EMR) that includes electronic documentation of all narrative components of the medical record. To support clinicians using the system, multiple efforts have been instituted to ease the creation of narrative reports. Although electronic documentation is easier to read and improves access to information, it also may create new and additional hazards for users. This study is the first step in a series of studies to evaluate the issues surrounding the creation and use of electronic documentation. Eighty-eight providers across multiple clinical roles were interviewed in 10 primary care sites in the VA system. Interviews were tape-recorded, transcribed and qualitatively analyzed for themes. In addition, specific questions were asked about perceived harm due to electronic documentation practices. Five themes relating to difficulties with electronic documentation were identified: 1) information overload; 2) hidden information; 3) lack of trust; 4) communication; 5) decision-making. Three providers reported that they knew of an incident where current documentation practices had caused patient harm and over 75% of respondents reported significant mis-trust of the system.

  13. Safeguards Guidance Document for Designers of Commercial Nuclear Facilities: International Nuclear Safeguards Requirements and Practices For Uranium Enrichment Plants

    Energy Technology Data Exchange (ETDEWEB)

    Robert Bean; Casey Durst

    2009-10-01

    This report is the second in a series of guidelines on international safeguards requirements and practices, prepared expressly for the designers of nuclear facilities. The first document in this series is the description of generic international nuclear safeguards requirements pertaining to all types of facilities. These requirements should be understood and considered at the earliest stages of facility design as part of a new process called “Safeguards-by-Design.” This will help eliminate the costly retrofit of facilities that has occurred in the past to accommodate nuclear safeguards verification activities. The following summarizes the requirements for international nuclear safeguards implementation at enrichment plants, prepared under the Safeguards by Design project, and funded by the U.S. Department of Energy (DOE) National Nuclear Security Administration (NNSA), Office of NA-243. The purpose of this is to provide designers of nuclear facilities around the world with a simplified set of design requirements and the most common practices for meeting them. The foundation for these requirements is the international safeguards agreement between the country and the International Atomic Energy Agency (IAEA), pursuant to the Treaty on the Non-proliferation of Nuclear Weapons (NPT). Relevant safeguards requirements are also cited from the Safeguards Criteria for inspecting enrichment plants, found in the IAEA Safeguards Manual, Part SMC-8. IAEA definitions and terms are based on the IAEA Safeguards Glossary, published in 2002. The most current specification for safeguards measurement accuracy is found in the IAEA document STR-327, “International Target Values 2000 for Measurement Uncertainties in Safeguarding Nuclear Materials,” published in 2001. For this guide to be easier for the designer to use, the requirements have been restated in plainer language per expert interpretation using the source documents noted. The safeguards agreement is fundamentally a

  14. 49 CFR 236.338 - Mechanical locking required in accordance with locking sheet and dog chart.

    Science.gov (United States)

    2010-10-01

    ... locking sheet and dog chart. 236.338 Section 236.338 Transportation Other Regulations Relating to... in accordance with locking sheet and dog chart. Mechanical locking shall be in accordance with locking sheet and dog chart currently in effect. ...

  15. North Atlantic IFR Route Planning Chart GEO-TIFF - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  16. North Atlantic IFR Route Planning Chart PDF File - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  17. Costs of conventional radical radiotherapy versus continuous hyperfractionated accelerated radiotherapy (CHART) in the treatment of patients with head and neck cancer or carcinoma of the bronchus. Medical Research Council CHART Steering Committee.

    Science.gov (United States)

    Coyle, D; Drummond, M F

    1997-01-01

    The objective of this study was to compare the costs of treatment with continuous hyperfractionated accelerated radiotherapy (CHART) and those of conventional radiotherapy for patients with (1) head and neck cancer and (2) carcinoma of the bronchus. The study was conducted concurrently with two multicentre randomized controlled trials. Data were collected on the use of hospital and community service resources and patients' travel for treatment. Data on resource use up to 3 months after entry to the study were available for 526 head and neck patients (314 receiving CHART and 212 conventional therapy) and 284 bronchus patients (175 CHART and 109 conventional therapy). For patients with head and neck cancer, CHART cost Pounds 1092 (P hostel facilities. The results of this cost analysis will help to facilitate a decision about whether the benefits of CHART, as determined by the clinical trials, are worth the additional costs of hospital-based resource use. The collection of detailed patient-specific resource-use data from a number of centres allows the determination of ways for reducing the cost differential between therapies and making CHART a more cost effective treatment alternative.

  18. Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

    Science.gov (United States)

    Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

    2015-06-01

    Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- m

  19. 47 CFR 1.14 - Citation of Commission documents.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Citation of Commission documents. 1.14 Section... Rules of Practice and Procedure General § 1.14 Citation of Commission documents. The appropriate reference to the FCC Record shall be included as part of the citation to any document that has been printed...

  20. Supplemental Information Source Document Waste Management

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Craig [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Halpern, Jonathan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wrons, Ralph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reiser, Anita [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mond, Michael du [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Shain, Matthew [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-12-01

    This Supplemental Information Source Document for Waste Management was prepared in support of future analyses including those that may be performed as part of the Sandia National Laboratories, New Mexico (SNL/NM) Site-Wide Environmental Impact Statement. This document presents information about waste management practices at SNL/NM, including definitions, inventory data, and an overview of current activities.

  1. Applying Nightingale charts to evaluate the heterogeneity of biomedical waste in a Hospital

    Directory of Open Access Journals (Sweden)

    Janini Cristina Paiz

    2014-12-01

    Full Text Available OBJECTIVES: to evaluate the heterogeneity of biomedical waste (BW using Nightingale charts.METHOD: cross-sectional study consisting of data collection on wastes (direct observation of receptacles, physical characterisation, and gravimetric composition, development of a Management Information System, and creation of statistical charts.RESULTS: the wastes with the greatest degree of heterogeneity are, in order, recyclable, infectious, and organic wastes; chemical waste had the most efficient segregation; Nightingale charts are useful for quick visualisation and systematisation of information on heterogeneity.CONCLUSION: the development of a management information system and the use of Nightingale charts allows for the identification and correction of errors in waste segregation, which increase health risks and contamination by infectious and chemical wastes and reduce the sale and profit from recyclables.

  2. Nuclides 2000: an electronic chart of the nuclides on CD-ROM

    International Nuclear Information System (INIS)

    Magill, J.

    2000-01-01

    The 'Nuclides 2000' software package is an electronic chart of the nuclides, available on CD-ROM for Microsoft Windows operating systems, which offers extensive basic information on physics and radiology of the familiar nuclides. Moreover, 'Nuclides 2000' contains codes for a number of applications which allow the required data to be computed quickly and reliably by means of interactive user guidance. The data and codes are supplemented by information in the format of contributions on the history of radioactivity and radiochemistry, and on subjects of interest in physics, such as C-14 dating and the generation of Ti-44 in a supernova, and by a link collection of Internet addresses. As a detailed database, 'Nuclides 2000' can be used for teaching, research, and for practical applications. (orig.) [de

  3. Description of a practice model for pharmacist medication review in a general practice setting

    DEFF Research Database (Denmark)

    Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk

    2014-01-01

    BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. CONCLUSION: We have provided a detailed description of a practical approach to pharmacists' medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance...

  4. Documentation of delirium in the VA electronic health record

    Science.gov (United States)

    2014-01-01

    Background Delirium is a life-threatening, clinical syndrome common among the elderly and hospitalized patients. Delirium is under-recognized and misdiagnosed, complicating efforts to study the epidemiology and construct appropriate decision support to improve patient care. This study was primarily conducted to realize how providers documented confirmed cases of delirium in electronic health records as a preliminary step for using computerized methods to identify patients with delirium from electronic health records. Methods The Mental Health Consult (MHC) team reported cases of delirium to the study team during a 6-month study period (December 1, 2009 - May 31, 2010). A chart extraction tool was developed to abstract documentation of diagnosis, signs and symptoms and known risk factors of delirium. A nurse practitioner, and a clinical pharmacist independently reviewed clinical notes during each patients hospital stay to determine if delirium and or sign and symptoms of delirium were documented. Results The MHC team reported 25 cases of delirium. When excluding MHC team notes, delirium was documented for 5 of the 25 patients (one reported case in a physician’s note, four in discharge summaries). Delirium was ICD-9 Coded for 7 of the 25 cases. Signs and symptoms associated with delirium were characterized in 8 physician notes, 11 discharge summaries, and 14 nursing notes, accounting for 16 of the 25 cases with identified delirium. Conclusions Documentation of delirium is highly inconsistent even with a confirmed diagnosis. Hence, efforts to use existing data to precisely estimate the prevalence of delirium or to conduct epidemiological studies based on medical records will be challenging. PMID:24708799

  5. Progress in the technology of nautical charting

    Digital Repository Service at National Institute of Oceanography (India)

    Joseph, A.

    ". The article skims through the various aspects of safety of navigation such as nautical charts created by the Arabs in the medieval days of stellar navigation in the Indian Ocean; the contributions by the Chinese, the British, and the Portuguese; hydrographic...

  6. Unpacking Docent Practice in Free Choice Science Learning Settings: A Qualitative Study Documenting the What and Whys of Docent Interpretive Practice

    Science.gov (United States)

    Good, Laura H.

    Museum settings including aquariums, zoos and science centers rely heavily on their volunteer docent populations to interact with and communicate science and conservation concepts to the visiting public. The interactions docents have with museum visitors are important to meeting the educational expectations of museums and improving public science literacy as a whole, yet research to date is limited around docent practice, docents' reflections on that practice nor the sources for docents to learn that practice. Thus, we have little understanding of the interpretive practice docents actually undertake whilst interacting with visitors, why they choose to enact particular strategies, and how they came to learn those practices. Using a grounded qualitative approach within a framework of mediated action and cultural historical activity theory, this case study utilized video observations of docent practice at a science center, pre and post observation interviews, and focus groups to 1) document docent practices for engaging visitors, 2) explain those practices from the docents' own perspectives, and 3) examine those practices from the point of view of how they align with teaching and learning theories and interpretive practice. Thematic analysis using constant comparative methods demonstrate four claims about docent practice: 1) docents view teaching in the museum as opportunities to spark interest with these new experiences. Practices are chosen to engage visitors in these experiences. Docents choose to highlight these experiences as they believe they are reasons to be engaged; 2) docents as teachers are perceptive about their audience. They pay attention to patterns and provide information in response to those patterns. Docents utilize a shared repertoire of practice and information in their community developed from understanding visitor patterns of interest; 3) docents care about their setting and the exhibits within it. They also care about the visitor experience as a

  7. Rubber stamp templates for improving clinical documentation: A paper-based, m-Health approach for quality improvement in low-resource settings.

    Science.gov (United States)

    Kleczka, Bernadette; Musiega, Anita; Rabut, Grace; Wekesa, Phoebe; Mwaniki, Paul; Marx, Michael; Kumar, Pratap

    2018-06-01

    The United Nations' Sustainable Development Goal #3.8 targets 'access to quality essential healthcare services'. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones. The Guidelines Adherence in Slums Project targeted ten private sector primary healthcare clinics serving informal settlements in Nairobi, Kenya. Each clinic was provided with rubber stamp templates to support documentation and management of commonly encountered outpatient conditions. Participatory design methods were used to customize templates to the workflows and infrastructure of each clinic. Rubber stamps were used to print templates into paper charts, providing clinicians with checklists for use during consultations. Templates used bubble format data entry, which could be digitized from images taken on mobile phones. Besides rubber stamp templates, the intervention included booklets of guideline compilations, one Android phone for digitizing images of templates, and one data feedback/continuing medical education session per clinic each month. In this paper we focus on the effect of the intervention on documentation of three non-communicable diseases in one clinic. Seventy charts of patients enrolled in the chronic disease program (hypertension/diabetes, n=867; chronic respiratory diseases, n=223) at one of the ten intervention clinics were sampled. Documentation of each individual patient encounter in the pre-intervention (January-March 2016) and post-intervention period (May-July) was scored for information in four dimensions - general data, patient assessment, testing, and management. Control criteria included

  8. Desktop publishing and validation of custom near visual acuity charts.

    Science.gov (United States)

    Marran, Lynn; Liu, Lei; Lau, George

    2008-11-01

    Customized visual acuity (VA) assessment is an important part of basic and clinical vision research. Desktop computer based distance VA measurements have been utilized, and shown to be accurate and reliable, but computer based near VA measurements have not been attempted, mainly due to the limited spatial resolution of computer monitors. In this paper, we demonstrate how to use desktop publishing to create printed custom near VA charts. We created a set of six near VA charts in a logarithmic progression, 20/20 through 20/63, with multiple lines of the same acuity level, different letter arrangements in each line and a random noise background. This design allowed repeated measures of subjective accommodative amplitude without the potential artifact of familiarity of the optotypes. The background maintained a constant and spatial frequency rich peripheral stimulus for accommodation across the six different acuity levels. The paper describes in detail how pixel-wise accurate black and white bitmaps of Sloan optotypes were used to create the printed custom VA charts. At all acuity levels, the physical sizes of the printed custom optotypes deviated no more than 0.034 log units from that of the standard, satisfying the 0.05 log unit ISO criterion we used to demonstrate physical equivalence. Also, at all acuity levels, log unit differences in the mean target distance for which reliable recognition of letters first occurred for the printed custom optotypes compared to the standard were found to be below 0.05, satisfying the 0.05 log unit ISO criterion we used to demonstrate functional equivalence. It is possible to use desktop publishing to create custom near VA charts that are physically and functionally equivalent to standard VA charts produced by a commercial printing process.

  9. Design and analysis of control charts for standard deviation with estimated parameters

    NARCIS (Netherlands)

    Schoonhoven, M.; Riaz, M.; Does, R.J.M.M.

    2011-01-01

    This paper concerns the design and analysis of the standard deviation control chart with estimated limits. We consider an extensive range of statistics to estimate the in-control standard deviation (Phase I) and design the control chart for real-time process monitoring (Phase II) by determining the

  10. Tooth wear risk assessment and care-planning in general dental practice.

    Science.gov (United States)

    O'Toole, S; Khan, M; Patel, A; Patel, N J; Shah, N; Bartlett, D; Movahedi, S

    2018-03-09

    Objective To assess charting, risk assessment and treatment-planning of tooth wear between recently qualified and experienced dentists in general dental practice.Design Service evaluation.Setting Multi-setting evaluation of three mixed NHS/Private general dental practices in North-East London.Methods The clinical notes of new patient examinations on dentate adults presenting from the 1 October 2016 to 31 December 2016 were audited collecting data on tooth wear charting, risk assessment and treatment planning. Data were analysed using descriptives, chi square and logistic regressions in SPSS. Significance was inferred at p charted for 48% of those attending foundation dentists and 5% of those attending experienced dentists. Diet was assessed in 50.6% of patients examined by foundation dentists and 1.0% of patients examined by experienced dentists. Foundation dentists were more likely to chart tooth wear, risk assess and preventively manage tooth wear compared to experienced dentists (p <0.001).Conclusion This service evaluation highlights that improvements are required in recording, risk assessing and preventive treatment planning of erosive tooth wear. Experienced dentists were less likely to risk assess tooth wear and less likely to provide preventive treatment. Experienced GDPs may benefit from re-training in this area.

  11. Multivariate control charts based on net analyte signal (NAS) and Raman spectroscopy for quality control of carbamazepine

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, Werickson Fortunato de Carvalho [Institute of Chemistry, University of Campinas - UNICAMP, P.O. Box 6154, 13083-970 Campinas, SP (Brazil); National Institute of Metrology, Standardization and Industrial Quality, Inmetro, Dimci/Dquim - Directorate of Metrology, Science and Industry/Division of Chemical Metrology, Av. Nossa Senhora das Gracas 50, Building 6, 25250-020, Xerem, Duque de Caxias, RJ (Brazil); Poppi, Ronei Jesus, E-mail: ronei@iqm.unicamp.br [Institute of Chemistry, University of Campinas - UNICAMP, P.O. Box 6154, 13083-970 Campinas, SP (Brazil); National Institute of Science and Technology (INCT) for Bioanalytics, 13083-970 Campinas, SP (Brazil)

    2011-10-31

    Raman spectroscopy and control charts based on the net analyte signal (NAS) were applied to polymorphic characterization of carbamazepine. Carbamazepine presents four polymorphic forms: I-IV (dihydrate). X-ray powder diffraction was used as a reference technique. The control charts were built generating three charts: the NAS chart that corresponds to the analyte of interest (form III in this case), the interference chart that corresponds to the contribution of other compounds in the sample and the residual chart that corresponds to nonsystematic variations. For each chart, statistical limits were developed using samples within the quality specifications. It was possible to identify the different polymorphic forms of carbamazepine present in pharmaceutical formulations. Thus, an alternative method for the quality monitoring of the carbamazepine polymorphic forms after the crystallization process is presented.

  12. Multivariate control charts based on net analyte signal (NAS) and Raman spectroscopy for quality control of carbamazepine

    International Nuclear Information System (INIS)

    Rocha, Werickson Fortunato de Carvalho; Poppi, Ronei Jesus

    2011-01-01

    Raman spectroscopy and control charts based on the net analyte signal (NAS) were applied to polymorphic characterization of carbamazepine. Carbamazepine presents four polymorphic forms: I-IV (dihydrate). X-ray powder diffraction was used as a reference technique. The control charts were built generating three charts: the NAS chart that corresponds to the analyte of interest (form III in this case), the interference chart that corresponds to the contribution of other compounds in the sample and the residual chart that corresponds to nonsystematic variations. For each chart, statistical limits were developed using samples within the quality specifications. It was possible to identify the different polymorphic forms of carbamazepine present in pharmaceutical formulations. Thus, an alternative method for the quality monitoring of the carbamazepine polymorphic forms after the crystallization process is presented.

  13. SU-G-IeP3-14: Updating Tools for Radiographic Technique Charts

    Energy Technology Data Exchange (ETDEWEB)

    Walz-Flannigan, A; Lucas, J; Buchanan, K; Schueler, B [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: Manual technique selection in radiography is needed for imaging situations where there is difficulty in proper positioning for AEC, prosthesis, for non-bucky imaging, or for guiding image repeats. Basic information about how to provide consistent image signal and contrast for various kV and tissue thickness is needed to create manual technique charts, and relevant for physicists involved in technique chart optimization. Guidance on technique combinations and rules-of-thumb to provide consistent image signal still in use today are based on measurements with optical density of screen-film combinations and older generation x-ray systems. Tools such as a kV-scale chart can be useful to know how to modify mAs when kV is changed in order to maintain consistent image receptor signal level. We evaluate these tools for modern equipment for use in optimizing proper size scaled techniques. Methods: We used a water phantom to measure calibrated signal change for CR and DR (with grid) for various beam energies. Tube current values were calculated that would yield a consistent image signal response. Data was fit to provide sufficient granularity of detail to compose technique-scale chart. Tissue thickness approximated equivalence to 80% of water depth. Results: We created updated technique-scale charts, providing mAs and kV combinations to achieve consistent signal for CR and DR for various tissue equivalent thicknesses. We show how this information can be used to create properly scaled size-based manual technique charts. Conclusion: Relative scaling of mAs and kV for constant signal (i.e. the shape of the curve) appears substantially similar between film-screen and CR/DR. This supports the notion that image receptor related differences are minor factors for relative (not absolute) changes in mAs with varying kV. However, as demonstrated creation of these difficult to find detailed technique-scales are useful tools for manual chart optimization.

  14. Areva, reference document 2006

    International Nuclear Information System (INIS)

    2006-01-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains information on the markets, market shares and competitive position of the AREVA group. Content: - 1 Person responsible for the reference document and persons responsible for auditing the financial statements; - 2 Information pertaining to the transaction (Not applicable); - 3 General information on the company and its share capital: Information on AREVA, on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; - 4 Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts, The principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and development programs, intellectual property and trademarks, Risk and insurance; - 5 Assets - Financial position - Financial performance: Analysis of and comments on the group's financial position and performance, 2006 Human Resources Report, Environmental Report, Consolidated financial statements, Notes to the consolidated financial statements, AREVA SA financial statements, Notes to the corporate financial statements; 6 - Corporate Governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Combined General Meeting of Shareholders of May 3, 2007; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2006, Outlook; 8 - Glossary; 9 - Table of concordance

  15. Areva reference document 2007

    International Nuclear Information System (INIS)

    2008-01-01

    This reference document contains information on the AREVA group's objectives, prospects and development strategies, particularly in Chapters 4 and 7. It contains also information on the markets, market shares and competitive position of the AREVA group. Content: 1 - Person responsible for the reference document and persons responsible for auditing the financial statements; 2 - Information pertaining to the transaction (not applicable); 3 - General information on the company and its share capital: Information on Areva, Information on share capital and voting rights, Investment certificate trading, Dividends, Organization chart of AREVA group companies, Equity interests, Shareholders' agreements; 4 - Information on company operations, new developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, The energy businesses of the AREVA group, Front End division, Reactors and Services division, Back End division, Transmission and Distribution division, Major contracts 140 Principal sites of the AREVA group, AREVA's customers and suppliers, Sustainable Development and Continuous Improvement, Capital spending programs, Research and Development programs, Intellectual Property and Trademarks, Risk and insurance; 5 - Assets financial position financial performance: Analysis of and comments on the group's financial position and performance, Human Resources report, Environmental report, Consolidated financial statements 2007, Notes to the consolidated financial statements, Annual financial statements 2007, Notes to the corporate financial statements; 6 - Corporate governance: Composition and functioning of corporate bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual Ordinary General Meeting of Shareholders of April 17, 2008; 7 - Recent developments and future prospects: Events subsequent to year-end closing for 2007, Outlook; Glossary; table of concordance

  16. Is Your Biobank Up to Standards? A Review of the National Canadian Tissue Repository Network Required Operational Practice Standards and the Controlled Documents of a Certified Biobank.

    Science.gov (United States)

    Hartman, Victoria; Castillo-Pelayo, Tania; Babinszky, Sindy; Dee, Simon; Leblanc, Jodi; Matzke, Lise; O'Donoghue, Sheila; Carpenter, Jane; Carter, Candace; Rush, Amanda; Byrne, Jennifer; Barnes, Rebecca; Mes-Messons, Anne-Marie; Watson, Peter

    2018-02-01

    Ongoing quality management is an essential part of biobank operations and the creation of high quality biospecimen resources. Adhering to the standards of a national biobanking network is a way to reduce variability between individual biobank processes, resulting in cross biobank compatibility and more consistent support for health researchers. The Canadian Tissue Repository Network (CTRNet) implemented a set of required operational practices (ROPs) in 2011 and these serve as the standards and basis for the CTRNet biobank certification program. A review of these 13 ROPs covering 314 directives was conducted after 5 years to identify areas for revision and update, leading to changes to 7/314 directives (2.3%). A review of all internal controlled documents (including policies, standard operating procedures and guides, and forms for actions and processes) used by the BC Cancer Agency's Tumor Tissue Repository (BCCA-TTR) to conform to these ROPs was then conducted. Changes were made to 20/106 (19%) of BCCA-TTR documents. We conclude that a substantial fraction of internal controlled documents require updates at regular intervals to accommodate changes in best practices. Reviewing documentation is an essential aspect of keeping up to date with best practices and ensuring the quality of biospecimens and data managed by biobanks.

  17. Bivariate copulas on the exponentially weighted moving average control chart

    Directory of Open Access Journals (Sweden)

    Sasigarn Kuvattana

    2016-10-01

    Full Text Available This paper proposes four types of copulas on the Exponentially Weighted Moving Average (EWMA control chart when observations are from an exponential distribution using a Monte Carlo simulation approach. The performance of the control chart is based on the Average Run Length (ARL which is compared for each copula. Copula functions for specifying dependence between random variables are used and measured by Kendall’s tau. The results show that the Normal copula can be used for almost all shifts.

  18. Flexible Design and Operation of a Smart Charging Microgrid (Briefing Charts)

    Science.gov (United States)

    2014-04-08

    release; distribution unlimited 13. SUPPLEMENTARY NOTES Briefing Charts for SAE World Congress 2014 14. ABSTRACT A microgrid is a controllable ...UNCLASSIFIED Distribution Statement A: Approved for Public Release Flexible Design and Operation of a Smart Charging Microgrid Annette G... control number. 1. REPORT DATE 08 APR 2014 2. REPORT TYPE Briefing Charts 3. DATES COVERED 08-01-2014 to 09-03-2014 4. TITLE AND SUBTITLE

  19. Results of a multicentre randomised controlled trial of statistical process control charts and structured diagnostic tools to reduce ward-acquired meticillin-resistant Staphylococcus aureus: the CHART Project.

    Science.gov (United States)

    Curran, E; Harper, P; Loveday, H; Gilmour, H; Jones, S; Benneyan, J; Hood, J; Pratt, R

    2008-10-01

    Statistical process control (SPC) charts have previously been advocated for infection control quality improvement. To determine their effectiveness, a multicentre randomised controlled trial was undertaken to explore whether monthly SPC feedback from infection control nurses (ICNs) to healthcare workers of ward-acquired meticillin-resistant Staphylococcus aureus (WA-MRSA) colonisation or infection rates would produce any reductions in incidence. Seventy-five wards in 24 hospitals in the UK were randomised into three arms: (1) wards receiving SPC chart feedback; (2) wards receiving SPC chart feedback in conjunction with structured diagnostic tools; and (3) control wards receiving neither type of feedback. Twenty-five months of pre-intervention WA-MRSA data were compared with 24 months of post-intervention data. Statistically significant and sustained decreases in WA-MRSA rates were identified in all three arms (Pcontrol wards, but with no significant difference between the control and intervention arms (P=0.23). There were significantly more post-intervention 'out-of-control' episodes (P=0.021) in the control arm (averages of 0.60, 0.28, and 0.28 for Control, SPC and SPC+Tools wards, respectively). Participants identified SPC charts as an effective communication tool and valuable for disseminating WA-MRSA data.

  20. Control charts for health care monitoring under intermittent out-of-control behavior

    NARCIS (Netherlands)

    Albers, Willem/Wim

    Health care monitoring typically concerns attribute data with very low failure rates. Efficient control charts then signal if the waiting time till r (e.g. r≤5) failures is too small. An interesting alternative is the MAX-chart, which signals if all the associated r waiting times for a single

  1. Control charts for health care monitoring under intermittent out-of-control behavior

    NARCIS (Netherlands)

    Albers, Willem/Wim

    2011-01-01

    Health care monitoring typically concerns attribute data with very low failure rates. Efficient control charts then signal if the waiting time till r (e.g. r≤5) failures is too small. An interesting alternative is the MAX-chart, which signals if all the associated r waiting times for a single

  2. Neonatal Diagnostics: Towards Dynamic Growth Charts of Neuro-motor control

    Directory of Open Access Journals (Sweden)

    Elizabeth B Torres

    2016-11-01

    Full Text Available Current rise of neurodevelopmental disorders, poses a critical need to detect risk early in order to rapidly intervene. One of the tools Pediatricians use to track development is the standard Growth Chart. The Growth Charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data —obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based growth charts and combining these dynamic changes with underlying fluctuations in motor performance—as they transition from spontaneous random noise to a systematic signal— we demonstrate a method to detect very early stunting in the development of voluntary neuro-motor control and to flag risk of neurodevelopmental derail.

  3. The construction of control chart for PM10 functional data

    Science.gov (United States)

    Shaadan, Norshahida; Jemain, Abdul Aziz; Deni, Sayang Mohd

    2014-06-01

    In this paper, a statistical procedure to construct a control chart for monitoring air quality (PM10) using functional data is proposed. A set of daily indices that represent the daily PM10 curves were obtained using Functional Principal Component Analysis (FPCA). By means of an iterative charting procedure, a reference data set that represented a stable PM10 process was obtained. The data were then used as a reference for monitoring future data. The application of the procedure was conducted using seven-year (2004-2010) period of recorded data from the Klang air quality monitoring station located in the Klang Valley region of Peninsular Malaysia. The study showed that the control chart provided a useful visualization tool for monitoring air quality and was capable in detecting abnormality in the process system. As in the case of Klang station, the results showed that with reference to 2004-2008, the air quality (PM10) in 2010 was better than that in 2009.

  4. A circular organization chart promotes a hospital-wide focus on teams.

    Science.gov (United States)

    Fanning, M M

    1997-01-01

    Our Lady of the Way Hospital, like most hospitals in the late 1980s and early 1990s, exemplified the bureaucratic organization represented by the traditional "line and box organization chart." Additionally, as in most small hospitals, the CEO of Our Lady of the Way Hospital--a 39-bed, JCAHO accredited, general, acute care hospital in Martin, Kentucky--had direct management responsibility for several functional departments. In 1992, administration replaced the traditional, hierarchical organization chart with a circular structure that reflected its increased reliance on team processes throughout the organization. The new structure also significantly reduced the number of reporting assignments to the CEO. This article describes the hospital's transition to a team-based organization, illustrates the application of a circular organization chart, and assesses its value and limitations.

  5. The Significant Incidents and Close Calls in Human Space Flight Chart: Lessons Learned Gone Viral

    Science.gov (United States)

    Wood, Bill; Pate, Dennis; Thelen, David

    2010-01-01

    This presentation will explore the surprising history and events that transformed a mundane spreadsheet of historical spaceflight incidents into a popular and widely distributed visual compendium of lessons learned. The Significant Incidents and Close Calls in Human Space Flight Chart (a.k.a. The Significant Incidents Chart) is a popular and visually captivating reference product that has arisen from the work of the Johnson Space Center (JSC) Safety and Mission Assurance (S&MA) Flight Safety Office (FSO). It began as an internal tool intended to increase our team s awareness of historical and modern space flight incidents. Today, the chart is widely recognized across the agency as a reference tool. It appears in several training and education programs. It is used in familiarization training in the JSC Building 9 Mockup Facility and is seen by hundreds of center visitors each week. The chart visually summarizes injuries, fatalities, and close calls sustained during the continuing development of human space flight. The poster-sized chart displays over 100 total events that have direct connections to human space flight endeavors. The chart is updated periodically. The update process itself has become a collaborative effort. Many people, spanning multiple NASA organizations, have provided suggestions for additional entries. The FSO maintains a growing list of subscribers who have requested to receive updates. The presenters will discuss the origins and motivations behind the significant incidents chart. A review of the inclusion criteria used to select events will be offered. We will address how the chart is used today by S&MA and offer a vision of how it might be used by other organizations now and in the future. Particular emphasis will be placed on features of the chart that have met with broad acceptance and have helped spread awareness of the most important lessons in human spaceflight.

  6. Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices.

    Science.gov (United States)

    Livingstone, I A T; Tarbert, C M; Giardini, M E; Bastawrous, A; Middleton, D; Hamilton, R

    2016-01-01

    Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out

  7. Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices.

    Directory of Open Access Journals (Sweden)

    I A T Livingstone

    Full Text Available Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc. and three ETDRS (Early Treatment Diabetic Retinopathy Study visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2 providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90% regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%. Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off had adequate mean luminance (≥ 120 cd/m2 and Weber contrast (≥ 90%, but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%. Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out

  8. Charting environmental pollution. [by noise measurements

    Science.gov (United States)

    Halpert, E.; Bizo, F.; Karacsonyi, Z.

    1974-01-01

    It is found that areas affected by different noxious agents are within the limits traced for high noise level areas; consequently, it is suggested that high noise pressure levels should be used as the primary indication of environmental pollution. A complex methodology is reported for charting environmental pollution due to physical, chemical and biological noxious agents on the scale of an industrial district.

  9. SU-E-T-408: Evaluation of the Type and Frequency of Variations Discovered During Routine Secondary Patient Chart Review

    International Nuclear Information System (INIS)

    Hardin, M; Harrison, A; Lockamy, V; Li, J; Peng, C; Potrebko, P; Yu, Y; Doyle, L; Cao, J

    2015-01-01

    Purpose: Desire to improve efficiency and throughput inspired a review of our physics chart check procedures. Departmental policy mandates plan checks pre-treatment, after first treatment and weekly every 3–5 days. This study examined the effectiveness of the “after first” check with respect to improving patient safety and clinical efficiency. Type and frequency of variations discovered during this redundant secondary review was examined over seven months. Methods: A community spreadsheet was created to record variations in care discovered during chart review following the first fraction of treatment and before the second fraction (each plan reviewed prior to treatment). Entries were recorded from August 2014 through February 2015, amounting to 43 recorded variations out of 906 reviewed charts. The variations were divided into categories and frequencies were assessed month-to-month. Results: Analysis of recorded variations indicates an overall variation rate of 4.7%. The initial rate was 13.5%; months 2–7 average 3.7%. The majority of variations related to discrepancies in documentation at 46.5%, followed by prescription, plan deficiency, and dose tracking related variations at 25.5%, 12.8%, and 12.8%, respectively. Minor variations (negligible consequence on patient treatment) outweighed major variations 3 to 1. Conclusion: This work indicates that this redundant secondary check is effective. The first month spike in rates could be due to the Hawthorne/observer effect, but the consistent 4% variation rate suggests the need for periodical re-training on variations noted as frequent to improve awareness and quality of the initial chart review process, which may lead to improved treatment quality, patient safety and increased clinical efficiency. Utilizing these results, a continuous quality improvement process following Deming’s Plan-Do-Study-Act (PDSA) methodology was generated. The first iteration of this PDSA was adding a specific dose tracking

  10. SU-E-T-408: Evaluation of the Type and Frequency of Variations Discovered During Routine Secondary Patient Chart Review

    Energy Technology Data Exchange (ETDEWEB)

    Hardin, M; Harrison, A; Lockamy, V; Li, J; Peng, C; Potrebko, P; Yu, Y; Doyle, L; Cao, J [Thomas Jefferson University, Philadelphia, PA (United States)

    2015-06-15

    Purpose: Desire to improve efficiency and throughput inspired a review of our physics chart check procedures. Departmental policy mandates plan checks pre-treatment, after first treatment and weekly every 3–5 days. This study examined the effectiveness of the “after first” check with respect to improving patient safety and clinical efficiency. Type and frequency of variations discovered during this redundant secondary review was examined over seven months. Methods: A community spreadsheet was created to record variations in care discovered during chart review following the first fraction of treatment and before the second fraction (each plan reviewed prior to treatment). Entries were recorded from August 2014 through February 2015, amounting to 43 recorded variations out of 906 reviewed charts. The variations were divided into categories and frequencies were assessed month-to-month. Results: Analysis of recorded variations indicates an overall variation rate of 4.7%. The initial rate was 13.5%; months 2–7 average 3.7%. The majority of variations related to discrepancies in documentation at 46.5%, followed by prescription, plan deficiency, and dose tracking related variations at 25.5%, 12.8%, and 12.8%, respectively. Minor variations (negligible consequence on patient treatment) outweighed major variations 3 to 1. Conclusion: This work indicates that this redundant secondary check is effective. The first month spike in rates could be due to the Hawthorne/observer effect, but the consistent 4% variation rate suggests the need for periodical re-training on variations noted as frequent to improve awareness and quality of the initial chart review process, which may lead to improved treatment quality, patient safety and increased clinical efficiency. Utilizing these results, a continuous quality improvement process following Deming’s Plan-Do-Study-Act (PDSA) methodology was generated. The first iteration of this PDSA was adding a specific dose tracking

  11. Extractive Summarisation of Medical Documents

    OpenAIRE

    Abeed Sarker; Diego Molla; Cecile Paris

    2012-01-01

    Background Evidence Based Medicine (EBM) practice requires practitioners to extract evidence from published medical research when answering clinical queries. Due to the time-consuming nature of this practice, there is a strong motivation for systems that can automatically summarise medical documents and help practitioners find relevant information. Aim The aim of this work is to propose an automatic query-focused, extractive summarisation approach that selects informative sentences from medic...

  12. SIZE CHART FOR SOCKS FOR SCHOOL BOYS IN SRI LANKA

    OpenAIRE

    Lanarolle W.D.G*, Jeewandara V.K., Amadoru R.S., Wijayarathna E.K.B. and Randike H.M.

    2017-01-01

    The structure of the body of human depends on many factors. Hence the sizes and size charts for garments need to be developed for a specific nation/human group. This paper presents a size chart developed for socks for school boys in Sri Lanka. The foot and leg measurements of 2650 school boys in six different provinces of the country is used in the analysis in order to get a reasonable sample size as the foot and leg measurements may have many influences. Correlation between different f...

  13. 28 CFR 68.45 - Designation of parts of documents.

    Science.gov (United States)

    2010-07-01

    ... UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR IMMIGRATION-RELATED EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.45... afforded an opportunity to examine the entire document and to offer in evidence in like manner other...

  14. Documenting Instructional Practices in Large Introductory STEM Lecture Courses

    Science.gov (United States)

    Vu, Viet Quoc

    STEM education reform in higher education is framed around the need to improve student learning outcomes, increase student retention, and increase the number of underrepresented minorities and female students in STEM fields, all of which would ultimately contribute to America's competitiveness and prosperity. To achieve these goals, education reformers call for an increase in the adoption of research-based "promising practices" in classrooms. Despite efforts to increase the adoption of more promising practices in classrooms, postsecondary instructors are still likely to lecture and use traditional teaching approaches. To shed light on this adoption dilemma, a mix-methods study was conducted. First, instructional practices in large introductory STEM courses were identified, followed by an analysis of factors that inhibit or contribute to the use of promising practices. Data were obtained from classroom observations (N = 259) of large gateway courses across STEM departments and from instructor interviews (N = 67). Results show that instructors are already aware of promising practices and that change strategies could move from focusing on the development and dissemination of promising practices to focusing on improving adoption rates. Teaching-track instructors such as lecturers with potential for security of employment (LPSOE) and lecturers with security of employment (LSOE) have adopted promising practices more than other instructors. Interview data show that LPSOEs are also effective at disseminating promising practices to their peers, but opinion leaders (influential faculty in a department) are necessary to promote adoption of promising practices by higher ranking instructors. However, hiring more LPSOEs or opinion leaders will not be enough to shift instructional practices. Variations in the adoption of promising practices by instructors and across departments show that any reform strategy needs to be systematic and take into consideration how information is

  15. Body Mass Index (BMI) Charts (For Parents)

    Science.gov (United States)

    ... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for ... charts for boys and girls to account for differences in growth rates and amounts of body fat as the two genders mature. That information is recorded in your child's ...

  16. Concurrent chart review provides more accurate documentation and increased calculated case mix index, severity of illness, and risk of mortality.

    Science.gov (United States)

    Frazee, Richard C; Matejicka, Anthony V; Abernathy, Stephen W; Davis, Matthew; Isbell, Travis S; Regner, Justin L; Smith, Randall W; Jupiter, Daniel C; Papaconstantinou, Harry T

    2015-04-01

    Case mix index (CMI) is calculated to determine the relative value assigned to a Diagnosis-Related Group. Accurate documentation of patient complications and comorbidities and major complications and comorbidities changes CMI and can affect hospital reimbursement and future pay for performance metrics. Starting in 2010, a physician panel concurrently reviewed the documentation of the trauma/acute care surgeons. Clarifications of the Centers for Medicare and Medicaid Services term-specific documentation were made by the panel, and the surgeon could incorporate or decline the clinical queries. A retrospective review of trauma/acute care inpatients was performed. The mean severity of illness, risk of mortality, and CMI from 2009 were compared with the 3 subsequent years. Mean length of stay and mean Injury Severity Score by year were listed as measures of patient acuity. Statistical analysis was performed using ANOVA and t-test, with p reimbursement and more accurately stratify outcomes measures for care providers. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Jean Rotz and the Marine Chart, 1542

    Science.gov (United States)

    Taylor, E. G. R.

    This paper was first published in the Journal in 1954 (Vol. 7, p. 138). It is followed by comments from Michael Richey.At the time (1542) when Jean Rotz presented Henry VIII with a variation compass, and an accompanying treatise on its making and use, the question of magnetic variation was an acute one. It formed part of a wider controversy concerning the general validity of the sea-chart which had been raised among seamen. As to this, Dr Pedro Nunez, writing a treatise in 1537 addressed to his friend and pupil the Infante Dom Luys of Portugal, said that there were skilled pilots who derided the chart and declared it to be - the falsest thing in the world. Hastening to its defence, Nunez dealt at length with the navigating errors introduced by ignoring the convergence of the meridians, and showed besides that a rhumb, or line of constant bearing was a spiral curve on the globe.

  18. Orientations of BCFW charts on the Grassmannian

    International Nuclear Information System (INIS)

    Olson, Timothy M.

    2015-01-01

    The Grassmannian formulation of N=4 super Yang-Mills theory expresses tree-level scattering amplitudes as linear combinations of residues from certain contour integrals. BCFW bridge decompositions using adjacent transpositions simplify the evaluation of individual residues, but orientation information is lost in the process. We present a straightforward algorithm to compute relative orientations between the resulting coordinate charts, and we show how to generalize the technique for charts corresponding to sequences of any not-necessarily-adjacent transpositions. As applications of these results, we demonstrate the existence of a signed boundary operator that manifestly squares to zero and prove via our algorithm that any residues appearing in the tree amplitude sum are decorated with appropriate signs so all poles that appear twice cancel exactly, not just mod 2 as in previous works. We also identify other non-physical poles in the boundary of Grassmannian representations of the amplitude and justify their removal so that the final result contains only physical local poles.

  19. APLIKASI GANTT CHART PADA ALGORITMA PENJADUALAN PROSES

    Directory of Open Access Journals (Sweden)

    Sri Handayani

    2014-01-01

    Full Text Available Operating system is a compulsory subject taken in the Information Technology Student FTIK - USM . In the discussion of the material management process of the operating systems course , there are some scheduling algorithm which processes need to be understood and any existing process scheduling algorithm presented in the form of Grantt Charts . Because of the difficulties experienced by students in understanding the process of scheduling algorithms by an Operating System become researchers inspiration to conduct this study to make an application Grantt Chart.. This study uses a waterfall system development , where the flow will follow the research the phase in waterfall . This application will be built using Visual Basic 6 .  The purpose of this research is to produce an application of learning are presented in graphical form to facilitate students in understanding the material scheduling process performed by an operating system so that students can also understand how a computer can do multiple processes simultaneously.

  20. Fire characteristics charts for fire behavior and U.S. fire danger rating

    Science.gov (United States)

    Faith Ann Heinsch; Pat Andrews

    2010-01-01

    The fire characteristics chart is a graphical method of presenting U.S. National Fire Danger Rating indices or primary surface or crown fire behavior characteristics. A desktop computer application has been developed to produce fire characteristics charts in a format suitable for inclusion in reports and presentations. Many options include change of scales, colors,...

  1. The Mythical Retention Chart and the Corruption of Dale's Cone of Experience

    Science.gov (United States)

    Subramony, Deepak Prem; Molenda, Michael; Betrus, Anthony K.; Thalheimer, Will

    2014-01-01

    In response to the wide-scale proliferation of "the cone of learning"--a fanciful retention chart confounded with Dale's Cone of Experience--the authors make four major claims debunking this fantasy and provide documentary evidence to support these claims. The first claim is that the data in the mythical retention chart do not make…

  2. Previous Attempts to Debunk the Mythical Retention Chart and Corrupted Dale's Cone

    Science.gov (United States)

    Subramony, Deepak Prem; Molenda, Michael; Betrus, Anthony K.; Thalheimer, Will

    2014-01-01

    Critics have been attempting to debunk the mythical retention chart at least since 1971. The earliest critics, David Curl and Frank Dwyer, were addressing just the retention data. Beginning around 2002, a new generation of critics has taken on the illegitimate combination of the retention chart and Edgar Dale's Cone of Experience--the corrupted…

  3. Statistical Design of an Adaptive Synthetic X- Control Chart with Run Rule on Service and Management Operation

    Directory of Open Access Journals (Sweden)

    Shucheng Yu

    2016-01-01

    Full Text Available An improved synthetic X- control chart based on hybrid adaptive scheme and run rule scheme is introduced to enhance the statistical performance of traditional synthetic X- control chart on service and management operation. The proposed scientific hybrid adaptive schemes consider both variable sampling interval and variable sample size scheme. The properties of the proposed chart are obtained using Markov chain approach. An extensive set of numerical results is presented to test the effectiveness of the proposed model in detecting small and moderate shifts in the process mean. The results show that the proposed chart is quicker than the standard synthetic X- chart and CUSUM chart in detecting small and moderate shifts in the process of service and management operation.

  4. Charting Ingredients for Life

    Science.gov (United States)

    2005-01-01

    [figure removed for brevity, see original site] Figure 1: Spectrum Charts Light from a Faraway Galaxy This graph, or spectrum, charts light from a faraway galaxy located 10 billion light years from Earth. It tracks mid-infrared light from an extremely luminous galaxy when the universe was only 1/4 of its current age. Spectra are created when an instrument called a spectrograph spreads light out into its basic parts, like a prism turning sunlight into a rainbow. They reveal the signatures, or 'fingerprints,' of molecules that make up a galaxy and contribute to its light. Spitzer's infrared spectrometer identified characteristic fingerprints of complex organic molecules called polycyclic aromatic hydrocarbons, illustrated in the artist's concept in the inset. These large molecules comprised of carbon and hydrogen, are considered among the building blocks of life. Scientists determined it took 10 billion years for photons from this galaxy to reach Spitzer's infrared eyes. These complex carbon and hydrogen molecules are from a young galaxy which is undergoing intense star formation, at the time the universe was only 3.5 billion years old. These distant galaxies with enormous amounts of gas being converted into young stars are some of the most luminous objects in the sky. Enshrouded by dust, they are only faint, inconspicuous little dots in optical images. They are as bright as 10 trillion suns put together and 10 times brighter than starburst galaxies seen in our local universe. This prompts a fascinating question as to what physical process is driving such enormous energy production in these galaxies when the universe is so young. These data were taken by Spitzer's infrared spectrograph in August and September 2004.

  5. Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals

    Directory of Open Access Journals (Sweden)

    Rasmussen TB

    2018-04-01

    Full Text Available Thomas Bøjer Rasmussen, Sinna Pilgaard Ulrichsen, Mette Nørgaard Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark Background: Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes.Objective: The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses.Materials and methods: We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations.Results: Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals’ estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54. In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease.Conclusion: The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most

  6. Evolving Techniques of Documentation of a World Heritage Site in Lahore

    Science.gov (United States)

    Arif, R.; Essa, K.

    2017-08-01

    Lahore is an ancient, culturally rich city amidst which are embedded two world heritage sites. The state of historic preservation in the country is impoverished with a dearth of training and poor documentation skills, thus these monuments are decaying and in dire need of attention. The Aga Khan Cultural Service - Pakistan is one of the first working in heritage conservation in the country. AKCSP is currently subjecting the UNESCO World Heritage site of the Mughal era Lahore Fort to an intensive and multi-faceted architectural documentation process. This is presented here as a case study to chart the evolution of documentation techniques and enunciate the spectrum of challenges faced in the documentation of an intricate Mughal heritage site for conservation in the Pakistani context. 3D - laser scanning is used for the purpose of heritage conservation for the first time, and since has been utilised on heritage buildings and urban fabric in ongoing projects. These include Lahore Fort, Walled city of Lahore as well as the Baltit Fort, a project restored in the past, assisting in the maintenance of conserved buildings. The documentation team is currently discovering the full potential of this technology especially its use in heritage conservation simultaneously overcoming challenges faced. Moreover negotiating solutions to auto-generate 2D architectural drawings from the 3D pointcloud output. The historic architecture is juxtaposed with contemporary technology in a region where such a combination is rarely found. The goal is to continually develop the documentation methodologies whilst investigating other technologies in the future.

  7. EVOLVING TECHNIQUES OF DOCUMENTATION OF A WORLD HERITAGE SITE IN LAHORE

    Directory of Open Access Journals (Sweden)

    R. Arif

    2017-08-01

    Full Text Available Lahore is an ancient, culturally rich city amidst which are embedded two world heritage sites. The state of historic preservation in the country is impoverished with a dearth of training and poor documentation skills, thus these monuments are decaying and in dire need of attention. The Aga Khan Cultural Service - Pakistan is one of the first working in heritage conservation in the country. AKCSP is currently subjecting the UNESCO World Heritage site of the Mughal era Lahore Fort to an intensive and multi-faceted architectural documentation process. This is presented here as a case study to chart the evolution of documentation techniques and enunciate the spectrum of challenges faced in the documentation of an intricate Mughal heritage site for conservation in the Pakistani context. 3D - laser scanning is used for the purpose of heritage conservation for the first time, and since has been utilised on heritage buildings and urban fabric in ongoing projects. These include Lahore Fort, Walled city of Lahore as well as the Baltit Fort, a project restored in the past, assisting in the maintenance of conserved buildings. The documentation team is currently discovering the full potential of this technology especially its use in heritage conservation simultaneously overcoming challenges faced. Moreover negotiating solutions to auto-generate 2D architectural drawings from the 3D pointcloud output. The historic architecture is juxtaposed with contemporary technology in a region where such a combination is rarely found. The goal is to continually develop the documentation methodologies whilst investigating other technologies in the future.

  8. A Watercolor NPR System with Web-Mining 3D Color Charts

    Science.gov (United States)

    Chen, Lieu-Hen; Ho, Yi-Hsin; Liu, Ting-Yu; Hsieh, Wen-Chieh

    In this paper, we propose a watercolor image synthesizing system which integrates the user-personalized color charts based on web-mining technologies with the 3D Watercolor NPR system. Through our system, users can personalize their own color palette by using keywords such as the name of the artist or by choosing color sets on an emotional map. The related images are searched from web by adopting web mining technology, and the appropriate colors are extracted to construct the color chart by analyzing these images. Then, the color chart is rendered in a 3D visualization system which allows users to view and manage the distribution of colors interactively. Then, users can use these colors on our watercolor NPR system with a sketch-based GUI which allows users to manipulate watercolor attributes of object intuitively and directly.

  9. The Effect of Autocorrelation on the Hotelling T-2 Control Chart

    DEFF Research Database (Denmark)

    Vanhatalo, Erik; Kulahci, Murat

    2015-01-01

    One of the basic assumptions for traditional univariate and multivariate control charts is that the data are independent in time. For the latter, in many cases, the data are serially dependent (autocorrelated) and cross-correlated because of, for example, frequent sampling and process dynamics......- correlation structures for different magnitudes of shifts in the process mean is not fully explored in the literature. In this article, the performance of the Hotelling T-2 control chart for different shift sizes and various autocorrelation and cross- correlation structures are compared based on the average...... and using the raw data with adjusted control limits calculated through Monte Carlo simulations; and (iii) constructing the control chart for the residuals from a multivariate time series model fitted to the raw data. To limit the complexity, we use a first-order vector autoregressive process and focus...

  10. Reconstructing Data Flow Diagrams from Structure Charts Based on the Input and Output Relationship

    OpenAIRE

    YAMAMOTO, Shuichiro

    1995-01-01

    The traceability of data flow diagrams against structure charts is very important for large software development. Specifying if there is a relationship between a data flow diagram and a structure chart is a time consuming task. Existing CASE tools provide a way to maintain traceability. If we can extract the input-output relationship of a system from a structure chart, the corresponding data flow diagram can be automatically generated from the relationship. For example, Benedusi et al. propos...

  11. Comparing performance on the MNREAD iPad application with the MNREAD acuity chart.

    Science.gov (United States)

    Calabrèse, Aurélie; To, Long; He, Yingchen; Berkholtz, Elizabeth; Rafian, Paymon; Legge, Gordon E

    2018-01-01

    Our purpose was to compare reading performance measured with the MNREAD Acuity Chart and an iPad application (app) version of the same test for both normally sighted and low-vision participants. Our methods included 165 participants with normal vision and 43 participants with low vision tested on the standard printed MNREAD and on the iPad app version of the test. Maximum Reading Speed, Critical Print Size, Reading Acuity, and Reading Accessibility Index were compared using linear mixed-effects models to identify any potential differences in test performance between the printed chart and the iPad app. Our results showed the following: For normal vision, chart and iPad yield similar estimates of Critical Print Size and Reading Acuity. The iPad provides significantly slower estimates of Maximum Reading Speed than the chart, with a greater difference for faster readers. The difference was on average 3% at 100 words per minute (wpm), 6% at 150 wpm, 9% at 200 wpm, and 12% at 250 wpm. For low vision, Maximum Reading Speed, Reading Accessibility Index, and Critical Print Size are equivalent on the iPad and chart. Only the Reading Acuity is significantly smaller (I. E., better) when measured on the digital version of the test, but by only 0.03 logMAR (p = 0.013). Our conclusions were that, overall, MNREAD parameters measured with the printed chart and the iPad app are very similar. The difference found in Maximum Reading Speed for the normally sighted participants can be explained by differences in the method for timing the reading trials.

  12. VARIATION OF CHART DATUM TOWARDS MARITIME DELIMITATION DUE TO RISING SEA LEVEL

    Directory of Open Access Journals (Sweden)

    A. R. M. Faizuddin

    2017-10-01

    Full Text Available The importance of Chart Datum in hydrographic surveying is inarguable because its determination is part of the process to obtain the actual depth of bathymetry. The Chart Datum has a relationship with the determination of base points because any uncertainty of the base points would definitely cause uncertainty to the determination of the maritime baseline. If there is any doubt on the baselines, it will then cause doubt on the maritime zones as well which includes the equidistant line that forms the border between the two countries. However, due to the ongoing rising sea level, there has been some variations of the Chart Datum in some areas in Malaysia. This research discusses about the variation of Mean Sea Level and Chart Datum for the tide gauge stations at Geting, Cendering, Sedili and Tioman at East Coast and Kukup, Langkawi, Lumut and Penang at the West Coast of Peninsular Malaysia. The tidal analysis was carried out by using the 23 years of data beginning at 1993 to 2015. The observed tidal data for 23 years were processed and analysed by using GeoTide software. In this research, the Harmonic Analysis technique was used in order to calculate the values of Mean Sea Level and the Chart Datum while the slope of the shoreline is modelled by using Global Mapper. The linear trend of the Mean Sea Level and the Chart Datum was analysed to determine the increase of the annual sea level in millimetres accuracy and also to determine the variation of the Chart Datum for each tidal station and its impact towards maritime baseline. The result has shown that the linear trend of sea level rise varies from 24 millimetres per year up to 168 millimetres per year at the East Coast and 24 millimetres per year up to 96 millimetres per year at the West Coast of Peninsular Malaysia. As for the maritime baseline, results has indicated that there exist shifting in the horizontal which are varies from 1.564 metres per year to 3.299 metres per year at the East Coast

  13. Variation of Chart Datum Towards Maritime Delimitation due to Rising Sea Level

    Science.gov (United States)

    Faizuddin, A. R. M.; Razali, M. M.

    2017-10-01

    The importance of Chart Datum in hydrographic surveying is inarguable because its determination is part of the process to obtain the actual depth of bathymetry. The Chart Datum has a relationship with the determination of base points because any uncertainty of the base points would definitely cause uncertainty to the determination of the maritime baseline. If there is any doubt on the baselines, it will then cause doubt on the maritime zones as well which includes the equidistant line that forms the border between the two countries. However, due to the ongoing rising sea level, there has been some variations of the Chart Datum in some areas in Malaysia. This research discusses about the variation of Mean Sea Level and Chart Datum for the tide gauge stations at Geting, Cendering, Sedili and Tioman at East Coast and Kukup, Langkawi, Lumut and Penang at the West Coast of Peninsular Malaysia. The tidal analysis was carried out by using the 23 years of data beginning at 1993 to 2015. The observed tidal data for 23 years were processed and analysed by using GeoTide software. In this research, the Harmonic Analysis technique was used in order to calculate the values of Mean Sea Level and the Chart Datum while the slope of the shoreline is modelled by using Global Mapper. The linear trend of the Mean Sea Level and the Chart Datum was analysed to determine the increase of the annual sea level in millimetres accuracy and also to determine the variation of the Chart Datum for each tidal station and its impact towards maritime baseline. The result has shown that the linear trend of sea level rise varies from 24 millimetres per year up to 168 millimetres per year at the East Coast and 24 millimetres per year up to 96 millimetres per year at the West Coast of Peninsular Malaysia. As for the maritime baseline, results has indicated that there exist shifting in the horizontal which are varies from 1.564 metres per year to 3.299 metres per year at the East Coast and from 1

  14. Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study.

    Science.gov (United States)

    Hafez, Dina; Nelson, Daniel B; Martin, Evan G; Cohen, Alicia J; Northway, Rebecca; Kullgren, Jeffrey T

    2017-04-04

    Early diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians' (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs' decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients. We conducted semi-structured chart-stimulated recall interviews with 20 University of Michigan Health System (UMHS) primary care physicians. PCPs were asked about their recent decisions to screen or not screen 134 purposively sampled non-diabetic patients who met American Diabetes Association criteria for screening for T2DM. Interviews were audio-recorded, transcribed, and analyzed using qualitative directed content analysis. Data on patient demographic characteristics and comorbidities were abstracted from the electronic health record. The most common reasons PCPs gave for not screening 63 patients for T2DM were knowledge of a previously normal screening test (49%) and a visit for reasons other than a health maintenance examination (48%). The most common reasons PCPs gave for screening 71 patients for T2DM were knowledge of a previously abnormal screening test (49%), and patients' weight (42%) and age (38%). PCPs correctly interpreted 89% of screening test results and communicated 95% of test results to patients. Among 24 patients found to have prediabetes, PCPs usually (58%) recommended weight loss and increased physical activity but never recommended participation in a Diabetes Prevention Program or use of metformin. Previous screening test results, visit types, and patients' weight and age influenced PCPs' decisions to screen for T2DM. When patients were screened, test results were generally correctly interpreted and consistently communicated. Recommendations to patients

  15. Assessing achievement in nephrology training: using clinic chart audits to quantitatively screen competency.

    Science.gov (United States)

    Yuan, Christina M; Prince, Lisa K; Zwettler, Amy J; Nee, Robert; Oliver, James D; Abbott, Kevin C

    2014-11-01

    Entrustable professional activities (EPAs) are complex tasks representing vital physician functions in multiple competencies, used to demonstrate trainee development along milestones. Managing a nephrology outpatient clinic has been proposed as an EPA for nephrology fellowship training. Retrospective cohort study of nephrology fellow outpatient clinic performance using a previously validated chart audit tool. Outpatient encounter chart audits for training years 2008-2009 through 2012-2013, corresponding to participation in the Nephrology In-Training Examination (ITE). A median of 7 auditors (attending nephrologists) audited a mean of 1,686±408 (SD) charts per year. 18 fellows were audited; 12, in both of their training years. Proportion of chart audit and quality indicator deficiencies. Longitudinal deficiency and ITE performance. Among fellows audited in both their training years, chart audit deficiencies were fewer in the second versus the first year (5.4%±2.0% vs 17.3%±7.0%; PITE score less than the 25th percentile for second-year fellows (P=0.03), with no significant association for first-year fellows. Auditor-reported deficiencies declined between the first and second halves of the year (17.0% vs 11.1%; PITE and the nephrology subspecialty board examination. Published by Elsevier Inc.

  16. A physician-led initiative to improve clinical documentation results in improved health care documentation, case mix index, and increased contribution margin.

    Science.gov (United States)

    Aiello, Francesco A; Judelson, Dejah R; Durgin, Jonathan M; Doucet, Danielle R; Simons, Jessica P; Durocher, Dawn M; Flahive, Julie M; Schanzer, Andres

    2018-05-04

    Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin. A physician-led coding initiative to educate physicians on the documentation of comorbidities and conditions was initiated with concurrent chart review sessions with coding specialists for 3 months, and then as needed, after the creation of a vascular surgery documentation guide. Clinical documentation and billing for all carotid endarterectomy (CEA) and open infrainguinal procedures (OIPs) performed between January 2013 and July 2016 were stratified into precoding and postcoding initiative groups. Age, duration of stay, direct costs, actual reimbursements, contribution margin (CM), CMI, rate of complication or comorbidity, major complication or comorbidity, severity of illness, and risk of mortality assigned to each discharge were abstracted. Data were compared over time by standardizing Centers for Medicare and Medicaid Services (CMS) values for each diagnosis related group and using a CMS base rate reimbursement. Among 458 CEA admissions, postcoding initiative CEA patients (n = 253) had a significantly higher CMI (1.36 vs 1.25; P = .03), CM ($7859 vs $6650; P = .048), and CMS base rate reimbursement ($8955 vs $8258; P = .03) than precoding initiative CEA patients (n = 205). The proportion of admissions with a documented major complication or comorbidity and complication or comorbidity was significantly higher after the coding initiative (43% vs

  17. Improved binomial charts for high-quality processes

    NARCIS (Netherlands)

    Albers, Willem/Wim

    For processes concerning attribute data with (very) small failure rate p, often negative binomial control charts are used. The decision whether to stop or continue is made each time r failures have occurred, for some r≥1. Finding the optimal r for detecting a given increase of p first requires

  18. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

    Directory of Open Access Journals (Sweden)

    Carl Magnus Sköld

    2016-07-01

    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  19. Strategy as Performative Practice

    DEFF Research Database (Denmark)

    Kornberger, Martin; Clegg, Stewart

    2011-01-01

    is it based upon? And what are its power effects? Based on a detailed empirical analysis of the strategy-making process, the article charts how strategy rendered the city knowable and how performative effects of strategizing mobilized the public and legitimized outcomes of the process while silencing other...... (traditionally the domain of science) and values (the realm of politics); third, and consequently, that strategy is a sociopolitical practice that aims at mobilizing people, marshalling political will and legitimizing decisions. The article concludes with reflections on five practical implications of the study....

  20. Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

    Science.gov (United States)

    Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

    2016-01-01

    Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

  1. A Cause-Consequence Chart of a Redundant Protection System

    DEFF Research Database (Denmark)

    Nielsen, Dan Sandvik; Platz, O.; Runge, B.

    1975-01-01

    A cause-consequence chart is applied in analysing failures of a redundant protection system (a core spray system in a nuclear power plant). It is shown how the diagram provides a basis for calculating two probability measures for malfunctioning of the protection system. The test policy of compone...... of components is taken into account. The possibility of using parameter variation as a basis for the choice of test policy is indicated.......A cause-consequence chart is applied in analysing failures of a redundant protection system (a core spray system in a nuclear power plant). It is shown how the diagram provides a basis for calculating two probability measures for malfunctioning of the protection system. The test policy...

  2. Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.

    Science.gov (United States)

    Martin, Shelby; Wagner, Jesse; Lupulescu-Mann, Nicoleta; Ramsey, Katrina; Cohen, Aaron; Graven, Peter; Weiskopf, Nicole G; Dorr, David A

    2017-08-02

    To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization. Nine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard. EHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.

  3. Umbilical venous catheters placement evaluation on frontal radiogram: application of a simplified flow-chart for radiology residents.

    Science.gov (United States)

    Salerno, Sergio; Tudisca, Chiara; Murmura, Elena; Matranga, Domenica; La Tona, Giuseppe; Lo Re, Giuseppe; Lo Casto, Antonio

    2017-05-01

    Umbilical Venous Catheter (UVC) are commonly used in neonatal period; they can be not correctly positioned and could be associated with complications. The purpose of this article is to suggest a flow-chart to evaluate the placement of UVC, testing it in young radiologists-in-training. We developed a simple flow-chart to asses, steps by step, UVC placement considering its course and tip location (ideally placed in the atriocaval junction). We tested the flow-chart impact asking to 20 residents to evaluate the placement of 10 UVC before and after they familiarized with the flow-chart and the anatomical findings of a newborn. The agreement among the 20 students was evaluated too. The number of correct characterizations was different due to the administration of the flow-chart. One hundred and six correct UVC assessments at the beginning switched to 196 after the administration of the flow-chart (p = 0.0001). The observed agreement among the twenty radiology residents was statistically significant, both before (kappa = 0.41, p < 0.001) and after (kappa = 0.37, p < 0.001) the flow-chart administration. The developed flow-chart demonstrated to be useful in increasing residents performance in UVC placement assessment.

  4. Ahmad's NPRT System: A Practical Innovation for Documenting Male Pattern Baldness

    OpenAIRE

    Ahmad, Muhammad

    2016-01-01

    Various classifications for male pattern baldness are mentioned in the literature. The 'Norwood's classification is the most commonly used but it has certain limitations. The new system has included 'three' extra features which were not mentioned in any other classification. It provides an opportunity to document the full and correct picture while documenting male pattern baldness. It also aids in assessing the treatment for various degrees of baldness.

  5. Ahmad's NPRT system: A practical innovation for documenting male pattern baldness

    Directory of Open Access Journals (Sweden)

    Muhammad Ahmad

    2016-01-01

    Full Text Available Various classifications for male pattern baldness are mentioned in the literature. The 'Norwood's classification is the most commonly used but it has certain limitations. The new system has included 'three' extra features which were not mentioned in any other classification. It provides an opportunity to document the full and correct picture while documenting male pattern baldness. It also aids in assessing the treatment for various degrees of baldness.

  6. TWRS technical baseline database manager definition document

    International Nuclear Information System (INIS)

    Acree, C.D.

    1997-01-01

    This document serves as a guide for using the TWRS Technical Baseline Database Management Systems Engineering (SE) support tool in performing SE activities for the Tank Waste Remediation System (TWRS). This document will provide a consistent interpretation of the relationships between the TWRS Technical Baseline Database Management software and the present TWRS SE practices. The Database Manager currently utilized is the RDD-1000 System manufactured by the Ascent Logic Corporation. In other documents, the term RDD-1000 may be used interchangeably with TWRS Technical Baseline Database Manager

  7. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  8. Documentation of best interest by intensivists: a retrospective study in an Ontario critical care unit

    Directory of Open Access Journals (Sweden)

    Scales Damon C

    2010-02-01

    Full Text Available Abstract Background Intensive care physicians often must rely on substitute decision makers to address all dimensions of the construct of "best interest" for incapable, critically ill patients. This task involves identifying prior wishes and to facilitate the substitute decision maker's understanding of the incapable patient's condition and their likely response to treatment. We sought to determine how well such discussions are documented in a typical intensive care unit. Methods Using a quality of communication instrument developed from a literature search and expert opinion, 2 investigators transcribed and analyzed 260 handwritten communications for 105 critically ill patients who died in the intensive care unit between January and June 2006. Cohen's kappa was calculated before analysis and then disagreements were resolved by consensus. We report results on a per-patient basis to represent documented communication as a process leading up to the time of death in the ICU. We report frequencies and percentages for discrete data, median (m and interquartile range (IQR for continuous data. Results Our cohort was elderly (m 72, IQR 58-81 years and had high APACHE II scores predictive of a high probability of death (m 28, IQR 23-36. Length of stay in the intensive care unit prior to death was short (m 2, IQR 1-5 days, and withdrawal of life support preceded death for more than half (n 57, 54%. Brain death criteria were present for 18 patients (17%. Although intensivists' communications were timely (median 17 h from admission to critical care, the person consenting on behalf of the incapable patient was explicitly documented for only 10% of patients. Life support strategies at the time of communication were noted in 45% of charts, and options for their future use were presented in 88%. Considerations relevant to determining the patient's best interest in relation to the treatment plan were not well documented. While explicit survival estimates were

  9. 7 CFR 15.71 - Form of documents to be filed.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Office of the Secretary of Agriculture NONDISCRIMINATION Rules of Practice and Procedure for... and Service of Documents § 15.71 Form of documents to be filed. All copies of documents filed in a... shall show the docket number and title of the proceeding on the front page. ...

  10. Sticker charts: a method for improving adherence to treatment of chronic diseases in children.

    Science.gov (United States)

    Luersen, Kara; Davis, Scott A; Kaplan, Sebastian G; Abel, Troy D; Winchester, Woodrow W; Feldman, Steven R

    2012-01-01

    Poor adherence is a common problem and may be an underlying cause of poor clinical outcomes. In pediatric populations, positive reinforcement techniques such as sticker charts may increase motivation to adhere to treatment regimens. To review the use of sticker charts to improve adherence in children with chronic disease, Medline and PsycINFO searches were conducted using the key words "positive reinforcement OR behavior therapy" and "adherence OR patient compliance" and "child." Randomized controlled retrospective cohort or single-subject-design studies were selected. Studies reporting adherence to the medical treatment of chronic disease in children using positive reinforcement techniques were included in the analysis. The systematic search was supplemented by identifying additional studies identified through the reference lists and authors of the initial articles found. Positive reinforcement techniques such as sticker charts increase adherence to medical treatment regimens. In several studies, this effect was maintained for months after the initial intervention. Better adherence correlated with better clinical outcomes in some, but not all, studies. Few studies examining the use of sticker charts were identified. Although single-subject-design studies are useful in establishing the effect of a behavioral intervention, larger randomized controlled trials would help determine the precise efficacy of sticker chart interventions. Adherence to medical treatments in children can be increased using sticker charts or other positive reinforcement techniques. This may be an effective means to encourage children with atopic dermatitis to apply their medications and improve clinical outcomes. © 2012 Wiley Periodicals, Inc.

  11. Concise nuclear isobar charts

    Energy Technology Data Exchange (ETDEWEB)

    Bucka, H.

    1986-01-01

    In the Concise Nuclear Isobar Charts, data on binding energies of protons and neutrons in the ground state and excitation energies for low-lying nuclear energy levels are displayed, both of which are of great interest for transition processes as well as for questions of nuclear structure. Also, quantum numbers for angular momentum and parity are shown for these energy levels. For the stable nuclei, data for the relative abundances, and for unstable nucleon configurations, the transition probabilities are included in the data displayed. Due to the representation chosen for the atomic nuclei, in many cases a very clear first survey of systematic properties of nuclear energy states as well as spontaneous decay processes is achieved.

  12. Methods for reduction of scattered x-ray in measuring MTF with the square chart

    International Nuclear Information System (INIS)

    Hatagawa, Masakatsu; Yoshida, Rie

    1982-01-01

    A square wave chart has been used to measure the MTF of a screen-film system. The problem is that the scattered X-ray from the chart may give rise to measurement errors. In this paper, the authors proposed two methods to reduce the scattered X-ray: the first method is the use of a Pb mask and second is to provide for an air gap between the chart and the screen-film system. In these methods, the scattered X-ray from the chart was reduced. MTFs were measured by both of the new methods and the conventional method, and MTF values of the new methods were in good agreement while that of the conventional method was not. It was concluded that these new methods are able to reduce errors in the measurement of MTF. (author)

  13. The Uniform Chart of Accounts and Its Use in Management Control.

    Science.gov (United States)

    1982-10-01

    accounting reports [Ref. 10: p.45]. Horngren [Ref. 5: p. 162] notes that a common complaint of *, managers is that they are unfairly charged with costs ...aids of amsst 0W somir IM WOR M oo Owp U CA Hospital Management Control Uniform Chart of Accounts Performance Measurement Hospital Cost Accounting ...Output Measurement HCU 30. he.T ACT fCamnnus m .. s ado It 09000*Min d IdWOReeO 661 eammeei ~Full implementation of thc Uniform Chart of Accounts (UCA

  14. The Fuzzy u-Chart for Sustainable Manufacturing in the Vietnam Textile Dyeing Industry

    Directory of Open Access Journals (Sweden)

    Kim-Phung Truong

    2017-07-01

    Full Text Available The inevitability of measurement errors and/or humans of subjectivity in data collection processes make accumulated data imprecise, and are thus called fuzzy data. To adapt to this fuzzy domain in a manufacturing process, a traditional u control chart for monitoring the average number of nonconformities per unit is required to extend. In this paper, we first generalize the u chart, named fuzzy u-chart, whose control limits are built on the basis of resolution identity, which is a well-known fuzzy set theory. Then, an approach to fuzzy-logic reasoning, incorporating the decision-maker’s varying levels of optimism towards the online process, is proposed to categorize the manufacturing conditions. In addition, we further develop a condition-based classification mechanism, where the process conditions can be discriminated into intermittent states between in-control and out-of-control. As anomalous conditions are monitored to some extent, this condition-based classification mechanism can provide the critical information to deliberate the cost of process intervention with respect to the gain of quality improvement. Finally, the proposed fuzzy u-chart is implemented in the Vietnam textile dyeing industry to replace its conventional u-chart. The results demonstrate that the industry can effectively evade unnecessary adjustments to its current processes; thus, the industry can substantially reduce its operational cost and potential loss.

  15. Community Documentation Centre on Industrial Risk. Bulletin no. 8

    International Nuclear Information System (INIS)

    Masera, M.; Rasmussen, K.

    1993-01-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  16. Community Documentation Centre on Industrial Risk. Bulletin no. 4

    International Nuclear Information System (INIS)

    Gow, H.B.F.

    1991-01-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  17. Community Documentation Centre on Industrial Risk. Bulletin no. 10

    International Nuclear Information System (INIS)

    Perschke, A.; Kirchsteiger, C.

    1996-01-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  18. Community Documentation Centre on Industrial Risk. Bulletin no. 5

    International Nuclear Information System (INIS)

    Gow, H.B.F.

    1991-11-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  19. Community Documentation Centre on Industrial Risk. Bulletin no. 7

    International Nuclear Information System (INIS)

    Gow, H.B.F.; Carditello, I.

    1993-04-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  20. Community Documentation Centre on Industrial Risk. Bulletin no. 9

    International Nuclear Information System (INIS)

    Perschke, A.

    1995-01-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  1. Community Documentation Centre on Industrial Risk. Bulletin no. 6

    International Nuclear Information System (INIS)

    Gow, H.B.F.

    1992-06-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  2. Community Documentation Centre on Industrial Risk. Bulletin no. 11

    International Nuclear Information System (INIS)

    Perschke, A.; Kirchsteiger, C.; Carnevali, C.

    1997-01-01

    The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

  3. Self-authentication of value documents

    Science.gov (United States)

    Hayosh, Thomas D.

    1998-04-01

    To prevent fraud it is critical to distinguish an authentic document from a counterfeit or altered document. Most current technologies rely on difficult-to-print human detectable features which are added to a document to prevent illegal reproduction. Fraud detection is mostly accomplished by human observation and is based upon the examiner's knowledge, experience and time allotted for examination of a document. Another approach to increasing the security of a value document is to add a unique property to each document. Data about that property is then encoded on the document itself and finally secured using a public key based digital signature. In such a scheme, machine readability of authenticity is possible. This paper describes a patent-applied-for methodology using the unique property of magnetic ink printing, magnetic remanence, that provides for full self- authentication when used with a recordable magnetic stripe for storing a digital signature and other document data. Traditionally the authenticity of a document is determined by physical examination for color, background printing, paper texture, printing resolution, and ink characteristics. On an initial level, there may be numerous security features present on a value document but only a few can be detected and evaluated by the untrained individual. Because security features are normally not standardized except on currency, training tellers and cashiers to do extensive security evaluation is not practical, even though these people are often the only people who get a chance to closely examine the document in a payment system which is back-end automated. In the context of this paper, one should be thinking about value documents such as commercial and personal checks although the concepts presented here can easily be applied to travelers cheques, credit cards, event tickets, passports, driver's licenses, motor vehicle titles, and even currency. For a practical self-authentication system, the false alarms

  4. Management of needlestick injuries in general dental practice

    OpenAIRE

    Smith, A.J.; Cameron, S.O.; Bagg, J.; Kennedy, D.

    2001-01-01

    The objective of this paper is to advise on the development of practical policies for needlestick injuries in general dental practice. Policies for dealing with occupational exposure to chronic blood borne viruses, namely, hepatitis B, C and HIV are evolving. This article was particularly prompted by recent changes in post exposure prophylaxis for HIV infection. A flow chart is also included which should be of possible use in general dental practice. Needlestick injuries are of increasing con...

  5. Application of Hotelling’s T2 charts in monitoring quality parameters in a drinking water supply system

    International Nuclear Information System (INIS)

    Costa, Mafalda T.; Carolino, Elisabete; Oliveira, Teresa A.

    2015-01-01

    In water supply systems with distribution networkthe most critical aspects of control and Monitoring of water quality, which generates crises system, are the effects of cross-contamination originated by the network typology. The classics of control of quality systems through the application of Shewhart charts are generally difficult to manage in real time due to the high number of charts that must be completed and evaluated. As an alternative to the traditional control systems with Shewhart charts, this study aimed to apply a simplified methodology of a monitoring plan quality parameters in a drinking water distribution, by applying Hotelling’s T 2 charts and supplemented with Shewhart charts with Bonferroni limits system, whenever instabilities with processes were detected

  6. Documenting Evidence of Practice: The Power of Formative Assessment

    Science.gov (United States)

    Stefl-Mabry, Joette

    2018-01-01

    The field of school librarianship has long called for stronger evidence related to school libraries and student achievement (Stefl-Mabry and Raddick 2017; Stefl-Mabry et al. 2016; Morris and Cahill 2017). This article outlines a systematic method for school librarians to document student learning and provide tangible confirmation of their…

  7. Grand Canyon VFR Chart - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The Federal Aviation Administration (FAA) digital-Visual Chart series is designed to meet the needs of users who require georeferenced raster images of a FAA Visual...

  8. ROBUSTIFICATION OF MULTIVARIATE CONTROL CHART √|S| IN CONTROL PHASE I

    Directory of Open Access Journals (Sweden)

    Edwin Dugarte-Peña

    2016-07-01

    Full Text Available This article, chart robustification based on the square root of the sample generalized variance √|S|, is studied to control the variability of a bivariate normal process in stage 1 of Phase I control, built with observations for rational subgroups, and using the robust estimators, MVE, MCD and estimator S. These charts, are being compared with the usual chart, based on unbiased sample estimator, S, of the covariance matrix, ∑_0, in the presence of outliers from perturbation schemes such as, ∑_0 inflation contamination, and contamination affecting only the correlation. We use as performance measure, the mean squared error in estimating ∑_0, and absolute bias in the estimate, used √(|∑_0 | , about the unbiased estimators for each one of the parameters respectively    built with the rational subgroups that remain after the purification process undertaken in Phase 1 and are consider as the data group that represent the stage of the stable variation process.

  9. BED-time charts and their application to the problems of interruptions in external beam radiotherapy treatments

    International Nuclear Information System (INIS)

    Sinclair, Judith A.; Oates, Jason P.; Dale, Roger G.

    1999-01-01

    Purpose: The use of radiobiological modelling to examine the likely consequences of interruptions to radiotherapy schedules and to assess various compensatory measures. Methods and Materials: An effect-time graphical display, the BED-time chart, has been developed using the linear-quadratic (LQ) model. This is used to examine the effects on tumour and normal tissues of treatment interruption scenarios representative of clinical situations. The mathematical criteria governing successful salvage have also been drafted and applied to typical situations. Results: The successful salvage of an interrupted treatment is dependent on a number of interacting factors and the method presented here can be used to examine the trade-offs that exist. Although the mathematics may be complex, it is shown that the dilemmas posed by an interrupted treatment may be more easily appreciated with reference to BED-time charts. These may therefore have a useful role as a teaching aid for portraying a wider variety of radiotherapy problems and also in the documentation of interruptions to treatment and the measures taken to compensate for them. Conclusions: Interruptions to radiotherapy regimes are undesirable and compensatory measures need to be initiated as soon as possible after the gap, with a view to completing the amended treatment within the originally prescribed treatment time. Adequate compensation is particularly difficult for long gaps and gaps which occur towards the end of the scheduled treatment. Modelling exercises can help establish guidelines on the available windows of opportunity

  10. Charts for interpreting wildland fire behavior characteristics

    Science.gov (United States)

    Patricia L. Andrews; Richard C. Rothermel

    1982-01-01

    The fire characteristics chart is proposed as a graphical method ofpresenting two primary characteristics of fire behavior – spread rate and intensity. Its primary use is communicating and interpreting either site-specific predictions of fire behavior or National Fire-Danger Rating System (NFDRS) indexes and components. Rate of spread, heat per unit area, flame length...

  11. 12 CFR 747.24 - Scope of document discovery.

    Science.gov (United States)

    2010-01-01

    ... act of Congress, or the principles of common law provide. (d) Time limits. All discovery, including... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Scope of document discovery. 747.24 Section 747... of Practice and Procedure § 747.24 Scope of document discovery. (a) Limits on discovery. (1) Subject...

  12. Document Models

    Directory of Open Access Journals (Sweden)

    A.A. Malykh

    2017-08-01

    Full Text Available In this paper, the concept of locally simple models is considered. Locally simple models are arbitrarily complex models built from relatively simple components. A lot of practically important domains of discourse can be described as locally simple models, for example, business models of enterprises and companies. Up to now, research in human reasoning automation has been mainly concentrated around the most intellectually intensive activities, such as automated theorem proving. On the other hand, the retailer business model is formed from ”jobs”, and each ”job” can be modelled and automated more or less easily. At the same time, the whole retailer model as an integrated system is extremely complex. In this paper, we offer a variant of the mathematical definition of a locally simple model. This definition is intended for modelling a wide range of domains. Therefore, we also must take into account the perceptual and psychological issues. Logic is elitist, and if we want to attract to our models as many people as possible, we need to hide this elitism behind some metaphor, to which ’ordinary’ people are accustomed. As such a metaphor, we use the concept of a document, so our locally simple models are called document models. Document models are built in the paradigm of semantic programming. This allows us to achieve another important goal - to make the documentary models executable. Executable models are models that can act as practical information systems in the described domain of discourse. Thus, if our model is executable, then programming becomes redundant. The direct use of a model, instead of its programming coding, brings important advantages, for example, a drastic cost reduction for development and maintenance. Moreover, since the model is well and sound, and not dissolved within programming modules, we can directly apply AI tools, in particular, machine learning. This significantly expands the possibilities for automation and

  13. Outreach activity by using three-dimensional nuclear chart. Understanding nuclear physics and nuclear energy

    International Nuclear Information System (INIS)

    Koura, Hiroyuki

    2015-01-01

    A three-dimensional nuclear chart is constructed with toy blocks for usage of outreach activity related on nuclear physics and atomic energy. The height of each block represents quantities like atomic mass per nucleon, the total half-life, etc. The bulk properties of the nuclei can be easily understood by using these charts. Explanations for the energy generation of nuclear fusion and fission are visually given. In addition, we newly set another chart with blocks of fission fragment mass distribution from U-235 + a thermal neutron. As an example, the origin of abundances of rather radioactive isotopes like Sr-90 and Cs-137 is explained which created in nuclear reactor and also distributed in the eastern side of Fukushima prefecture due to the accident of Fukushima-Daiichi Nuclear Power Plant. Using our charts, lectures entitled 'Alchemy of the Universe' were delivered to high schools and public places. (author)

  14. Safeguarding critical e-documents implementing a program for securing confidential information assets

    CERN Document Server

    Smallwood, Robert F

    2012-01-01

    Practical, step-by-step guidance for corporations, universities and government agencies to protect and secure confidential documents and business records Managers and public officials are looking for technology and information governance solutions to "information leakage" in an understandable, concise format. Safeguarding Critical E-Documents provides a road map for corporations, governments, financial services firms, hospitals, law firms, universities and other organizations to safeguard their internal electronic documents and private communications.Provides practical, step-by-step guidance o

  15. Quality of caesarean delivery services and documentation in first-line referral facilities in Afghanistan: a chart review

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

    Full Text Available Abstract Background Increasing appropriate use and documentation of caesarean section (CS has the potential to decrease maternal and perinatal mortality in settings with low CS rates. We analyzed data collected as part of a comprehensive needs assessment of emergency obstetric and newborn care (EmONC facilities in Afghanistan to gain a greater understanding of the clinical indications, timeliness, and outcomes of CS deliveries. Methods Records were reviewed at 78 government health facilities expected to function as EmONC providers that were located in secure areas of the country. Information was collected on the three most recent CS deliveries in the preceding 12 months at facilities with at least one CS delivery in the preceding three months. After excluding 16 facilities with no recent CS deliveries, the sample includes 173 CS deliveries at 62 facilities. Results No CS deliveries were performed in the previous three months at 21% of facilities surveyed; all of these were lower-level facilities. Most CS deliveries (88% were classified as emergencies, and only 12% were referrals from another facility. General anesthesia was used in 62% of cases, and spinal or epidural anesthesia in 34%. Only 28% of cases were managed with a partograph. Surgery began less than one hour after the decision for a CS delivery in just 30% of emergency cases. Among the 173 cases, 27 maternal deaths, 28 stillbirths, and 3 early neonatal deaths were documented. In cases of maternal and fetal death, the most common indications for CS delivery were placenta praevia or abruption and malpresentation. In 62% of maternal deaths, the fetus was stillborn or died shortly after birth. In 48% of stillbirths, the fetus had a normal heart rate at the last check. Information on partograph use was missing in 38% of cases, information on parity missing in 23% of cases and indications for cesareans missing in 9%. Conclusions Timely referral within and to EmONC facilities would decrease

  16. The effect of fetal sex on customized fetal growth charts.

    Science.gov (United States)

    Rizzo, Giuseppe; Prefumo, Federico; Ferrazzi, Enrico; Zanardini, Cristina; Di Martino, Daniela; Boito, Simona; Aiello, Elisa; Ghi, Tullio

    2016-12-01

    To evaluate the effect of fetal sex on singleton pregnancy growth charts customized for parental characteristics, race, and parity Methods: In a multicentric cross-sectional study, 8070 ultrasonographic examinations from low-risk singleton pregnancies between 16 and 40 weeks of gestation were considered. The fetal measurements obtained were biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Quantile regression was used to examine the impact of fetal sex across the biometric percentiles of the fetal measurements considered together with parents' height, weight, parity, and race. Fetal gender resulted to be a significant covariate for BDP, HC, and AC with higher values for male fetuses (p ≤ 0.0009). Minimal differences were found among sexes for FL. Parity, maternal race, paternal height and maternal height, and weight resulted significantly related to the fetal biometric parameters considered independently from fetal gender. In this study, we constructed customized biometric growth charts for fetal sex, parental, and obstetrical characteristics using quantile regression. The use of gender-specific charts offers the advantage to define individualized normal ranges of fetal biometric parameters at each specific centile. This approach may improve the antenatal identification of abnormal fetal growth.

  17. Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial design.

    Science.gov (United States)

    Bartunek, Jozef; Davison, Beth; Sherman, Warren; Povsic, Thomas; Henry, Timothy D; Gersh, Bernard; Metra, Marco; Filippatos, Gerasimos; Hajjar, Roger; Behfar, Atta; Homsy, Christian; Cotter, Gad; Wijns, William; Tendera, Michal; Terzic, Andre

    2016-02-01

    Cardiopoiesis is a conditioning programme that aims to upgrade the cardioregenerative aptitude of patient-derived stem cells through lineage specification. Cardiopoietic stem cells tested initially for feasibility and safety exhibited signs of clinical benefit in patients with ischaemic heart failure (HF) warranting definitive evaluation. Accordingly, CHART-1 is designed as a large randomized, sham-controlled multicentre study aimed to validate cardiopoietic stem cell therapy. Patients (n = 240) with chronic HF secondary to ischaemic heart disease, reduced LVEF (Heart Failure Questionnaire score, 6 min walk test, LV end-systolic volume, and LVEF at 9 months. The secondary efficacy endpoint is the time to cardiovascular death or worsening HF at 12 months. Safety endpoints include mortality, readmissions, aborted sudden deaths, and serious adverse events at 12 and 24 months. The CHART-1 clinical trial is powered to examine the therapeutic impact of lineage-directed stem cells as a strategy to achieve cardiac regeneration in HF populations. On completion, CHART-1 will offer a definitive evaluation of the efficacy and safety of cardiopoietic stem cells in the treatment of chronic ischaemic HF. NCT01768702. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  18. Assessment of LANL solid low-level mixed waste documentation

    International Nuclear Information System (INIS)

    Jennrich, E.A.; Lund, D.M.; Davis, K.D.; Hoevemeyer, S.S.

    1991-04-01

    DOE Order 5820.2A requires that a system performance assessment be conducted to assure efficient and compliant management of all radioactive waste. The objective of this report is to determine the present status of the Radioactive Waste Operations Section and the Chemical Waste Operations Section capabilities regarding preparation and maintenance of appropriate criteria, plans, and procedures. Additionally, a comparison is made which identifies areas where these documents are not presently in existence or being fully implemented. The documents being assessed in this report are: Solid Low-Level Mixed Waste Acceptance Criteria, Solid Low-Level Mixed Waste Characterization Plan, Solid Low-Level Mixed waste Certification Plan, Solid Low-Level Mixed Waste Acceptance Procedures, Solid Low-Level Mixed Waste characterization Procedures, Solid Low-Level Mixed Waste Certification Procedures, Solid Low-Level Mixed Waste Training Procedures, and Solid Low-Level Mixed Waste Recordkeeping Requirements. This report compares the current status of preparation and implementation, by the Radioactive Waste Operations Section and the Chemical Waste Operations Section, of these documents to the requirements of DOE 5820.2A,. 40 CFR 260 to 270, and to recommended practice. Chapters 2 through 9 of the report presents the results of the comparison in tabular form for each of the documents being assessed, followed by narrative discussion of all areas which are perceived to be unsatisfactory or out of compliance with respect to the availability and content of the documents. The final subpart of each of the following chapters provides recommendations where documentation practices may be improved to achieve compliance or to follow the recommended practice

  19. Designing Documents for People to Use

    Directory of Open Access Journals (Sweden)

    David Sless

    Full Text Available This article reports on the work of Communication Research Institute (CRI, an international research center specializing in communication and information design. With the support of government, regulators, industry bodies, and business—and with the participation of people and their advocates—CRI has worked on over 200 public document design projects since it began as a small unit in 1985. CRI investigates practical methods and achievable standards for designing digital and paper public documents, including forms; workplace procedural notices; bills, letters, and emails sent by organizations; labels and instructions that accompany products and services; and legal and financial documents and contracts. CRI has written model grammars for the document types it designs, and the cumulative data from CRI projects has led to a set of systematic methods for designing public-use documents to a high standard. Through research, design, publishing, and advocacy, CRI works to measurably improve the ordinary documents we all have to use. Keywords: Information design, Design methods, Design standards, Communication design, Design diagnostic testing, Design research

  20. Fusing Multiscale Charts into 3D ENC Systems Based on Underwater Topography and Remote Sensing Image

    Directory of Open Access Journals (Sweden)

    Tao Liu

    2015-01-01

    Full Text Available The purpose of this study is to propose an approach to fuse multiscale charts into three-dimensional (3D electronic navigational chart (ENC systems based on underwater topography and remote sensing image. This is the first time that the fusion of multiscale standard ENCs in the 3D ENC system has been studied. First, a view-dependent visualization technology is presented for the determination of the display condition of a chart. Second, a map sheet processing method is described for dealing with the map sheet splice problem. A process order called “3D order” is designed to adapt to the characteristics of the chart. A map sheet clipping process is described to deal with the overlap between the adjacent map sheets. And our strategy for map sheet splice is proposed. Third, the rendering method for ENC objects in the 3D ENC system is introduced. Fourth, our picking-up method for ENC objects is proposed. Finally, we implement the above methods in our system: automotive intelligent chart (AIC 3D electronic chart display and information systems (ECDIS. And our method can handle the fusion problem well.