WorldWideScience

Sample records for compliance update quality

  1. Updated ozone absorption cross section will reduce air quality compliance

    Directory of Open Access Journals (Sweden)

    E. D. Sofen

    2015-12-01

    et al. (2015 as 1.8 % smaller than the accepted value (Hearn, 1961 used for the preceding 50 years. Thus, ozone measurements that applied the older cross section systematically underestimate the amount of ozone in air. We correct the reported historical surface data from North America and Europe and find that this modest change in cross section has a significant impact on the number of locations that are out of compliance with air quality regulations if the air quality standards remain the same. We find 18, 23, and 20 % increases in the number of sites that are out of compliance with current US, Canadian, and European ozone air quality health standards for the year 2012. Should the new cross-section value be applied, it would impact attainment of air quality standards and compliance with relevant clean air acts, unless the air quality target values themselves were also changed proportionately. We draw attention to how a small change in gas metrology has a global impact on attainment and compliance with legal air quality standards. We suggest that further laboratory work to evaluate the new cross section is needed and suggest three possible technical and policy responses should the new cross section be adopted.

  2. Managing quality and compliance.

    Science.gov (United States)

    McNeil, Alice; Koppel, Carl

    2015-01-01

    Critical care nurses assume vital roles in maintaining patient care quality. There are distinct facets to the process including standard setting, regulatory compliance, and completion of reports associated with these endeavors. Typically, multiple niche software applications are required and user interfaces are varied and complex. Although there are distinct quality indicators that must be tracked as well as a list of serious or sentinel events that must be documented and reported, nurses may not know the precise steps to ensure that information is properly documented and actually reaches the proper authorities for further investigation and follow-up actions. Technology advances have permitted the evolution of a singular software platform, capable of monitoring quality indicators and managing all facets of reporting associated with regulatory compliance.

  3. Quality beyond compliance.

    Science.gov (United States)

    Centanni, N; Monroe, M; White, L; Larson, R

    1999-01-01

    The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

  4. Compliance with air quality regulations

    International Nuclear Information System (INIS)

    Steen, D.V.; Tackett, D.L.

    1990-01-01

    Due to the probable passage of Clean Air Act Amendments in 1990, electric utilities throughout the United States are faced with numerous choices to comply with the new acid rain regulations, expected in 1991. The choice of a compliance plan is not a simple task. Every compliance option will be costly. At Ohio Edison, deliberations are quite naturally influenced by past compliance with air quality regulations. This paper discusses compliance with air quality regulations in the 1970's, clean coal technologies and advanced scrubbers, and compliance with air quality regulations in 1995 - 2000. The choice of a compliance strategy for many utilities will involve serving customer loads through some combination of scrubbers, clean coal technologies, fuel switching, fuel blending, redispatch of units, and emissions trading. Whatever the final choice, it must be economic while providing sufficient flexibility to accommodate the critical uncertainties of load growth, state regulatory treatment, markets for emission allowances, advancements in control technologies, additional federal requirements for air emissions, equipment outages and fuel supply disruptions.s

  5. CSTT Update: Fuel Quality Analyzer

    Energy Technology Data Exchange (ETDEWEB)

    Brosha, Eric L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lujan, Roger W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mukundan, Rangachary [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rockward, Tommy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero, Christopher J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Williams, Stefan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wilson, Mahlon S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-02-06

    These are slides from a presentation. The following topics are covered: project background (scope and approach), developing the prototype (timeline), update on intellectual property, analyzer comparisons (improving humidification, stabilizing the baseline, applying clean-up strategy, impact of ionomer content and improving clean-up), proposed operating mode, considerations for testing in real-world conditions (Gen 1 analyzer electronics development, testing partner identified, field trial planning), summary, and future work.

  6. Balancing compliance and cost when implementing a Quality Assurance program

    International Nuclear Information System (INIS)

    Pickering, S.Y.

    1997-12-01

    When implementing a Quality Assurance (QA) program, compliance and cost must be balanced. A QA program must be developed that hits the mark in terms of adequate control and documentation, but does not unnecessarily expand resources. As the Waste Isolation Pilot Plant (WIPP) has moved towards certification, Sandia National Laboratories has learned much about balancing compliance and costs. Some of these lessons are summarized here

  7. Perceived service quality's effect on patient satisfaction and behavioural compliance.

    Science.gov (United States)

    Mohamed, Bahari; Azizan, Noor Azlinna

    2015-01-01

    The purpose of this paper is to advance healthcare service quality research using hierarchical component models. This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses. The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS. Only one hospital was evaluated. The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design. Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.

  8. Quality of life and compliance in geriatric patients

    Directory of Open Access Journals (Sweden)

    Igor Kalugin

    2017-09-01

    Full Text Available Background. Older adults usually have more than one chronic disease. In most cases, each condition requires constant pharmacotherapy. On average, the clinical examination of patients aged 60 and older reveals at least four or five different chronic pathological states in various phases and stages. Disease interference changes the classical clinical picture, increases the number of complications and their severity, affects the quality of life and prognosis, as a result - complicated medical diagnostic process and reduced compliance. The presence in the elderly both mental and physical illness significantly affects the quality of life. Psychological interventions aimed at a patient's awareness of the disease and methods of its treatment, the creation of therapeutic alliance and the prevention of self-medication, according to our hypothesis, contributes to compliance and quality of life improvement in polymorbid elderly patients suffering from mental disorders. Methods. In the study took part 325 patients who underwent inpatient treatment at the gerontopsychiatric department and signed provided informed consent. The study had a design of a randomized controlled clinical trial. Patients were randomized to experimental and control groups in a ratio of 3 to 1 based on age and gender. The study group of 238 people received standard treatment and psychological interventions. A comparison group of 87 people had only standard treatment. Patients were evaluated for quality of life with SF-36 scale and compliance with Morisky Medication Adherence Scale. Results. We have seen significant intergroup differences on the Morisky Medication Adherence Scale in the baseline period. Consequently, its results were not be taken into account in the final analysis. Before treatment patients’ quality of life between the study groups did not differ statistically (p = 0.317. After the treatment, a statistically significant difference in life quality between experimental

  9. On the quality of compliance mechanisms in the Kyoto Protocol

    International Nuclear Information System (INIS)

    Nentjes, Andries; Klaassen, Ger

    2004-01-01

    In this paper we evaluate the compliance mechanisms in the Kyoto Protocol as agreed at the seventh Conference of Parties to the United Nations Framework Convention on Climate Change (UNFCCC) in Marrakech. We differ from the literature since we concentrate on the complete set of compliance rules agreed in Marrakech and, as a new element, we systematically discuss these compliance incentives in conjunction with the implicit compliance incentives: reputation protection, emission trading and banking. We conclude that effectiveness and efficiency go hand in hand for all explicit and implicit compliance incentives except one--emission trading. Trading improves efficiency but this can also occur at the cost of increasing non-compliance

  10. Quality criteria for cardiac images: An update

    International Nuclear Information System (INIS)

    Bernardi, G.; Bar, O.; Jezewski, T.; Vano, E.; Maccia, C.; Trianni, A.; Padovani, R.

    2008-01-01

    The DIMOND II and III Cardiology Groups have agreed on quality criteria for cardiac images and developed a scoring system, to provide a tool to test quality of coronary angiograms, which was demonstrated to be of value in clinical practice. In the last years, digital flat panel technology has been introduced in cardiac angiographic systems and the radiological technique may have been influenced by the better performance of these new detectors. This advance in digital imaging, together with the lesson learned from previous studies, warranted the revision of the quality criteria for cardiac angiographic images as formerly defined. DIMOND criteria were reassessed to allow a simpler evaluation of angiograms. Clinical criteria were simplified and separated from technical criteria. Furthermore, the characteristics of an optimised angiographic technique have been outlined. (authors)

  11. Primary Science Quality Mark--2016 Update

    Science.gov (United States)

    Turner, Jane

    2016-01-01

    Back in May 2011, an article in "Primary Science" described how the idea for a quality mark for primary science was developed from an initial conversation at an Association for Science Education annual conference (Turner, Marshall and Elsmore, 2011). Its intention then, as now, was to support and champion good practice and raise the…

  12. 36. The relationship between compliance and quality of life among ...

    African Journals Online (AJOL)

    Esem

    Department of Psychology, University of Zambia. ABSTRACT ... Main outcomes: Compliance to treatment, impact about ... adolescents and also influenced positive behaviour .... Diabetes can affect an adolescent's emotions both directly ... increased risk of depression and anxiety, which may be ... Importance of compliance.

  13. Update and revision of WHO air quality guidelines for Europe

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

    1996-12-31

    The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

  14. Update and revision of WHO air quality guidelines for Europe

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M. [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

    1995-12-31

    The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

  15. Validation of gamma irradiator controls for quality and regulatory compliance

    International Nuclear Information System (INIS)

    Harding, R.B.; Pinteric, F.J.A.

    1995-01-01

    Since 1978 the U.S. Food and Drug Administration (FDA) has had both the legal authority and the Current Good Manufacturing Practice (CGMP) regulations in place to require irradiator owners who process medical devices to produce evidence of Irradiation Process Validation. One of the key components of Irradiation Process Validation is the validation of the irradiator controls. However, it is only recently that FDA audits have focused on this component of the process validation. What is Irradiator Control System Validation? What constitutes evidence of control? How do owners obtain evidence? What is the irradiator supplier's role in validation? How does the ISO 9000 Quality Standard relate to the FDA's CGMP requirement for evidence of Control System Validation? This paper presents answers to these questions based on the recent experiences of Nordion's engineering and product management staff who have worked with several US-based irradiator owners. This topic - Validation of Irradiator Controls - is a significant regulatory compliance and operations issues within the irradiator suppliers' and users' community. (author)

  16. Improvement of Hand Hygiene Quality and Compliance Using Bioburden Measurement and Online Feedback in Germany.

    Science.gov (United States)

    Günther, Frank; Rudolph, Kai; Frank, Uwe; Mutters, Nico T

    2017-01-01

    To improve compliance with hand hygiene, a novel method with inclusion of an online reporting system was developed, comprising measurement of total hand bioburden, anonymous online feedback, and onsite training. The intervention significantly improved both compliance and quality of hand hygiene and reduced Staphylococcus aureus incidence. Infect Control Hosp Epidemiol 2016;1-4.

  17. Long-term pavement performance compliance with Department of Transportation information dissemination quality guidelines

    Science.gov (United States)

    2008-11-01

    This document provides information on the compliance of the LTPP program with the guidelines the Department of Transportation (DOT) issued Information Dissemination Quality Guidelines (IDQG). These guidelines were developed in response to requirement...

  18. 75 FR 51825 - Quality and Compliance in Merging and Emerging Cultures; Public Conference

    Science.gov (United States)

    2010-08-23

    ... announcing a public conference entitled ``The New Paradigm: Quality and Compliance in Merging and Emerging... accommodations because of a disability, please contact Wanda Neal, at least 7 days in advance of the conference...

  19. Public Governance Quality and Tax Compliance Behavior in Nigeria: The Moderating Role of Financial Condition and Risk Preference

    Directory of Open Access Journals (Sweden)

    James O. Alabede

    2011-06-01

    public governance quality on tax compliance behavior of individual taxpayers as well as the moderating effect of financial condition and risk preference on tax compliance and its determinants. This study extended tax compliance model to incorporate public governance quality and moderating effects of financial condition and risk preference.

  20. 40 CFR 125.61 - Existence of and compliance with applicable water quality standards.

    Science.gov (United States)

    2010-07-01

    ... applicable water quality standards. 125.61 Section 125.61 Protection of Environment ENVIRONMENTAL PROTECTION... Water Act § 125.61 Existence of and compliance with applicable water quality standards. (a) There must exist a water quality standard or standards applicable to the pollutant(s) for which a section 301(h...

  1. ISS Ambient Air Quality: Updated Inventory of Known Aerosol Sources

    Science.gov (United States)

    Meyer, Marit

    2014-01-01

    Spacecraft cabin air quality is of fundamental importance to crew health, with concerns encompassing both gaseous contaminants and particulate matter. Little opportunity exists for direct measurement of aerosol concentrations on the International Space Station (ISS), however, an aerosol source model was developed for the purpose of filtration and ventilation systems design. This model has successfully been applied, however, since the initial effort, an increase in the number of crewmembers from 3 to 6 and new processes on board the ISS necessitate an updated aerosol inventory to accurately reflect the current ambient aerosol conditions. Results from recent analyses of dust samples from ISS, combined with a literature review provide new predicted aerosol emission rates in terms of size-segregated mass and number concentration. Some new aerosol sources have been considered and added to the existing array of materials. The goal of this work is to provide updated filtration model inputs which can verify that the current ISS filtration system is adequate and filter lifetime targets are met. This inventory of aerosol sources is applicable to other spacecraft, and becomes more important as NASA considers future long term exploration missions, which will preclude the opportunity for resupply of filtration products.

  2. 77 FR 25721 - Small Entity Compliance Guide: Bottled Water: Quality Standard: Establishing an Allowable Level...

    Science.gov (United States)

    2012-05-01

    ...] Small Entity Compliance Guide: Bottled Water: Quality Standard: Establishing an Allowable Level for di(2... ``Bottled Water: Quality Standard: Establishing an Allowable Level for di(2- ethylhexyl)phthalate--Small... an allowable level for di(2- ethylhexyl)phthalate (DEHP). This final rule is effective April 16, 2012...

  3. Has compliance with CLIA requirements really improved quality in US clinical laboratories?

    Science.gov (United States)

    Ehrmeyer, Sharon S; Laessig, Ronald H

    2004-08-02

    The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) mandate universal requirements for all U.S. clinical laboratory-testing sites. The intent of CLIA'88 is to ensure quality testing through a combination of minimum quality practices that incorporate total quality management concepts. These regulations do not contain established, objective indicators or measures to assess quality. However, there is an implicit assumption that compliance with traditionally accepted good laboratory practices--following manufacturers' directions, routinely analysing quality control materials, applying quality assurance principles, employing and assessing competent testing personnel, and participating in external quality assessment or proficiency testing (PT)--will result in improved test quality. The CLIA'88 regulations do include PT performance standards, which intentionally or unintentionally, define intra-laboratory performance. Passing PT has become a prime motivation for improving laboratory performance; it can also be used as an objective indicator to assess whether compliance to CLIA has improved intra-laboratory quality. Data from 1994 through 2002 indicate that the percentage of laboratories passing PT has increased. In addition to PT performance, subjective indicators of improved quality--frequency of inspection deficiencies, the number of government sanctions for non-compliance, and customer satisfaction--were evaluated. The results from these subjective indicators are more difficult to interpret but also seem to show improved quality in US clinical laboratories eleven years post-CLIA'88.

  4. Biometric templates selection and update using quality measures

    Science.gov (United States)

    Abboud, Ali J.; Jassim, Sabah A.

    2012-06-01

    To deal with severe variation in recording conditions, most biometric systems acquire multiple biometric samples, at the enrolment stage, for the same person and then extract their individual biometric feature vectors and store them in the gallery in the form of biometric template(s), labelled with the person's identity. The number of samples/templates and the choice of the most appropriate templates influence the performance of the system. The desired biometric template(s) selection technique must aim to control the run time and storage requirements while improving the recognition accuracy of the biometric system. This paper is devoted to elaborating on and discussing a new two stages approach for biometric templates selection and update. This approach uses a quality-based clustering, followed by a special criterion for the selection of an ultimate set of biometric templates from the various clusters. This approach is developed to select adaptively a specific number of templates for each individual. The number of biometric templates depends mainly on the performance of each individual (i.e. gallery size should be optimised to meet the needs of each target individual). These experiments have been conducted on two face image databases and their results will demonstrate the effectiveness of proposed quality-guided approach.

  5. Assessment of compliance costs resulting from implementation of the proposed Great Lakes water quality guidance

    International Nuclear Information System (INIS)

    Fenner, K.; Podar, M.; Snyder, B.

    1993-01-01

    The primary purpose of the study was to develop an estimate of the incremental cost to direct dischargers resulting from the implementation of the proposed Great Lakes Water Quality Guidance (GLWQG). This estimate reflects the incremental cost of complying with permit requirements developed using the Implementation Procedures and water quality criteria proposed in the GLWQG versus permit requirements based on existing State water quality standards. Two secondary analyses were also performed, one to develop a preliminary estimate of the costs that would be incurred by indirect dischargers to publicly owned treatment works (POTWs), and another to evaluate the cost-effectiveness of the GLWQG. Finally, several sensitivity analyses were performed to evaluate the impact of several major assumptions on the estimated compliance costs. To estimate compliance costs, permit limitations and conditions based on existing State water quality standards were compared to water quality-based limitations and conditions based on the proposed GLWQG criteria and Implementation Procedures for a sample of plants. The control measures needed to comply with the proposed GLWQG-based effluent limitations were evaluated. Individual plant compliance costs were estimated for these control measures based on information on treatment technology and cost analyses available in the literature. An overall compliance cost was projected from the sample based on statistical methods

  6. Quality Assurance through Accreditation: When Resistance Meets Over-Compliance

    Science.gov (United States)

    Salto, Dante J.

    2018-01-01

    A large number of countries worldwide have established quality assurance mechanisms in Higher Education, ranging from the long-engrained system (United States) to more recent developments in Europe, Latin America and other regions. This study explores the way Higher Education institutions, as examples of autonomous organisations, respond to a new…

  7. [Establishing IAQ Metrics and Baseline Measures.] "Indoor Air Quality Tools for Schools" Update #20

    Science.gov (United States)

    US Environmental Protection Agency, 2009

    2009-01-01

    This issue of "Indoor Air Quality Tools for Schools" Update ("IAQ TfS" Update) contains the following items: (1) News and Events; (2) IAQ Profile: Establishing Your Baseline for Long-Term Success (Feature Article); (3) Insight into Excellence: Belleville Township High School District #201, 2009 Leadership Award Winner; and (4) Have Your Questions…

  8. [Reduce Energy Costs While Maintaining Healthy IAQ.] "Indoor Air Quality Tools for Schools" Update #17

    Science.gov (United States)

    US Environmental Protection Agency, 2009

    2009-01-01

    This issue of "Indoor Air Quality Tools for Schools" Update ("IAQ TfS" Update) contains the following items: (1) News and Events; (2) Feature Article: Reduce Energy Costs while Maintaining Healthy IAQ; (3) Insight into Excellence: North East Independent School District ; (4) School Building Week 2009; and (5) Have Your Questions Answered!

  9. Biological pathways, candidate genes, and molecular markers associated with quality-of-life domains: an update

    NARCIS (Netherlands)

    Sprangers, Mirjam A. G.; Thong, Melissa S. Y.; Bartels, Meike; Barsevick, Andrea; Ordoñana, Juan; Shi, Qiuling; Wang, Xin Shelley; Klepstad, Pål; Wierenga, Eddy A.; Singh, Jasvinder A.; Sloan, Jeff A.; Abertnethy, Amy P.; Baas, Frank; Barsevick, Andrea M.; Boomsma, Dorret I.; Bottomley, Andrew; Brundage, Michael; Cella, David; Chauhan, Cynthia; Cleeland, Charles S.; Coens, Corneel; Dueck, Amylou C.; Frost, Marlene H.; Hall, Per; Halyard, Michele Y.; van Laarhoven, Hanneke W. M.; Martin, Nicholas G.; Miaskowski, Christine; Mosing, Miriam; Movsas, Benjamin; Oliveira, Joao R.; Patrick, Donald L.; Pedersen, Nancy L.; Raat, Hein; Reeve, Bryce; Stephen, Ristvedt; Ropka, Mary E.; Schwartz, Carolyn; Shi, Quiling; Shinozaki, Gen; Swaab, Dick; Talwalkar, Jayant; Thong, Melissa; van Noorden, Cornelis J. F.; Veenhoven, Ruut; Wagner, Gert; Wierenga, Eddy; Yang, Ping; Zwinderman, Ailko H.

    2014-01-01

    There is compelling evidence of a genetic foundation of patient-reported quality of life (QOL). Given the rapid development of substantial scientific advances in this area of research, the current paper updates and extends reviews published in 2010. The objective was to provide an updated overview

  10. Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

    Science.gov (United States)

    Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

    2016-10-01

    In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

  11. Quality management benchmarking: FDA compliance in pharmaceutical industry.

    Science.gov (United States)

    Jochem, Roland; Landgraf, Katja

    2010-01-01

    By analyzing and comparing industry and business best practice, processes can be optimized and become more successful mainly because efficiency and competitiveness increase. This paper aims to focus on some examples. Case studies are used to show knowledge exchange in the pharmaceutical industry. Best practice solutions were identified in two companies using a benchmarking method and five-stage model. Despite large administrations, there is much potential regarding business process organization. This project makes it possible for participants to fully understand their business processes. The benchmarking method gives an opportunity to critically analyze value chains (a string of companies or players working together to satisfy market demands for a special product). Knowledge exchange is interesting for companies that like to be global players. Benchmarking supports information exchange and improves competitive ability between different enterprises. Findings suggest that the five-stage model improves efficiency and effectiveness. Furthermore, the model increases the chances for reaching targets. The method gives security to partners that did not have benchmarking experience. The study identifies new quality management procedures. Process management and especially benchmarking is shown to support pharmaceutical industry improvements.

  12. Continuing Medical Education Improves Gastroenterologists' Compliance with Inflammatory Bowel Disease Quality Measures.

    Science.gov (United States)

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

    2016-07-01

    Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists. We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities. Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists' performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure. The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013). QI-focused CME improves community-based gastroenterologists' compliance with IBD quality measures and measures aligned with NQS priorities.

  13. [Quality and compliance with Clinical Practice Guidelines of Chronic Noncommunicable Diseases in primary care].

    Science.gov (United States)

    Poblano-Verástegui, Ofelia; Vieyra-Romero, Waldo I; Galván-García, Ángel F; Fernández-Elorriaga, María; Rodríguez-Martínez, Antonia I; Saturno-Hernández, Pedro J

    2017-01-01

    To assess the quality and compliance of clinical practice guidelines (CPG) applicable to chronic non-communicable diseases (CNCD) in primary healthcare (CS), and views of staff on the barriers, facilitators and their use. 18 valued CPG with AGREEII, 3 are selected to develop indicators and assess compliance using lot quality acceptance sample (LQAS, standard 75 / 95% threshold 40 / 75% respectively, α:0. 05, β:0. 10) on 5 CS. 70 professionals surveyed about knowledge and use of CPG. Average quality of the CPG was 57.2%; low rating in domains: "Applicability" (<25%), "Stakeholder involvement" (43.5%) and "Rigour of development" (55.0%). Compliance in CS ranges from 39 to 53.4%. Professionals show uneven knowledge of CPG; 44 to 45% (according to CPG), they declare that they are not used, they identify as main barriers the lack of training, and their difficult accessibility and management. The quality and implementation of evaluated CPG is deficient constituting an opportunity of improvement in health services.

  14. Air quality compliance improvements through operational management of air resources (OMAR)

    International Nuclear Information System (INIS)

    Goddard, W.B.; Goddard, C.B.

    1990-01-01

    Geothermal well fields and power plants require operational and emergency atmospheric venting. Venting activities are monitored for compliance with regulations which limit air pollutant emissions and Ambient Air Quality Standards (AAQS). Continuous compliance monitoring data which includes hydrogen sulfide (H2S) levels and meteorological conditions is only available moths after being compiled. In this paper an automated computerized system called OMAR is described in the following which checks data and allows users access to real-time and near real-time data reports. The data can then be used for managing necessary venting or other real-time data needs. The OMAR system hardware and software is descried and is in use at The Geysers and at the Coso KGRA geothermal developments in California. The system has been designed to assist developers, engineers, scientists, and the local air districts in their goal of maintaining ambient air quality within Federal, State and Local standards

  15. Data Updating Methods for Spatial Data Infrastructure that Maintain Infrastructure Quality and Enable its Sustainable Operation

    Science.gov (United States)

    Murakami, S.; Takemoto, T.; Ito, Y.

    2012-07-01

    The Japanese government, local governments and businesses are working closely together to establish spatial data infrastructures in accordance with the Basic Act on the Advancement of Utilizing Geospatial Information (NSDI Act established in August 2007). Spatial data infrastructures are urgently required not only to accelerate computerization of the public administration, but also to help restoration and reconstruction of the areas struck by the East Japan Great Earthquake and future disaster prevention and reduction. For construction of a spatial data infrastructure, various guidelines have been formulated. But after an infrastructure is constructed, there is a problem of maintaining it. In one case, an organization updates its spatial data only once every several years because of budget problems. Departments and sections update the data on their own without careful consideration. That upsets the quality control of the entire data system and the system loses integrity, which is crucial to a spatial data infrastructure. To ensure quality, ideally, it is desirable to update data of the entire area every year. But, that is virtually impossible, considering the recent budget crunch. The method we suggest is to update spatial data items of higher importance only in order to maintain quality, not updating all the items across the board. We have explored a method of partially updating the data of these two geographical features while ensuring the accuracy of locations. Using this method, data on roads and buildings that greatly change with time can be updated almost in real time or at least within a year. The method will help increase the availability of a spatial data infrastructure. We have conducted an experiment on the spatial data infrastructure of a municipality using those data. As a result, we have found that it is possible to update data of both features almost in real time.

  16. Compliance and quality of life in patients on prescribed voice rest.

    Science.gov (United States)

    Rousseau, Bernard; Cohen, Seth M; Zeller, Amy S; Scearce, Leda; Tritter, Andrew G; Garrett, C Gaelyn

    2011-01-01

    To determine patient compliance with voice rest and the impact of voice rest on quality of life (QOL). Prospective. University hospital. Demographics, self-reported compliance, QOL impact on a 100-mm visual analog scale (VAS), and communication methods were collected from 84 participants from 2 academic voice centers. Of 84 participants, 36.9% were men, 63.1% were women, and 64.3% were singers. The mean age of participants was 47.2 years. The mean duration of voice rest was 8.8 days (range, 3-28), and the median was 7 days. Overall compliance was 34.5%. Postoperative voice rest patients were more compliant than non-postoperative patients (42.4% vs 16.0%, P = .04, χ(2)). Voice rest had an impact on QOL (mean ± SD, 68.5 ± 27.7). Voice rest also had a greater impact on singers than nonsingers (mean VAS 77.2 vs 63.6, P = .03, t test) and on those age <60 years than those age ≥ 60 years (mean VAS 74.4 vs 46.7, P < .001, t test). More talkative patients and those with longer periods of voice rest had worse QOL scores (Spearman correlation = 0.35, P = .001 and Spearman correlation = 0.24, P = .03, respectively). Restrictions in personal and social life were noted in 36.9% of patients, 46.4% were unable to work, 44.0% felt frustrated, and 38.1% reported feeling handicapped while on voice rest. Given poor patient compliance and the significant impact of voice rest on QOL, further studies are warranted to examine the efficacy of voice rest and factors that may contribute to patient noncompliance with treatment.

  17. Quality of life with rivaroxaban in patients with non-valvular atrial fibrilation by therapeutic compliance.

    Science.gov (United States)

    Márquez-Contreras, Emilio; Martell-Claros, Nieves; Gil-Guillén, Vicente; De la Figuera-Von Wichmann, Mariano; Sánchez-López, Eugenio; Gil-Gil, Ines; Márquez-Rivero, Sara

    2017-03-01

    To assess the quality of life (QOL) with rivaroxaban in patients with non-valvular atrial fibrilation (NVAF) related to therapeutic compliance. Prospective, longitudinal, multicenter study was developed in 160 Spanish primary or specialized care centers. We included 412 patients treated with rivaroxaban, prescribed for stroke prevention. Three visits were conducted: baseline, 6 and 12 months. Compliance was measured by electronic monitoring systems. QOL was measured by a specific questionnaire. We calculated the percentage of compliance means, the percentage of daily compliers and the score of QOL. Three hundred and seventy patients finished the study (mean age 75.19 SD: 7.5 years). Daily compliance was 83.5% (CI 78.53-88.57%) (n = 309) and 80% (CI 74.65-85.35%) at 6 and 12 months, respectively. Average QOL rating was 112.85 (SD 29.31) in non-compliant and 111.80 (SD 29.31) in the compliant group (p = Not significant), and after 12 months of 124.67 (SD 30.78) and 83.47 (SD 26.44), respectively (p < 0.0001), with a decrease in the score compliers (p < 0.01) and an increase in non-compliant group (p < 0.05). A higher number of drugs consumed, as well as the number of diseases/conditions suffered, the older age of the patients and having been previously treated with VKA were associated with a higher overall score (worse QOL). QOL in NVAF patients treated with rivaroxaban improved significantly over the study group at the expense of compliers. A worse QOL was associated with pluripathology, polymedication, older patients and previous treatment with VKA.

  18. A quality project to improve compliance with AAP guidelines for inpatient management of neonatal hyperbilirubinemia.

    Science.gov (United States)

    Tartaglia, Kimberly M; Campbell, Jessica; Shaniuk, Paul; McClead, Richard E

    2013-07-01

    The goal of this study was to improve compliance with published guidelines regarding management of neonatal hyperbilirubinemia in infants admitted to a general pediatric hospital ward and to improve support for their breastfeeding mothers. This quality improvement project was conducted by using Plan-Do-Study-Act cycles and statistical process control methods. Study subjects were infants > 35 weeks' gestation admitted for hyperbilirubinemia to the general inpatient ward of a large, freestanding pediatric hospital. We developed and implemented a guideline for the inpatient management of jaundiced neonates, with ongoing feedback given to the faculty on group performance. Outcome measures included monthly compliance scores based on American Academy of Pediatrics (AAP) guidelines for management of neonates > 35 weeks' gestation and the percentage of admitted jaundiced, breastfeeding infants whose mothers received lactation consultation during hospitalization. To determine the AAP compliance score, we reviewed and assigned points to each patient admission for completion of a standard evaluation, avoidance of unnecessary intravenous (IV) fluids and peripheral IV line placement, avoidance of rebound bilirubin checks while in the hospital, and the bilirubin level at discharge. Mean monthly AAP compliance scores increased from 60.5% of total possible points during the baseline period (January 2010-December 2010) to 90.4% during the intervention period (January 2011-December 2011). Lactation consultations increased from 48% during our baseline period to 63% during our early intervention period and to 90% during the last 5 months of our intervention. Length of stay was unchanged during the baseline and intervention periods. Interprofessional collaboration between nurses and physicians combined with a thoughtful campaign to increase awareness of published guidelines were successful in improving the care of infants admitted with unconjugated hyperbilirubinemia.

  19. Impact of a structured template and staff training on compliance and quality of clinical handover.

    Science.gov (United States)

    Ahmed, J; Mehmood, S; Rehman, S; Ilyas, C; Khan, L U R

    2012-01-01

    Change in junior doctors working pattern has brought effective and safe clinical handover into a central role to ensure the patient safety and high quality care. We investigated whether the compliance and quality of clinical handover could be improved through the use of a standardised and structured handover template. A computerised template was developed in accordance with handover guidelines provided by the Royal College of Surgeons of England. Pre- and post-intervention audits against an eleven-point dataset pertaining to the handover of acute surgical admissions were undertaken. The results from the two discrete audits periods were compared to examine the impact of intervention. There were 137 acute surgical admissions during pre-intervention and 155 admissions in post-intervention audit period. A significant improvement in overall handover practice was observed in post-intervention period. The documentation of patient hospital number (84 (61%) vs. 132 (85%) pimportance of safe clinical handover among the junior doctors. Implementation of a standardised guideline-based structured handover template and training of junior doctors are likely to improve compliance to agreed standards, promote quality of care, and protect patient safety. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Computer program CDCID: an automated quality control program using CDC update

    International Nuclear Information System (INIS)

    Singer, G.L.; Aguilar, F.

    1984-04-01

    A computer program, CDCID, has been developed in coordination with a quality control program to provide a highly automated method of documenting changes to computer codes at EG and G Idaho, Inc. The method uses the standard CDC UPDATE program in such a manner that updates and their associated documentation are easily made and retrieved in various formats. The method allows each card image of a source program to point to the document which describes it, who created the card, and when it was created. The method described is applicable to the quality control of computer programs in general. The computer program described is executable only on CDC computing systems, but the program could be modified and applied to any computing system with an adequate updating program

  1. Compliance/non-compliance with biosecurity rules specified in the Danish Quality Assurance system (KIK) and Campylobacter-positive broiler flocks 2012 and 2013.

    Science.gov (United States)

    Sandberg, M; Dahl, J; Lindegaard, L L; Pedersen, J R

    2017-01-01

    One source for Campylobacter jejuni infections in humans could be consumption of broiler meat. Transmission of Campylobacter into broiler houses/flocks occurs via many routes. A number of biosecurity rules is specified in the Quality Assurance System in Danish Chicken Production (KIK) - for which the broiler producers annually are audited for compliance with, by bureau Veritas. Multivariable logistic regression models were used to investigated the association between Compliance/non-compliance with biosecurity rules and Campylobacter-positive flocks - on KIK data from 2012 and 2013. Month and before after audit period were also included in the models. KIK rules important to comply with were: no vegetation around houses, closed systems for feed storage and distribution, and division between clean and unclean zones within broiler houses. A Campylobacter-reducing effect was observed of audit visits (in itself), indicating that there is more focus on compliance with KIK at the time of an audit visit, and that adequate daily biosecurity behavior is important. © 2016 Poultry Science Association Inc.

  2. Updating the tritium quality factor: the argument for conservatism

    International Nuclear Information System (INIS)

    Till, J.E.; Etnier, E.L.; Meyer, H.R.

    1980-01-01

    Estimated doses resulting from tritium releases to the environment are linearly dependent upon the quality factor (Q) chosen for tritium beta radiation. In 1969 the International Commission on Radiological Protection (ICRP) recommended using 1 as the Q for all low energy beta radiation. Considerable improvements have been made in evaluating exposures to tritium at very low dose rates and in refining physiological and biological endpoints since the 1969 ICRP recommendations. This study summarizes recent experiments to determine the relative biological effectiveness of tritium. Based upon our study of published data related to quality factor, its importance in the calculation of dose, and the currently accepted conservative philosophy in radiation protection, it is concluded that a value of 2 would seem to be more defensible for environmental assessments and that a reevaluation of the tritium quality factor by the ICRP is needed

  3. Incorporation of quality updates for JPSS CGS Products

    Science.gov (United States)

    Cochran, S.; Grant, K. D.; Ibrahim, W.; Brueske, K. F.; Smit, P.

    2016-12-01

    NOAA's next-generation environmental satellite, the Joint Polar Satellite System (JPSS) replaces the current Polar-orbiting Operational Environmental Satellites (POES). JPSS satellites carry sensors which collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The first JPSS satellite was launched in 2011 and is currently NOAA's primary operational polar satellite. The JPSS ground system is the Common Ground System (CGS), and provides command, control, and communications (C3) and data processing (DP). A multi-mission system, CGS provides combinations of C3/DP for numerous NASA, NOAA, DoD, and international missions. In preparation for the next JPSS satellite, CGS improved its multi-mission capabilities to enhance mission operations for larger constellations of earth observing satellites with the added benefit of streamlining mission operations for other NOAA missions. This paper will discuss both the theoretical basis and the actual practices used to date to identify, test and incorporate algorithm updates into the CGS processing baseline. To provide a basis for this support, Raytheon developed a theoretical analysis framework, and the application of derived engineering processes, for the maintenance of consistency and integrity of remote sensing operational algorithm outputs. The framework is an abstraction of the operationalization of the science-grade algorithm (Sci2Ops) process used throughout the JPSS program. By combining software and systems engineering controls, manufacturing disciplines to detect and reduce defects, and a standard process to control analysis, an environment to maintain operational algorithm maturity is achieved. Results of the use of this approach to implement algorithm changes into operations will also be detailed.

  4. Biological pathways, candidate genes, and molecular markers associated with quality-of-life domains : An update

    NARCIS (Netherlands)

    Sprangers, Mirjam A. G.; Thong, Melissa S. Y.; Bartels, Meike; Barsevick, Andrea; Ordonana, Juan; Shi, Qiuling; Wang, Xin Shelley; Klepstad, Pal; Wierenga, Eddy A.; Singh, Jasvinder A.; Sloan, Jeff A.

    Background There is compelling evidence of a genetic foundation of patient-reported quality of life (QOL). Given the rapid development of substantial scientific advances in this area of research, the current paper updates and extends reviews published in 2010. Objectives The objective was to provide

  5. Biological pathways, candidate genes, and molecular markers associated with quality-of-life domains : an update

    NARCIS (Netherlands)

    Sprangers, Mirjam A G; Thong, Melissa S Y; Bartels, Meike; Barsevick, Andrea; Ordoñana, Juan; Shi, Qiuling; Wang, Xin Shelley; Klepstad, Pål; Wierenga, Eddy A; Singh, Jasvinder A; Sloan, Jeff A; Swaab, D.F.

    BACKGROUND: There is compelling evidence of a genetic foundation of patient-reported quality of life (QOL). Given the rapid development of substantial scientific advances in this area of research, the current paper updates and extends reviews published in 2010. OBJECTIVES: The objective was to

  6. 76 FR 64017 - Approval and Promulgation of Air Quality Implementation Plans; South Carolina; Update to...

    Science.gov (United States)

    2011-10-17

    ... of Air Quality Implementation Plans; South Carolina; Update to Materials Incorporated by Reference... the ``good cause'' exemption in section 553(b)(3)(B) of the Administrative Procedure Act (APA) which... also finds that there is good cause under APA section 553(d)(3) for this correction to become effective...

  7. Surface quality and topographic inspection of variable compliance part after precise turning

    Science.gov (United States)

    Nieslony, P.; Krolczyk, G. M.; Wojciechowski, S.; Chudy, R.; Zak, K.; Maruda, R. W.

    2018-03-01

    The paper presents the problem of precise turning of the mould parts with variable compliance and demonstrates a topographic inspection of the machined surface quality. The study was conducted for the cutting tools made of cemented carbide with coatings, in a range of variable cutting parameters. The long shaft with special axial hole, made of hardened 55NiCrMoV6 steel was selected as a workpiece. The carried out study included the stiffness measurement of the machining system, as well as the investigation of cutting force components. In this context, the surface topography parameters were evaluated using the stylus profile meter and analysed. The research revealed that the surface topography, alongside the 3D functional parameters, and PSD influences the performance of the machined surface. The lowest surface roughness parameters values, equalled to Sa = 1 μm and Sz = 4.3 μm have been obtained during turning with cutting speed vc = 90 m/min. The stable turning of variable compliance part affects the surface texture formation with a unidirectional perpendicular, anisotropic structure. Nevertheless, in case of unstable turning, the characteristic chatter marks are observed, and process dynamics has greater contribution in formation of surface finish than turning kinematics and elastic plastic deformation of workpiece.

  8. Developing an effective toxicology/quality assurance partnership. Improving quality, compliance, and cooperation.

    Science.gov (United States)

    Usher, R W

    1995-12-01

    Toxicology and Quality Assurance (QA) at Eli Lilly and Company are well integrated, yet still independent organizations that are aligned with the same overall business objective: to efficiently deliver a high-quality product to the customer. One of the keys to success has been the implementation of a monitoring/metric and trend analysis program of key work processes that are central to the delivery of final product. Our metrics program indicates that the multiple changes that we have made have resulted in a higher quality product. This paper will discuss the practical changes we have made as a part of our Total Quality journey. This article is based solely on the authors' experiences while at Eli Lilly and Company.

  9. Varying the Quality of Business Communication Caused by Compliance of Different Accounting Rules

    Directory of Open Access Journals (Sweden)

    Agus Setyadi

    2009-06-01

    Full Text Available This study examines the extent of Indonesian companies‟ compliance with the Indonesian accounting regulations (IARC of inventory, fixed assets, and depreciation by analyzing 160 Indonesian listed companies‟ 2006 annual reports. This study also looks at potential factors that explain the level of this compliance. Analysis reveals a high level of 71.63% inventory compliance, 51.13% fixed assets compliance, and 99.69% depreciation compliance with accounting rules. T-test and regression analysis show that firm size is a significant predictor of accounting compliance. Importantly, ownership and governance structures do not influence the level of compliance. Although Indonesian firms complied with more than 50% of the key accounting rule provisions, regulatory intervention appears needed to improve compliance. Such regulation might include sanctions as promulgated by multilateral financial organizations (World Bank 2005.

  10. Report: ECHO Data Quality Audit – Phase I Results: The Integrated Compliance Information System Needs Security Controls to Protect Significant Non-Compliance Data

    Science.gov (United States)

    Report #09-P-0226, August 31, 2009. End users of the Permit Compliance System and Integrated Compliance Information System National Pollutant Discharge Elimination System can override the Significant Non-Compliance data field without more access controls.

  11. OAI-PMH repositories : quality issues regarding metadata and protocol compliance, tutorial 1

    CERN Multimedia

    CERN. Geneva; Cole, Tim

    2005-01-01

    This tutorial will provide an overview of emerging guidelines and best practices for OAI data providers and how they relate to expectations and needs of service providers. The audience should already be familiar with OAI protocol basics and have at least some experience with either data provider or service provider implementations. The speakers will present both protocol compliance best practices and general recommendations for creating and disseminating high-quality "shareable metadata". Protocol best practices discussion will include coverage of OAI identifiers, date-stamps, deleted records, sets, resumption tokens, about containers, branding, errors conditions, HTTP server issues, and repository lifecycle issues. Discussion of what makes for good, shareable metadata will cover topics including character encoding, namespace and XML schema issues, metadata crosswalk issues, support of multiple metadata formats, general metadata authoring recommendations, specific recommendations for use of Dublin Core elemen...

  12. User’s manual to update the National Wildlife Refuge System Water Quality Information System (WQIS)

    Science.gov (United States)

    Chojnacki, Kimberly A.; Vishy, Chad J.; Hinck, Jo Ellen; Finger, Susan E.; Higgins, Michael J.; Kilbride, Kevin

    2013-01-01

    National Wildlife Refuges may have impaired water quality resulting from historic and current land uses, upstream sources, and aerial pollutant deposition. National Wildlife Refuge staff have limited time available to identify and evaluate potential water quality issues. As a result, water quality–related issues may not be resolved until a problem has already arisen. The National Wildlife Refuge System Water Quality Information System (WQIS) is a relational database developed for use by U.S. Fish and Wildlife Service staff to identify existing water quality issues on refuges in the United States. The WQIS database relies on a geospatial overlay analysis of data layers for ownership, streams and water quality. The WQIS provides summary statistics of 303(d) impaired waters and total maximum daily loads for the National Wildlife Refuge System at the national, regional, and refuge level. The WQIS allows U.S. Fish and Wildlife Service staff to be proactive in addressing water quality issues by identifying and understanding the current extent and nature of 303(d) impaired waters and subsequent total maximum daily loads. Water quality data are updated bi-annually, making it necessary to refresh the WQIS to maintain up-to-date information. This manual outlines the steps necessary to update the data and reports in the WQIS.

  13. The application of quality control circle in neurosurgery ICU nurses in raising compliance of the head of a bed

    Directory of Open Access Journals (Sweden)

    Na LI

    2014-11-01

    Full Text Available Objective: To explore the application of quality control circle in raising compliance of the head of a bed in neurosurgery ICU nurses. Methods: The quality control circle was made up of 4 ICU nurses, determine the subject in order to improve the neurosurgery ICU nurses in raising compliance of the head of a bed, according to the QCC activity steps to formulate plans, including grasp the current situation, goal setting, through analysis, circle members develop strategy and plan implementation and review, finally compared the situation before and after neurosurgery ICU nurses raised bed activities compliance. Results: After implementation of QCC, neurosurgery ICU nurses raised bed to 30 ~ 45 degrees. After activities, circle members in the team cooperation ability, cohesion, to accept new things ability, and innovative thinking ability and to raise the understanding of the relevant knowledge of the head of a bed has improved significantly. Conclusion: The application of quality management circle activity improves the neurosurgery ICU nurses effectively raise the compliance of the head of a bed, improve the comprehensive quality of the clinical nurses.

  14. The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia.

    Science.gov (United States)

    Lien, Yin-Ju; Chang, Hsin-An; Kao, Yu-Chen; Tzeng, Nian-Sheng; Lu, Chien-Wen; Loh, Ching-Hui

    2018-02-01

    Impaired quality of life (QoL) is a common and clinically relevant feature of schizophrenia. In the present study, we attempted to formulate a model of QoL in the chronic stage of schizophrenia by including key variables-namely cognitive insight, self-stigma, insight into treatment, and medication compliance-that were proposed as its significant predictors in previous studies. We employed structural equation modeling (SEM) to simultaneously test the associations between these variables. A total of 170 community-dwelling patients with schizophrenia participated in this study. Cognitive insight, self-stigma, insight into treatment, medication compliance, and QoL were assessed through self-reporting. Symptoms were rated by interviewers. The influences of cognitive insight, stigma, insight into treatment, and medication compliance on QoL were supported using SEM. Our findings indicated that cognitive insight had a significant, positive, and direct effect on both self-stigma and insight into treatment; in contrast, it had a negative and direct effect on medication compliance. Notably, no evidence indicated a direct effect of cognitive insight on QoL. Thus, individuals with high cognitive insight reported low QoL because of stigma, low medication compliance, and their increased insight into treatment. In contrast, cognitive insight might indirectly ameliorate QoL mediated by the effect of insight into treatment on medication compliance. The findings provide additional support of the links between cognitive and clinical insight, self-stigma, medication compliance, and QoL in those with schizophrenia and suggest the need for screening and intervention services appropriate for this high-risk population.

  15. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    Science.gov (United States)

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Green gas. Gas of natural gas quality from biomass. Update of the 2004 study

    International Nuclear Information System (INIS)

    Welink, Jan-Henk; Dumont, M.; Kwant, K.

    2007-01-01

    In 2004 a study was published on green gas. Green gas is defined as a gaseous energy carrier from renewable biomass with a similar quality as natural gas. As a result of new developments in the field of co-digestion/fermentation the Dutch Ministry of Economic Affairs asked it's agency SenterNovem to update the 2004 study. The aim of the update is (1) to gain insight into operational aspects of green gas projects, e.g. reliability, efficiency and maintenance aspects; (2) stimulate the production of green gas, taking into account the economics of green gas projects, calculation of the financial gap of green gas production, efficient use of biogas (conversion to electricity or directly input into the natural gas distribution systems, and aspects with regard to commercialization and the market; and (3) the potential of green gas [nl

  17. 76 FR 16285 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water...

    Science.gov (United States)

    2011-03-23

    ... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for Toxic Pollutants in the Delaware... or ``Commission'') approved amendments to its Water Quality Regulations, Water Code and Comprehensive...

  18. 75 FR 41106 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan to Update Water...

    Science.gov (United States)

    2010-07-15

    ... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan to Update Water Quality Criteria for Toxic Pollutants in the Delaware... hold a public hearing to receive comments on proposed amendments to the Commission's Water Quality...

  19. 78 FR 58985 - Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update...

    Science.gov (United States)

    2013-09-25

    ..., Water Code and Comprehensive Plan to update stream quality objectives (also called ``water quality..., to Commission Secretary at 609-883-9522; if by U.S. Mail, to Commission Secretary, DRBC, P.O. Box...-7203. SUPPLEMENTARY INFORMATION: Background. The Commission in 1967 assigned stream quality objectives...

  20. Updating Sea Spray Aerosol Emissions in the Community Multiscale Air Quality Model

    Science.gov (United States)

    Gantt, B.; Bash, J. O.; Kelly, J.

    2014-12-01

    Sea spray aerosols (SSA) impact the particle mass concentration and gas-particle partitioning in coastal environments, with implications for human and ecosystem health. In this study, the Community Multiscale Air Quality (CMAQ) model is updated to enhance fine mode SSA emissions, include sea surface temperature (SST) dependency, and revise surf zone emissions. Based on evaluation with several regional and national observational datasets in the continental U.S., the updated emissions generally improve surface concentrations predictions of primary aerosols composed of sea-salt and secondary aerosols affected by sea-salt chemistry in coastal and near-coastal sites. Specifically, the updated emissions lead to better predictions of the magnitude and coastal-to-inland gradient of sodium, chloride, and nitrate concentrations at Bay Regional Atmospheric Chemistry Experiment (BRACE) sites near Tampa, FL. Including SST-dependency to the SSA emission parameterization leads to increased sodium concentrations in the southeast U.S. and decreased concentrations along the Pacific coast and northeastern U.S., bringing predictions into closer agreement with observations at most Interagency Monitoring of Protected Visual Environments (IMPROVE) and Chemical Speciation Network (CSN) sites. Model comparison with California Research at the Nexus of Air Quality and Climate Change (CalNex) observations will also be discussed, with particular focus on the South Coast Air Basin where clean marine air mixes with anthropogenic pollution in a complex environment. These SSA emission updates enable more realistic simulation of chemical processes in coastal environments, both in clean marine air masses and mixtures of clean marine and polluted conditions.

  1. Compliance Framing - Framing Compliance

    OpenAIRE

    Lutz-Ulrich Haack; Martin C. Reimann

    2012-01-01

    Corporations have to install various organizational measures to comply with legal as well as internal guidelines systematically. Compliance management systems have the challenging task to make use of an internal compliance-marketing approach in order to ensure not only an adequate but also effective compliance-culture. Compliance-literature and findings of persuasive goal-framing-theory give opposite implications for establishing a rather values- versus rule-based compliance-culture respectiv...

  2. Quality of care in palliative sedation: audit and compliance monitoring of a clinical protocol.

    Science.gov (United States)

    Benitez-Rosario, Miguel Angel; Castillo-Padrós, Manuel; Garrido-Bernet, Belén; Ascanio-León, Belen

    2012-10-01

    The European Association for Palliative Care and the U.S. National Hospice and Palliative Care Organization have published statements that recommend an audit of palliative sedation practices. The aim was to assess the feasibility of a quality care project in palliative sedation. We carried out an audit of adherence to a guideline regarding palliative sedation, undertaken as a yearly assessment during two years, of a sample of patient charts. With an audit tool, the charts were evaluated as to the presence of the ethical sedation checklist, information that justified palliative sedation, patient and/or family agreement, and the appropriateness of treatment in concordance with the clinical protocol. An educational program and result feedback meetings were used as the implementation strategy. Roughly 25% of the medical charts of patients who died in the palliative care unit were evaluated, 94 in 2007 and 110 in 2008. In 2007 and 2008, 63% and 57% of the patients, respectively, whose median age was 65 years, were sedated, with a median length of two days. The main reason for sedation was agitation concomitant with respiratory failure in roughly 60% and 75% of the cases in 2007 and 2008, respectively. Agreement of the patient/family about sedation was collected from 100% of the cases. The concordance of procedures with the sedation guideline was 100% in both years. Our quality-of-care strategy was shown to obtain a higher level of compliance with the palliative sedation guideline for at least two years. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  3. Inorganic chemical quality of European tap-water: 1. Distribution of parameters and regulatory compliance

    International Nuclear Information System (INIS)

    Banks, David; Birke, Manfred; Flem, Belinda; Reimann, Clemens

    2015-01-01

    Highlights: • A pan-European survey comprises >60 inorganic parameters in 579 tap water samples. • Compliance with standards for inorganic parameters is good (>99% in EU states). • Around 1% non-compliance is observed for arsenic and 0.2% for uranium. • No sample of water contained nitrate in excess of 45 mg/L. • A weak co-variation in Cu and Pb could indicate derivation from plumbing. - Abstract: 579 tap water samples were collected at the European scale and analysed in a single laboratory for more than 60 parameters. This dataset is evaluated here in terms of the statistical distribution of the analysed parameters and compliance with EU and international drinking water regulations. For most parameters a 99% (or better) degree of compliance was achieved. Among the parameters with the higher rates of non-compliance are: arsenic (1% non-compliance in EU member states, 1.6% when samples from non-EU states are also considered) and sodium (0.6%/1.0%). The decision by the WHO to raise its provisional guideline from 15 μg/L (WHO, 2004) to 30 μg/L (WHO, 2011) has reduced non-compliance for uranium from 1.0% to 0.2%. Despite the fact that tap water (i.e. presumed treated water) was collected, many observations can still be interpreted in terms of hydrogeochemical processes. The dataset demonstrates the potential value of very cost-effective, low-density sampling approaches at a continental (European) scale

  4. Audit Report on the Sacramento Army Depot Internal Review and Audit Compliance Office's "Audits of Warranties, Quality Deficiency Reports, and Reports of Discrepancies"

    National Research Council Canada - National Science Library

    1992-01-01

    The Sacramento Army Depot (SAAD) Internal Review and Audit Compliance Office (Internal Review) issued an audit report, "Audit of Warranties, Quality Deficiency Reports, and Reports of Discrepancies," on July 20, 1990...

  5. Directory of certificates of compliance for radioactive materials packages: Report of NRC approved quality assurance programs for radioactive material packages

    International Nuclear Information System (INIS)

    1988-12-01

    This directory contains a Report of the US Nuclear Regulatory Commission's Approved Packages (Volume 1), all Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective October 1, 1988. The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  6. Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

    Science.gov (United States)

    Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

    2008-10-01

    The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

  7. Aggregate analysis of regulatory authority assessors' comments to improve the quality of periodic safety update reports.

    Science.gov (United States)

    Jullian, Sandra; Jaskiewicz, Lukasz; Pfannkuche, Hans-Jürgen; Parker, Jeremy; Lalande-Luesink, Isabelle; Lewis, David J; Close, Philippe

    2015-09-01

    Marketing authorization holders (MAHs) are expected to provide high-quality periodic safety update reports (PSURs) on their pharmaceutical products to health authorities (HAs). We present a novel instrument aiming at improving quality of PSURs based on standardized analysis of PSUR assessment reports (ARs) received from the European Union HAs across products and therapeutic areas. All HA comments were classified into one of three categories: "Request for regulatory actions," "Request for medical and scientific information," or "Data deficiencies." The comments were graded according to their impact on patients' safety, the drug's benefit-risk profile, and the MAH's pharmacovigilance system. A total of 476 comments were identified through the analysis of 63 PSUR HA ARs received in 2013 and 2014; 47 (10%) were classified as "Requests for regulatory actions," 309 (65%) as "Requests for medical and scientific information," and 118 (25%) comments were related to "Data deficiencies." The most frequent comments were requests for labeling changes (35 HA comments in 19 ARs). The aggregate analysis revealed commonly raised issues and prompted changes of the MAH's procedures related to the preparation of PSURs. The authors believe that this novel instrument based on the evaluation of PSUR HA ARs serves as a valuable mechanism to enhance the quality of PSURs and decisions about optimization of the use of the products and, therefore, contributes to improve further the MAH's pharmacovigilance system and patient safety. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Directory of Certificates of Compliance for Radioactive Materials Packages: Report of NRC Approved Quality Assurance Programs for Radioactive Materials Packages

    International Nuclear Information System (INIS)

    1993-10-01

    This directory contains a Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs for Radioactive Materials Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  9. Multidisciplinary breast centres in Germany: a review and update of quality assurance through benchmarking and certification.

    Science.gov (United States)

    Wallwiener, Markus; Brucker, Sara Y; Wallwiener, Diethelm

    2012-06-01

    This review summarizes the rationale for the creation of breast centres and discusses the studies conducted in Germany to obtain proof of principle for a voluntary, external benchmarking programme and proof of concept for third-party dual certification of breast centres and their mandatory quality management systems to the German Cancer Society (DKG) and German Society of Senology (DGS) Requirements of Breast Centres and ISO 9001 or similar. In addition, we report the most recent data on benchmarking and certification of breast centres in Germany. Review and summary of pertinent publications. Literature searches to identify additional relevant studies. Updates from the DKG/DGS programmes. Improvements in surrogate parameters as represented by structural and process quality indicators suggest that outcome quality is improving. The voluntary benchmarking programme has gained wide acceptance among DKG/DGS-certified breast centres. This is evidenced by early results from one of the largest studies in multidisciplinary cancer services research, initiated by the DKG and DGS to implement certified breast centres. The goal of establishing a nationwide network of certified breast centres in Germany can be considered largely achieved. Nonetheless the network still needs to be improved, and there is potential for optimization along the chain of care from mammography screening, interventional diagnosis and treatment through to follow-up. Specialization, guideline-concordant procedures as well as certification and recertification of breast centres remain essential to achieve further improvements in quality of breast cancer care and to stabilize and enhance the nationwide provision of high-quality breast cancer care.

  10. Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

    Science.gov (United States)

    Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

    2015-09-01

    Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

  11. FDA (Food and Drug Administration) compliance program guidance manual and updates (FY 86). Section 4. Medical and radiological devices. Irregular report

    International Nuclear Information System (INIS)

    1986-01-01

    The FDA Compliance Program Guidance Manual provides a system for issuing and filing program plans and instructions directed to Food and Drug Administration Field operations for project implementation. Section IV provides those chapters of the Compliance Program Guidance Manual which pertain to the areas of medical and radiological devices. Some of the areas of coverage include laser and sunlamp standards inspections, compliance testing of various radiation-emitting products such as television receivers and microwave ovens, emergency response planning and policy, premarket approval and device manufacturers inspections, device problem reporting, sterilization of devices, and consumer education programs on medical and radiological devices

  12. Compliance and quality control monitoring of diagnostic X-ray facilities in Dar es Salaam city, Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Nkuba, Leonid L.; Nyanda, Pendo B., E-mail: leonid.nkuba@taec.or.tz [Tanzania Atomic Energy Commission, Radiation Control Directorate, Dar es Salaam (Tanzania, United Republic of)

    2017-09-01

    The compliance evaluation and quality control measurements on 60 diagnostic X-ray units were performed. The results on legal compliance show that 25 % of X-ray facilities operated without or with an expired license. The rest of the centers were new and had already applied for license and others had valid licenses. For basic requirements compliance, 47 % of X-ray facilities did not have the changing cubicles, 37 % of X-ray facilities did not post radiation warning sign and symbols also 46 % of units were found either without protective gear or operated by unqualified personnel. The QC test results showed that 93 % had X-ray tube voltage within the tolerance limit of 10 % and HVL ≥ 2.3 mmAl, at 80 kV was observed in 98.2 % of the units, whereas 98 % of exposure had acceptable kV reproducibility within the tolerance limit of 5 %. Of the X-ray generators assessed, 93 % had tolerable mAs linearity. 93 % and 97 % had acceptable beam alignment and light beam diaphragm. Of the assessed units, 13 (93 %) had tube leakage < 1000 μGy/hr at 1m. For shielding tests, 47 % of units had radiation levels above 0.5 μSv/hr at the main door leading to the X-ray rooms and the registration area. The dose rates > 10 μSv/hr were recorded at viewing windows, walls and doors of control cubicles and behind the doors of changing cubicles. These dose rates indicating higher health risk to workers and member of public. (author)

  13. Short bowel patients treated for two years with glucagon-like peptide 2 (GLP-2): compliance, safety, and effects on quality of life

    DEFF Research Database (Denmark)

    Jeppesen, P B; Lund, P; Gottschalck, I B

    2009-01-01

    BACKGROUND AND AIMS: Glucagon-like peptide 2 (GLP-2) has been shown to improve intestinal absorption in short bowel syndrome (SBS) patients in a short-term study. This study describes safety, compliance, and changes in quality of life in 11 SBS patients at baseline, week 13, 26, and 52 during two...... years of subcutaneous GLP-2 treatment, 400 microgram TID, intermitted by an 8-week washout period. METHODS: Safety and compliance was evaluated during the admissions. The Sickness Impact Profile (SIP), Short Form 36 (SF 36), and Inflammatory Bowel Disease Questionnaire (IBDQ) evaluated quality of life......-ascendo-anastomosis. The investigator excluded a patient due to unreliable feedback. Stoma nipple enlargement was seen in all 9 jejunostomy patients. Reported GLP-2 compliance was excellent (>93%). GLP-2 improved the overall quality of life VAS-score (4.1 +/- 2.8 cm versus 6.0 +/- 2.4 cm, P

  14. Updating sea spray aerosol emissions in the Community Multiscale Air Quality (CMAQ) model version 5.0.2

    Science.gov (United States)

    Gantt, B.; Kelly, J. T.; Bash, J. O.

    2015-11-01

    Sea spray aerosols (SSAs) impact the particle mass concentration and gas-particle partitioning in coastal environments, with implications for human and ecosystem health. Model evaluations of SSA emissions have mainly focused on the global scale, but regional-scale evaluations are also important due to the localized impact of SSAs on atmospheric chemistry near the coast. In this study, SSA emissions in the Community Multiscale Air Quality (CMAQ) model were updated to enhance the fine-mode size distribution, include sea surface temperature (SST) dependency, and reduce surf-enhanced emissions. Predictions from the updated CMAQ model and those of the previous release version, CMAQv5.0.2, were evaluated using several coastal and national observational data sets in the continental US. The updated emissions generally reduced model underestimates of sodium, chloride, and nitrate surface concentrations for coastal sites in the Bay Regional Atmospheric Chemistry Experiment (BRACE) near Tampa, Florida. Including SST dependency to the SSA emission parameterization led to increased sodium concentrations in the southeastern US and decreased concentrations along parts of the Pacific coast and northeastern US. The influence of sodium on the gas-particle partitioning of nitrate resulted in higher nitrate particle concentrations in many coastal urban areas due to increased condensation of nitric acid in the updated simulations, potentially affecting the predicted nitrogen deposition in sensitive ecosystems. Application of the updated SSA emissions to the California Research at the Nexus of Air Quality and Climate Change (CalNex) study period resulted in a modest improvement in the predicted surface concentration of sodium and nitrate at several central and southern California coastal sites. This update of SSA emissions enabled a more realistic simulation of the atmospheric chemistry in coastal environments where marine air mixes with urban pollution.

  15. A quality improvement project to improve the Medicare and Medicaid Services (CMS) sepsis bundle compliance rate in a large healthcare system.

    Science.gov (United States)

    Raschke, Robert A; Groves, Robert H; Khurana, Hargobind S; Nikhanj, Nidhi; Utter, Ethel; Hartling, Didi; Stoffer, Brenda; Nunn, Kristina; Tryon, Shona; Bruner, Michelle; Calleja, Maria; Curry, Steven C

    2017-01-01

    Sepsis is a leading cause of mortality and morbidity in hospitalised patients. The Centers for Medicare and Medicaid Services (CMS) mandated that US hospitals report sepsis bundle compliance rate as a quality process measure in October 2015. The specific aim of our study was to improve the CMS sepsis bundle compliance rate from 30% to 40% across 20 acute care hospitals in our healthcare system within 1 year. The study included all adult inpatients with sepsis sampled according to CMS specifications from October 2015 to September 2016. The CMS sepsis bundle compliance rate was tracked monthly using statistical process control charting. A baseline rate of 28.5% with 99% control limits was established. We implemented multiple interventions including computerised decision support systems (CDSSs) to increase compliance with the most commonly missing bundle elements. Compliance reached 42% (99% statistical process control limits 18.4%-38.6%) as CDSS was implemented system-wide, but this improvement was not sustained after CMS changed specifications of the outcome measure. Difficulties encountered elucidate shortcomings of our study methodology and of the CMS sepsis bundle compliance rate as a quality process measure.

  16. Updating sea spray aerosol emissions in the Community Multiscale Air Quality (CMAQ) model version 5.0.2

    OpenAIRE

    Gantt, B.; Kelly, J. T.; Bash, J. O.

    2015-01-01

    Sea spray aerosols (SSAs) impact the particle mass concentration and gas-particle partitioning in coastal environments, with implications for human and ecosystem health. Model evaluations of SSA emissions have mainly focused on the global scale, but regional-scale evaluations are also important due to the localized impact of SSAs on atmospheric chemistry near the coast. In this study, SSA emissions in the Community Multiscale Air Quality (CMAQ) model were updated to enhance the...

  17. Toward a food service quality management system for compliance with the Mediterranean dietary model.

    Science.gov (United States)

    Grigoroudis, Evangelos; Psaroudaki, Antonia; Diakaki, Christina

    2013-01-01

    The traditional diet of Cretan people in the 1960s is the basis of the Mediterranean dietary model. This article investigates the potential of this model to inspire proposals of meals by food-serving businesses, and suggests a methodology for the development of a quality management system, which will certify the delivery of food service according to this dietary model. The proposed methodology is built upon the principles and structure of the ISO 9001:2008 quality standard to enable integration with other quality, environmental, and food safety management systems.

  18. [Degree of compliance with health care quality criteria in the treatment of lower airway obstruction in Spanish pediatric emergency departments, reasons for noncompliance, and recommendations for improvement].

    Science.gov (United States)

    Claret Teruel, Gemma; Solé Ribalta, Anna; González Balenciaga, María; Paniagua Calzón, Natalia Marta; Korta Murua, Javier

    2016-06-01

    To determine the degree of compliance with health care quality criteria in the treatment of patients with lower airway obstruction in Spanish pediatric emergency departments (PEDs), to explore the reasons for noncompliance, and to make recommendations for improvement. We carried out a retrospective, cross-sectional study of a series of patients under the age of 14 years to determine the degree of compliance with 5 quality indicators. The patients were attended in 22 PEDs on days 1 and 15 of each month in 2013. We also distributed a questionnaire to chiefs of department to discover possible reasons for noncompliance. Finally, a group of experts followed a process to produce consensus-based recommendations to improve quality of care through compliance with the indicators. We included 2935 patients with a median (interquartile range) age of 2.8 (1.4-5.1) years. The overall rates of compliance were 39.8% for assessment of severity, 0.1% for measurement of peak flow, 64.4% for delay in attending a patient with severe shortness of breath, 59.1% for checking oxygen saturation and respiratory frequency, and 34.3% for treatment with inhalers and a spacer. The most common reasons for noncompliance were lack of time or material and the absence of the recommendation in protocols. The following improvement steps were recommended: reassess the usefulness of peak flow measurement in PEDs, reformulate the criteria for delay in attending patients with severe dyspnea, and adopt new indicators and templates that facilitate the recording of vital constants and scores on severity scales. An acceptable level of compliance was not achieved on any of the health care quality indicators for a variety of reasons. A series of steps should be taken to improve compliance.

  19. Breathing circuit compliance and accuracy of displayed tidal volume during pressure-controlled ventilation of infants: A quality improvement project.

    Science.gov (United States)

    Glenski, Todd A; Diehl, Carrie; Clopton, Rachel G; Friesen, Robert H

    2017-09-01

    Anesthesia machines have evolved to deliver desired tidal volumes more accurately by measuring breathing circuit compliance during a preuse self-test and then incorporating the compliance value when calculating expired tidal volume. The initial compliance value is utilized in tidal volume calculation regardless of whether the actual compliance of the breathing circuit changes during a case, as happens when corrugated circuit tubing is manually expanded after the preuse self-test but before patient use. We noticed that the anesthesia machine preuse self-test was usually performed on nonexpanded pediatric circuit tubing, and then the breathing circuit was subsequently expanded for clinical use. We aimed to demonstrate that performing the preuse self-test in that manner could lead to incorrectly displayed tidal volume on the anesthesia machine monitor. The goal of this quality improvement project was to change the usual practice and improve the accuracy of displayed tidal volume in infants undergoing general anesthesia. There were four stages of the project: (i) gathering baseline data about the performance of the preuse self-test and using infant and adult test lungs to measure discrepancies of displayed tidal volumes when breathing circuit compliance was changed after the initial preuse self-test; (ii) gathering clinical data during pressure-controlled ventilation comparing anesthesia machine displayed tidal volume with actual spirometry tidal volume in patients less than 10 kg before (machine preuse self-test performed while the breathing circuit was nonexpanded) and after an intervention (machine preuse self-test performed after the breathing circuit was fully expanded); (iii) performing department-wide education to help implement practice change; (iv) gathering postintervention data to determine the prevalence of proper machine preuse self-test. At constant pressure-controlled ventilation through fully expanded circuit tubing, displayed tidal volume was 83

  20. Progressing quality control in environmental impact assessment beyond legislative compliance: An evaluation of the IEMA EIA Quality Mark certification scheme

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia (United Kingdom); Research Unit for Environmental Sciences and Management, North-West University (South Africa); Fischer, Thomas B, E-mail: fischer@liverpool.ac.uk [School of Environmental Sciences, University of Liverpool (United Kingdom); Fothergill, Josh, E-mail: j.fothergill@iema.net [Institute of Environmental Management and Assessment, Lincoln (United Kingdom)

    2017-03-15

    The effectiveness of Environmental Impact Assessment (EIA) systems is contingent on a number of control mechanisms: procedural; judicial; evaluative; public and government agency; professional; and development aid agency. If we assume that procedural and judicial controls are guaranteed in developed EIA systems, then progressing effectiveness towards an acceptable level depends on improving the performance of other control mechanisms over time. These other control mechanisms are either absent, or are typically centrally controlled, requiring public finances; this we argue is an unpopular model in times of greater Government austerity. Here we evaluate a market-based mechanism for improving the performance of evaluative and professional control mechanisms, the UK Institute of Environmental Management and Assessments' EIA Quality Mark. We do this by defining dimensions of effectiveness for the purposes of our evaluation, and by identifying international examples of the approaches taken to delivering the other control measures to validate the approach taken in the EIA Quality Mark. We then evaluate the EIA Quality Mark, when used in combination with legal procedures and an active judiciary, against the effectiveness dimensions and use time-series analysis of registrant data to examine its ability to progress practice. We conclude that the EIA Quality Mark has merit as a model for a market-based mechanism, and may prove a more financially palatable approach for delivering effective EIA in mature systems in countries that lack centralised agency oversight. It may, therefore, be of particular interest to some Member States of the European Union for ensuring forthcoming certification requirements stemming from recent amendments to the EIA Directive. - Highlights: • Quality control mechanisms in EIA are identified. • Effectiveness of EIA is conceptualised for evaluation purposes. • The UK IEMA EIA Quality Mark is introduced as a market-based mechanism. • The

  1. Progressing quality control in environmental impact assessment beyond legislative compliance: An evaluation of the IEMA EIA Quality Mark certification scheme

    International Nuclear Information System (INIS)

    Bond, Alan; Fischer, Thomas B; Fothergill, Josh

    2017-01-01

    The effectiveness of Environmental Impact Assessment (EIA) systems is contingent on a number of control mechanisms: procedural; judicial; evaluative; public and government agency; professional; and development aid agency. If we assume that procedural and judicial controls are guaranteed in developed EIA systems, then progressing effectiveness towards an acceptable level depends on improving the performance of other control mechanisms over time. These other control mechanisms are either absent, or are typically centrally controlled, requiring public finances; this we argue is an unpopular model in times of greater Government austerity. Here we evaluate a market-based mechanism for improving the performance of evaluative and professional control mechanisms, the UK Institute of Environmental Management and Assessments' EIA Quality Mark. We do this by defining dimensions of effectiveness for the purposes of our evaluation, and by identifying international examples of the approaches taken to delivering the other control measures to validate the approach taken in the EIA Quality Mark. We then evaluate the EIA Quality Mark, when used in combination with legal procedures and an active judiciary, against the effectiveness dimensions and use time-series analysis of registrant data to examine its ability to progress practice. We conclude that the EIA Quality Mark has merit as a model for a market-based mechanism, and may prove a more financially palatable approach for delivering effective EIA in mature systems in countries that lack centralised agency oversight. It may, therefore, be of particular interest to some Member States of the European Union for ensuring forthcoming certification requirements stemming from recent amendments to the EIA Directive. - Highlights: • Quality control mechanisms in EIA are identified. • Effectiveness of EIA is conceptualised for evaluation purposes. • The UK IEMA EIA Quality Mark is introduced as a market-based mechanism. • The

  2. QUALITY OF LIFE AND TREATMENT COMPLIANCE IN PATIENTS WITH CHRONIC RENAL INSUFFICIENCY UNDER HEMODIALYSIS TREATMENT

    Directory of Open Access Journals (Sweden)

    FRANCOISE CONTRERAS

    2006-10-01

    Full Text Available The purpose of this study was to describe the quality of life among 33 patients with chronic kidney disease inhaemodialysis treatment and to establish whether there were differences features between them, due to adherencebehavior. Health Survey SF-36 was used, biochemical and clinical data was registered, as medical support for theadherence criteria. Significant decline in quality of life was evidenced in these patients; nevertheless the social functionwas preserved. The results of the t-student for independent samples showed significant differences in physical function,between the groups of patients with and without adherence to treatment (n = 19 and n = 13 respectively. Likewise,the first group reveal better quality of life related with mental health while the another group was related with physicalaspects. The implications of these results are discussed.

  3. From 'Compliance-based' to 'Performance-based' Quality - A trend in and evolution of U. S. quality standards

    International Nuclear Information System (INIS)

    Brown, Douglas A.; Taylor, H. Stephen; Johnson, Robert B.; Erler, Bryan A.; Daley, Thomas J.

    1995-01-01

    This paper traces the evolution of quality systems for nuclear power plant design, procurement, fabrication, installation, pre-operational testing, operations and maintenance in the U. S., as reflected in consensus standards such as N45.2, NQA-1, etc. Using a 'Defense-In-Depth' Quality Model, it highlights the changes in understanding where the responsibilities for quality should reside. Industries' growing recognition and operating experience show that a 'graded' approach to quality, based on safety significance, can be used to determine which quality criteria apply and the depth of implementing those criteria, resulting in potential long term cost savings and increased effectiveness) is also examined and discussed. Together, these two approaches form the basis for a performance-based quality system suitable for the business and technical environment of the 1990's and beyond. Performance-based Quality System - an approach that focuses on the end results, not the process, that directly contribute to safe and reliable plant operations. This approach includes monitoring performance or condition against predetermined, licensee-established goals, limits, or criteria in a manner sufficient to provide reasonable assurance that the safety function will be fulfilled. These criteria are based upon the design basis safety function, operating experience, and pertinent reliability studies. A licensee is allowed the flexibility to determine how best to achieve the results and adjust the application of quality elements accordingly. The roles of the individual worker, site/line supervision and management, independent quality verifiers (QA and QC), and external regulators are examined in the context of where and how industry quality standards have historically placed emphasis and accountability. The changes in these standards and their of effects are illustrated. Based on industry experience, the current understanding of the controls necessary to achieve safe, reliable and

  4. Directory of certificates of compliance for radioactive materials packages. Volume 3, revision 1. Summary report of NRC approved quality assurance programs for radioactive material packages

    International Nuclear Information System (INIS)

    1981-12-01

    The directory contains a Summary Report of NRC approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the U.S. Nuclear Regulatory Commission. To assist in identifying packaging, and index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory

  5. Assessing quality of life in patients with colorectal cancer: an update of the EORTC quality of life questionnaire

    NARCIS (Netherlands)

    Gujral, S.; Conroy, T.; Fleissner, C.; Sezer, O.; King, P. M.; Avery, K. N. L.; Sylvester, P.; Koller, M.; Sprangers, M. A. G.; Blazeby, J. M.

    2007-01-01

    The European Organisation for Research and Treatment of Cancer (EORTC) has a portfolio of questionnaire modules to supplement the QLQ-C30 to assess patient reported outcomes in cancer clinical trials. This study updated the module for colorectal cancer. A review of the literature identified 20

  6. Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

    Science.gov (United States)

    Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

    2014-02-01

    The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve.

  7. 76 FR 38992 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Update to Materials...

    Science.gov (United States)

    2011-07-05

    ... for Pennsylvania. Since the publication of the last IBR update, EPA has approved the following... revision'' and ``Applicable geographic area'' columns for the entry ``Continuous Source Testing Manual.'' 2... section 553(b)(3)(B) of the Administrative Procedures Act (APA) which, upon finding ``good cause...

  8. Water Quality Monitoring Around Submerged Wastewater Outfalls in Southern California: From Compliance Assessment to Impact of Climate Change

    Science.gov (United States)

    Nezlin, N. P.

    2016-02-01

    Routine monitoring near major submerged ocean outfalls in southern California is focused on the assessment of the effects of wastewater discharge on water-quality (WQ), including dissolved oxygen, pH, transmissivity, and phytoplankton biomass. The proposed WQ compliance assessment using DO as an indicator includes 1) identification of the area affected by effluent wastewater using Colored Dissolved Organic Matter (CDOM) as an effluent plume tracer, 2) selection of reference sampling sites representing `natural' conditions, and 3) comparison between DO profiles in the reference and plume-affected zones. This strategy is implemented as an interactive web-based tool including convenient data visualization options. At the same time, the data of WQ monitoring (regular quarterly observations starting 1998-present) provides an excellent platform to analyze the spatial and temporal (seasonal and interannual) variations in near-shore ocean ecosystem. An illustrative example is the trends in the depths of the euphotic layer and subsurface chlorophyll maximum layer (SCML), abruptly deepening during the most recent four-year period (2011-2014). These dramatic changes are associated with declining intensity of the North Pacific gyre circulation (NPGO index), decreasing upwelling and increasing transport of warm water from equatorial Pacific (PDO and ENSO cycles).

  9. Criminal Compliance

    Directory of Open Access Journals (Sweden)

    Cristina Antonella Andretta

    2015-10-01

    The article discusses the concepts of both compliance and criminal compliance, its main components and structure as well as the main rules relating to its global application, and finally his emergence in the Ecuadorian legal system.

  10. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.

    LENUS (Irish Health Repository)

    Ryan, Silke

    2012-02-01

    BACKGROUND: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. METHODS: 125 patients with the established diagnosis of OSAS (apnea\\/hypopnea index > or = 10\\/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. RESULTS: There was no difference in compliance between groups after 4 weeks (dry: 5.21 +\\/- 1.66 h\\/night, fluticasone: 5.66 +\\/- 1.68, humidifier: 5.21 +\\/- 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. CONCLUSION: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered.

  11. Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance): a case–control retrospective study. 2011 SOSORT Award winner

    OpenAIRE

    Tavernaro, Marta; Pellegrini, Anna; Tessadri, Fabrizio; Zaina, Fabio; Zonta, Andrea; Negrini, Stefano

    2012-01-01

    Abstract Background Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace Treatment Management Guidelines (SBTMG) have highlighted the perceived importance of the professional teams surrounding braced patients. Purpose To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Materials and methods Design. Initial cross-sectional study, followed by a retrospective case–control study. Population: Thirty-eight pa...

  12. Clean Water Act (CWA) Action Plan Implementation Priorities: Changes to Improve Water Quality, Increase Compliance and Expand Transparency

    Science.gov (United States)

    The Clean Water Act (CWA) Action Plan Implementation Priorities describes the new approaches to revamp the National Pollutant Discharge Elimination System (NPDES) permitting, compliance and enforcement program.Issued May 11, 2011

  13. Green gas. Gas of natural gas quality from biomass. Update of the 2004 study; Groen Gas. Gas van aardgaskwaliteit uit biomassa. Update van de studie uit 2004

    Energy Technology Data Exchange (ETDEWEB)

    Welink, Jan-Henk; Dumont, M.; Kwant, K. Datum januari 2007

    2007-01-15

    In 2004 a study was published on green gas. Green gas is defined as a gaseous energy carrier from renewable biomass with a similar quality as natural gas. As a result of new developments in the field of co-digestion/fermentation the Dutch Ministry of Economic Affairs asked it's agency SenterNovem to update the 2004 study. The aim of the update is (1) to gain insight into operational aspects of green gas projects, e.g. reliability, efficiency and maintenance aspects; (2) stimulate the production of green gas, taking into account the economics of green gas projects, calculation of the financial gap of green gas production, efficient use of biogas (conversion to electricity or directly input into the natural gas distribution systems, and aspects with regard to commercialization and the market; and (3) the potential of green gas. [Dutch] De laatste jaren wordt er gewerkt aan initiatieven om groen gas te produceren. Een recent initiatief is het opwaarderen van biogas tot aardgaskwaliteit door Biogast, wat er toe zal leiden dat al deze zomer Eneco op kleinschalig niveau duurzaam gas levert aan eindverbruikers. Het potentieel aan groen gas dat mogelijk gemaakt zou kunnen worden, is de laatste jaren ook veranderd. Met name de voorspoedige ontwikkelingen op het gebied van co-vergisting met mest zorgen voor een toename van het potentieel. In 2004 is een studie gemaakt over groen gas. Vanwege de voorspoedige ontwikkelingen op het gebied van co-vergisting is de situatie die gold voor het rapport uit 2004 veranderd. Het ministerie van Economische Zaken heeft SenterNovem gevraagd om een update te maken van de studie over groen gas uit 2004. De doelstelling van de update van deze studie Groen Gas is (1) het verkrijgen van inzicht op basis van de huidige ontwikkelingen, in: de bedrijfstechnische aspecten van dergelijke projecten, zoals betrouwbaarheid, rendement en onderhoudsaspecten; (2) aspecten voor het mogelijk stimuleren van de productie van groen gas. Hierbij hoort: (a

  14. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Przemyslaw Kardas

    2007-05-01

    Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

  15. Effects of Heated Humidification and Topical Steroids on Compliance, Nasal Symptoms, and Quality of Life in Patients with Obstructive Sleep Apnea Syndrome Using Nasal Continuous Positive Airway Pressure

    Science.gov (United States)

    Ryan, Silke; Doherty, Liam S.; Nolan, Geraldine M.; McNicholas, Walter T.

    2009-01-01

    Background: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. Methods: 125 patients with the established diagnosis of OSAS (apnea/hypopnea index ≥ 10/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. Results: There was no difference in compliance between groups after 4 weeks (dry: 5.21 ± 1.66 h/night, fluticasone: 5.66 ± 1.68, humidifier: 5.21 ± 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. Conclusion: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered. Citation: Ryan S; Doherty LS; Nolan GM; McNicholas WT. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal

  16. Achievement of process control, safety, and regulatory compliance in a mixed waste evaporator system at the Hanford Site using data quality objectives

    International Nuclear Information System (INIS)

    Von Bargen, B.H.

    1995-01-01

    The Data Quality Objectives (DQO) Process was applied to the operation of the 242-A Evaporator at the Hanford Site. A team consisting of representatives from process engineering, environmental engineering, regulatory compliance, analytical laboratories, and DOE utilized the step by step DQO process to define the issues, variables, and inputs necessary to develop the decision rules which govern plant operations. The sampling and analyses required to make these decisions was then optimized concerning factors such as sample number, total analyses, cost, radiation exposure, quality assurance, and deliverables

  17. Validating year 2000 compliance

    NARCIS (Netherlands)

    A. van Deursen (Arie); P. Klint (Paul); M.P.A. Sellink

    1997-01-01

    textabstractValidating year 2000 compliance involves the assessment of the correctness and quality of a year 2000 conversion. This entails inspecting both the quality of the conversion emph{process followed, and of the emph{result obtained, i.e., the converted system. This document provides an

  18. INCITS W1.1 development update: appearance-based image quality standards for printers

    Science.gov (United States)

    Zeise, Eric K.; Rasmussen, D. René; Ng, Yee S.; Dalal, Edul; McCarthy, Ann; Williams, Don

    2008-01-01

    In September 2000, INCITS W1 (the U.S. representative of ISO/IEC JTC1/SC28, the standardization committee for office equipment) was chartered to develop an appearance-based image quality standard. (1),(2) The resulting W1.1 project is based on a proposal (3) that perceived image quality can be described by a small set of broad-based attributes. There are currently six ad hoc teams, each working towards the development of standards for evaluation of perceptual image quality of color printers for one or more of these image quality attributes. This paper summarizes the work in progress of the teams addressing the attributes of Macro-Uniformity, Colour Rendition, Gloss & Gloss Uniformity, Text & Line Quality and Effective Resolution.

  19. Directory of Certificates of Compliance for Radioactive-Materials Packages. Summary report of NRC approved quality assurance programs for radioactive material packages

    International Nuclear Information System (INIS)

    1983-01-01

    This directory contains a Summary Report of the US Nuclear Regulatory Commission's Approved Packages (Volume I), all Certificates of Compliance (Volume 2), and Summary Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective December 31, 1982. The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the back of Volumes 1 and 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Summary Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  20. How Compliance Measures, Behavior Modification, and Continuous Quality Improvement Led to Routine HIV Screening in an Emergency Department in Brooklyn, New York.

    Science.gov (United States)

    Isaac, Jermel Kyri; Sanchez, Travis H; Brown, Emily H; Thompson, Gina; Sanchez, Christina; Fils-Aime, Stephany; Maria, Jose

    2016-01-01

    New York State adopted a new HIV testing law in 2010 requiring medical providers to offer an HIV test to all eligible patients aged 13-64 years during emergency room or ambulatory care visits. Since then, Wyckoff Heights Medical Center (WHMC) in Brooklyn, New York, began implementing routine HIV screening organization-wide using a compliance, behavior-modification, and continuous quality-improvement process. WHMC first implemented HIV screening in the emergency department (ED) and evaluated progress with the following monthly indicators: HIV tests offered, HIV tests accepted, HIV tests ordered (starting in December 2013), HIV tests administered, positive HIV tests, and linkage to HIV care. Compliance with the delivery of HIV testing was determined by the proportion of patients who, after accepting a test, received one. During August 2013 through July 2014, of 57,852 eligible patients seen in the WHMC ED, a total of 31,423 (54.3%) were offered an HIV test. Of those, 8,229 (26.2%) patients accepted a test. Of those, 6,114 (74.3%) underwent a test. A total of 26 of the 6,114 patients tested (0.4%) had a positive test, and 24 of the 26 HIV-positive patients were linked to HIV medical care. By July 2014, the monthly proportion of patients offered a test was 62%; the proportion of those offered a test who had a test ordered was 98%, and the proportion of those with a test ordered who were tested was 81%. Testing compliance increased substantially at the WHMC ED, from 77% in December 2013 to >98% in July 2014. Using compliance-monitoring, behavior-modification, and continuous quality-improvement processes produced substantial increases in offers and HIV test completion. WHMC is replicating this approach across departments, and other hospitals implementing routine HIV screening programs should consider this approach as well.

  1. Drinking water treatment plant costs and source water quality: An updated case study (2013-2016)

    Science.gov (United States)

    Watershed protection can play an important role in producing safe drinking water. However, many municipalities and drinking water treatment plants (DWTPs) lack the information on the potential benefits of watershed protection as an approach to improving source water quality. This...

  2. Compliance status

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford's compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute

  3. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  4. Performing compliance

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    the local policy workers front-staged some practices in the implementation process and back-staged others. The local policy workers deliberately performed ‘guideline compliance’ by using information control and impression management techniques. The findings suggest that local guideline compliance should...... be regarded as a staged performance in which deliberate techniques are used to produce and manage certain impressions of compliance....

  5. Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.

    Science.gov (United States)

    Miller, R G; Jackson, C E; Kasarskis, E J; England, J D; Forshew, D; Johnston, W; Kalra, S; Katz, J S; Mitsumoto, H; Rosenfeld, J; Shoesmith, C; Strong, M J; Woolley, S C

    2009-10-13

    To systematically review evidence bearing on the management of patients with amyotrophic lateral sclerosis (ALS). The authors analyzed studies from 1998 to 2007 to update the 1999 practice parameter. Topics covered in this section include slowing disease progression, nutrition, and respiratory management for patients with ALS. The authors identified 8 Class I studies, 5 Class II studies, and 43 Class III studies in ALS. Important treatments are available for patients with ALS that are underutilized. Noninvasive ventilation (NIV), percutaneous endoscopic gastrostomy (PEG), and riluzole are particularly important and have the best evidence. More studies are needed to examine the best tests of respiratory function in ALS, as well as the optimal time for starting PEG, the impact of PEG on quality of life and survival, and the effect of vitamins and supplements on ALS. Riluzole should be offered to slow disease progression (Level A). PEG should be considered to stabilize weight and to prolong survival in patients with ALS (Level B). NIV should be considered to treat respiratory insufficiency in order to lengthen survival (Level B) and to slow the decline of forced vital capacity (Level B). NIV may be considered to improve quality of life (Level C) [corrected].Early initiation of NIV may increase compliance (Level C), and insufflation/exsufflation may be considered to help clear secretions (Level C).

  6. Digital chest radiography: an update on modern technology, dose containment and control of image quality

    NARCIS (Netherlands)

    Schaefer-Prokop, Cornelia; Neitzel, Ulrich; Venema, Henk W.; Uffmann, Martin; Prokop, Mathias

    2008-01-01

    The introduction of digital radiography not only has revolutionized communication between radiologists and clinicians, but also has improved image quality and allowed for further reduction of patient exposure. However, digital radiography also poses risks, such as unnoticed increases in patient dose

  7. Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

    Science.gov (United States)

    Wiler, Jennifer L.; Granovsky, Michael; Cantrill, Stephen V.; Newell, Richard; Venkatesh, Arjun K.; Schuur, Jeremiah D.

    2016-01-01

    In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians. PMID:26973757

  8. Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

    Directory of Open Access Journals (Sweden)

    Jennifer L. Wiler, MD, MBA

    2016-03-01

    Full Text Available In 2007, the Centers for Medicaid and Medicare Services (CMS created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS. As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM. For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

  9. Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice.

    Science.gov (United States)

    Wiler, Jennifer L; Granovsky, Michael; Cantrill, Stephen V; Newell, Richard; Venkatesh, Arjun K; Schuur, Jeremiah D

    2016-03-01

    In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the "traditional PQRS" reporting program and the newer "Value Modifier" program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

  10. Year 2000 compliance issues.

    Science.gov (United States)

    1999-03-01

    This month, we continue our coverage of the year 2000 (Y2K) problem as it affects healthcare facilities and the professionals who work in them. We present the following articles: "Checking PCs for Y2K Compliance"--In this article, we describe the probable sources of Y2K-related errors in PCs and present simple procedures for testing the Y2K compliance of PCs and application software. "Y2K Assessment Equipment Expectations"--In this article, we review the Y2K compliance data from a small sampling of hospitals to help answer the question "What percentage of medical equipment will likely be susceptible to Y2K problems?" "Y2K Labeling of Medical Devices"--In this article, we discuss the pros and cons of instituting a program to label each medical device with its Y2K status. Also in this section, we present an updated list of organizations that support ECRI's Position Statement on the testing of medical devices for Y2K compliance, which we published in the December 1998 issue of Health Devices (27[12]). And we remind readers of the services ECRI can offer to help healthcare institutions cope with the Y2K problem.

  11. Directory of certificates of compliance for radioactive materials packages. Volume 3, Revision 14: Report of NRC approved quality assurance programs for radioactive materials packages

    International Nuclear Information System (INIS)

    1994-10-01

    This directory contains a Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs for Radioactive Materials Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  12. Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals

    Science.gov (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2014-01-01

    Objectives The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. Design A retrospective, longitudinal, multisite comparative survey. Setting Acute public hospitals in New South Wales, Australia. Participants 96 acute hospitals with accreditation survey results from two surveys during 2009–2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Outcomes Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010–2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Results Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010–2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phand hygiene rates, accreditation outcomes and infection control scores is less clear. Conclusions Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection

  13. Costs, quality of life and treatment compliance associated with antibiotic therapies in patients with cystic fibrosis: a review of the literature.

    Science.gov (United States)

    Weiner, Jennifer R; Toy, Edmond L; Sacco, Patricia; Duh, Mei Sheng

    2008-04-01

    Cystic fibrosis is the most common incurable hereditary disease in the US. Persistent respiratory infection is the leading cause of morbidity and mortality in cystic fibrosis patients. This study aimed to review the literature on economic and quality of life outcomes and treatment compliance associated with antibiotic therapies for cystic fibrosis patients. A systematic literature review was conducted using keyword searches of the MEDLINE database and selected conference abstracts. The review covered studies published between January 1990 and May 2007. Evidence suggests that inhaled tobramycin, a key chronic suppressive therapy, can reduce other healthcare costs. The main determinants of the cost of care include disease severity and respiratory infection. Costs vary widely by country. There is evidence that inhaled tobramycin and oral azithromycin improve quality of life and that treatment setting and patient convenience may also impact on quality of life. Antibiotic treatment compliance varied significantly and depended on the method of measurement, with more subjective measures tending to be higher. This review concludes by offering directions for future research.

  14. Comprehension and compliance with the discharge advice and quality of life at home among the postoperative neurosurgery patients discharged from PGIMER, Chandigarh, India

    Science.gov (United States)

    Kumar, Vishal; Singh, Amarjeet; Tewari, Manoj K.; Kaur, Sukhpal

    2016-01-01

    Problem Statement: Neurosurgical patients require special care not only in the hospital but also after their discharge from the hospital. Comprehension and compliance to the instructions given by the doctors/nurses at the time of discharge is important in home care of these patients. Many such patients suffer from various co-morbidities. Variable periods of convalescence affect health-related quality of life in these patients. Purpose of the Study: To determine the degree of compliance of neurosurgery patients and their family caregivers with the discharge advice given by the consultantsTo evaluate the quality of life of these patientsTo know the problems faced by these patients at home. Materials and Methods: This cross-sectional interview-based descriptive study was conducted in 2010 in Chandigarh. These patients were visited at their home. A scale was evolved to evaluate comprehension and compliance to the advice given at the time of discharge, according to the criteria developed by Clark et al. Lawton Brody instrumental activity of daily life and Spitzer quality of life index were used to assess patients' quality of life after the operation. Verbatim responses were recorded for the purpose of qualitative research. Results: Overall, 58 patients and their caregivers were interviewed at home. Mean age of the patients was 38.9 years. Out of 37 patients, 35 showed good comprehension and 33 patients had a good compliance with the instructions given for medication. The condition of 74.1% patients improved after the operation. Depression was reported in 31% of the patients. Many (36.2%) patients had to quit their job due to the disease. Almost half (47.4%) of the patients were independent in daily activities of their life while being evaluated on Barthel activity of daily life index. Conclusion and Recommendations: It is in the long term that the true complexity and impact of operations become apparent. After operation, such patients are likely to have a range of

  15. Quality assurance in CT: implementation of the updated national diagnostic reference levels using an automated CT dose monitoring system.

    Science.gov (United States)

    Appel, E; Kröpil, P; Bethge, O T; Aissa, J; Thomas, C; Antoch, G; Boos, J

    2018-03-20

    To evaluate the implementation of the updated computed tomography (CT) diagnostic reference levels (DRLs) from the German Federal Office for Radiation Protection into clinical routine using an automatic CT dose monitoring system. CT radiation exposure was analysed before and after implementing the updated national DRLs into routine clinical work in 2016. After the implementation process, institutional CT protocols were mapped to the anatomical regions for which DRLs were provided. Systematically, protocols that exceeded the thresholds were optimised and analysed in detail. The CT radiation output parameters analysed were volumetric CT dose index (CTDIvol) and dose-length product (DLP). Three radiologists evaluated subjective image quality using a three-point Likert scale. The study included 94,258 CT series (from 27,103 CT examinations) in adult patients performed in 2016. When averaged over all body regions with available DRL, institutional CTDIvol/DLP values were always below the DRLs (65.2±32.9%/67.3±41.5% initially; 59.4±32%/60.5±39.9% after optimisation). Values exceeding the national DRLs were found for pelvis (n=268; CTDIvol 107.7±65.7%/DLP 106.3±79.3%), lumbar spine (n=91; 160.8±74.7%/175.2±104.1%), and facial bones (n=527; 108±39%/152.7±75.7%). After optimisation, CTDIvol and DLP were 87.9±73%/87.8±80.8% for the pelvis, 67.8±33.2%/74.5±50.6% for the lumbar spine and 95.1±45.8%/133.3±74.6% for the viscerocranium. An automatic CT dose monitoring system enabled not only comprehensive monitoring of a DRL implementation process but can also help to optimise radiation exposure. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  16. MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Nicola, Gregory N; Allen, Bibb; Hughes, Danny R; Hirsch, Joshua A

    2017-03-01

    The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 advances the goal of tying Medicare payments to quality and value. In April 2016, CMS published an initial proposed rule for MACRA, renaming it the Quality Payment Program (QPP). Under QPP, clinicians receive payments through either advanced alternative payment models or the Merit-Based Incentive Payment System (MIPS), a consolidation of existing federal performance programs that applies positive or negative adjustments to fee-for-service payments. Most physicians will participate in MIPS. This review highlights implications of the QPP and MIPS for radiologists. Although MIPS incorporates radiology-specific quality measures, radiologists will also be required to participate in other practice improvement activities, including patient engagement. Recognizing physicians' unique practice patterns, MIPS will provide special considerations in performance evaluation for physicians with limited face-to-face patient interaction. Although such considerations will affect radiologists' likelihood of success under QPP, many practitioners will be ineligible for the considerations under currently proposed criteria. Reporting using qualified clinical data registries will benefit radiologists' performance by allowing expanded arrays of MIPS and non-MIPS specialty-specific measures. A group practice reporting option will substantially reduce administrative burden but introduce new challenges by requiring uniform determination of patient-facing status and performance measurement for all of the group's physicians (diagnostic radiologists, interventional radiologists, and nonradiologists) under the same taxpayer identification number. Given that the initial MIPS performance period begins in 2017, radiologists must begin preparing for QPP and taking actions to ensure their future success under this new quality-based payment system. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights

  17. Compliance Issues in Higher Education

    Science.gov (United States)

    Benedek, Petra

    2016-01-01

    Efficiency in the 1980's, quality in the 1990's, compliance in the 2010's - private sector management techniques and mechanisms find their way to public services. This paper facilitates the understanding of how compliance management controls can improve operations and prevent or detect failure or wrong doing. The last few years' empirical research…

  18. Compliance to consensus recommendations, surgeon's experience, and introduction of a quality assurance and management program: influence on therapy of early-stage ovarian carcinoma.

    Science.gov (United States)

    Kommoss, Stefan; Harter, Philipp; Traut, Alexander; Strutas, Deivis; Riegler, Nina; Buhrmann, Christine; Gomez, Ruth; du Bois, Andreas

    2009-05-01

    State-of-the-art surgical staging and adjuvant chemotherapy in early-stage ovarian carcinoma have an impact on patient's outcome, but compliance to guidelines and consensus recommendations is still poor. This article reports on our results before and after introduction of a quality assurance and management program in our clinic in 2001. Patients with ovarian carcinoma limited to the pelvis who underwent primary surgery in our hospital from 1997 to October 2007 were eligible for this study. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of compliance with our management program and physician's experience in ovarian carcinoma surgery on achieving both standards of surgery and chemotherapy. In a total of 117 women, a significant impact on adherence to guideline-defined comprehensive surgical staging was found for poor Eastern Cooperative Oncology Group performance status (odds ratio [OR], 22.16; confidence interval [CI] 3.2-152.0; P = 0.002) and year of surgery before 2001 (OR, 47.60; CI, 9.20-245.22; P grading less than G3 (OR, 4.14; CI, 1.20-14.22; P = 0.02) was a statistically significant predictor for receiving standard adjuvant chemotherapy. Survival analyses showed a trend toward improved survival for patients having received guideline-adopted therapy, but event numbers were too low for adequate analyses. The introduction of a quality assurance program for treatment of ovarian carcinoma represents a major improvement of patient care. It led to a higher compliance with consensus recommendations and showed already a trend toward improved outcome. Further outcome research should focus on methods for implementation of guidelines in daily practice in institutions caring for patients with ovarian carcinoma.

  19. Refinery water (intake and effluent) quality: Update of 1970s with 1990s toxicity testing

    International Nuclear Information System (INIS)

    Chapman, P.M.; Paine, M.D.; Moran, T.; Kierstead, T.

    1994-01-01

    The quality of two separate refinery intake waters and effluents was investigated: Petro-Canada (Oakville) and Novacor (Corunna Operations). This study comprised eight different test organized and 22 different toxicity end points, was built on and complemented pioneering 1970s work at the Petro-Canada refinery, and was designed to (a) determine any changes in effluent quality, (b) determine any previously unsuspected effluent toxicity, and (c) determine any potential for chronic toxicity in the effluent. Although Petro-Canada has steadily reduced contaminants in its effluent since the earlier study, toxicity has not changed and no new toxic effects were identified. Effect thresholds for the most sensitive animal species (Daphnia pulex) were 1 to 10% effluent in both studies. The Novacor effluent had lesser effects on biota than the Petro-Canada effluent. Intake waters demonstrated toxicity in some tests. Chronic effects on invertebrates and fish in receiving waters are predicted not to occur in the Novacor effluent is diluted 10- to 20-fold and the Petro-Canada effluent is diluted 50- to 100-fold

  20. [Update on microbiological quality assurance meat and meat products in Morocco].

    Science.gov (United States)

    Rachidi, H; Latrache, H

    2018-03-01

    Food safety has become an absolute necessity in all countries. As a result, Morocco has taken several measures and actions to develop food safety and food-borne disease control. This study aimed to highlight the level of improvement in the quality assurance of meat and meat products in Morocco. It is based on a non-exhaustive review of the regulatory texts governing food safety in the country, as well as a statistical study on establishments of meat and meat products adopting a self-checking system and approved by the National Office of Sanitary Safety of Food. Morocco has introduced several laws and regulations requiring sanitary control of food products. Also, the number of establishments of meat and meat products adopting a system of self-control and approved by the National Office of Sanitary Safety of Food has improved significantly. It has increased from 58 in 2007 to 273 in 2016. The adoption of self-monitoring systems allows better access to international markets, improved quality of food products and a considerable reduction in microbial contamination. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  1. Digital chest radiography: an update on modern technology, dose containment and control of image quality

    International Nuclear Information System (INIS)

    Schaefer-Prokop, Cornelia; Venema, Henk W.; Neitzel, Ulrich; Uffmann, Martin; Prokop, Mathias

    2008-01-01

    The introduction of digital radiography not only has revolutionized communication between radiologists and clinicians, but also has improved image quality and allowed for further reduction of patient exposure. However, digital radiography also poses risks, such as unnoticed increases in patient dose and suboptimum image processing that may lead to suppression of diagnostic information. Advanced processing techniques, such as temporal subtraction, dual-energy subtraction and computer-aided detection (CAD) will play an increasing role in the future and are all targeted to decrease the influence of distracting anatomic background structures and to ease the detection of focal and subtle lesions. This review summarizes the most recent technical developments with regard to new detector techniques, options for dose reduction and optimized image processing. It explains the meaning of the exposure indicator or the dose reference level as tools for the radiologist to control the dose. It also provides an overview over the multitude of studies conducted in recent years to evaluate the options of these new developments to realize the principle of ALARA. The focus of the review is hereby on adult applications, the relationship between dose and image quality and the differences between the various detector systems. (orig.)

  2. Directory of certificates of compliance for radioactive materials packages: summary report of NRC approved quality-assurance programs for radioactive-material packages. Volume 3, Revision 3

    International Nuclear Information System (INIS)

    1983-09-01

    This directory contains a Summary Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure them in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR 71.12 does not authorize the receipt, possession, use or transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, 50, or 70

  3. Directory of certificates of compliance for radioactive materials packages. Summary report of NRC approved quality assurance programs for radioactive material packages. Volume 3, Revision 6

    International Nuclear Information System (INIS)

    1986-10-01

    This directory contains a Summary Report of NRC Approved Packages (Volumes 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure them that have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR 71.12 does not authorize the receipt, possession, use of transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, 50, or 70

  4. Directory of certificates of compliance for radioactive materials packages. Summary report of NRC approved quality assurance programs for radioactive material packages. Volume 3, Revision 4

    International Nuclear Information System (INIS)

    1984-11-01

    This directory contains a Summary Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR 71.12 does not authorize the receipt, possession, use or transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, 50, or 70

  5. An update on the quality assurance for the waste vitrification plants

    Energy Technology Data Exchange (ETDEWEB)

    Caplinger, W.H.; Shugars, D.L.; Carlson, M.K.

    1990-01-01

    Immobilization of high-level defense production wastes is an important step in environmental restoration. The best available technology for immobilization of this waste currently is by incorporation into borosilicate glass, i.e., vitrification. Three US sites are active in the design, construction, or operation of vitrification facilities. The status, facility description and Quality Assurance (QA) development for each facility was presented at the 1989 Energy Division Conference. This paper presents the developments since that time. The West Valley Demonstration Project (WVDP) in northwestern New York State has demonstrated the technology. At the Savannah River Site (SRS) in South Carolina the Defense Waste Processing Facility (DWPF) has completed design, construction is essentially complete, and preparation for operation is underway. The Hanford Waste Vitrification Plant (HWVP) in Washington State is in initial Detailed Design. 4 refs.

  6. An update on the quality assurance for the waste vitrification plants

    International Nuclear Information System (INIS)

    Caplinger, W.H.; Shugars, D.L.; Carlson, M.K.

    1990-01-01

    Immobilization of high-level defense production wastes is an important step in environmental restoration. The best available technology for immobilization of this waste currently is by incorporation into borosilicate glass, i.e., vitrification. Three US sites are active in the design, construction, or operation of vitrification facilities. The status, facility description and Quality Assurance (QA) development for each facility was presented at the 1989 Energy Division Conference. This paper presents the developments since that time. The West Valley Demonstration Project (WVDP) in northwestern New York State has demonstrated the technology. At the Savannah River Site (SRS) in South Carolina the Defense Waste Processing Facility (DWPF) has completed design, construction is essentially complete, and preparation for operation is underway. The Hanford Waste Vitrification Plant (HWVP) in Washington State is in initial Detailed Design. 4 refs

  7. Interventions to improve hand hygiene compliance in patient care.

    Science.gov (United States)

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

    2010-09-08

    Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the

  8. Directory of certificates of compliance for radioactive materials packages: Report of NRC approved quality assurance programs for radioactive materials packages

    International Nuclear Information System (INIS)

    1990-10-01

    The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of compliance Number is included at the front of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  9. Directory of certificates of compliance for radioactive materials packages: Report of NRC approved quality assurance programs for radioactive materials packages

    International Nuclear Information System (INIS)

    1989-10-01

    The purpose of this directory is to make available a convenient source of information on packaging which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  10. Macrophyte and pH buffering updates to the Klamath River water-quality model upstream of Keno Dam, Oregon

    Science.gov (United States)

    Sullivan, Annett B.; Rounds, Stewart A.; Asbill-Case, Jessica R.; Deas, Michael L.

    2013-01-01

    A hydrodynamic, water temperature, and water-quality model of the Link River to Keno Dam reach of the upper Klamath River was updated to account for macrophytes and enhanced pH buffering from dissolved organic matter, ammonia, and orthophosphorus. Macrophytes had been observed in this reach by field personnel, so macrophyte field data were collected in summer and fall (June-October) 2011 to provide a dataset to guide the inclusion of macrophytes in the model. Three types of macrophytes were most common: pondweed (Potamogeton species), coontail (Ceratophyllum demersum), and common waterweed (Elodea canadensis). Pondweed was found throughout the Link River to Keno Dam reach in early summer with densities declining by mid-summer and fall. Coontail and common waterweed were more common in the lower reach near Keno Dam and were at highest density in summer. All species were most dense in shallow water (less than 2 meters deep) near shore. The highest estimated dry weight biomass for any sample during the study was 202 grams per square meter for coontail in August. Guided by field results, three macrophyte groups were incorporated into the CE-QUAL-W2 model for calendar years 2006-09. The CE-QUAL-W2 model code was adjusted to allow the user to initialize macrophyte populations spatially across the model grid. The default CE-QUAL-W2 model includes pH buffering by carbonates, but does not include pH buffering by organic matter, ammonia, or orthophosphorus. These three constituents, especially dissolved organic matter, are present in the upper Klamath River at concentrations that provide substantial pH buffering capacity. In this study, CE-QUAL-W2 was updated to include this enhanced buffering capacity in the simulation of pH. Acid dissociation constants for ammonium and phosphoric acid were taken from the literature. For dissolved organic matter, the number of organic acid groups and each group's acid dissociation constant (Ka) and site density (moles of sites per mole of

  11. Updating sea spray aerosol emissions in the Community Multiscale Air Quality (CMAQ) model version 5.0.2

    Data.gov (United States)

    U.S. Environmental Protection Agency — The uploaded data consists of the BRACE Na aerosol observations paired with CMAQ model output, the updated model's parameterization of sea salt aerosol emission size...

  12. Directory of Certificates of Compliance for Radioactive Materials Packages. Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages. Volume 3. Revision 5

    International Nuclear Information System (INIS)

    1985-10-01

    This directory contains a Summary Report of the US Nuclear Regulatory Commission's Approved Packages (Volume I), all Certificates of Compliance (Volume 2), and Summary Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective October 1, 1985. The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the back of Volumes 1 and 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Summary Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory. Shipments of radioactive material utilizing these packages must be in accordance with the provisions of 49 CFR Section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with a Nuclear Regulatory Commission approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR Section 71.12 does not authorize the receipt, possession, use or transfer of byproduct, source or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, or 70

  13. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  14. Ozone modeling for compliance planning: A synopsis of ''The Use of Photochemical Air Quality Models for Evaluating Emission Control Strategies: A Synthesis Report''

    International Nuclear Information System (INIS)

    Blanchard, C.L.

    1992-12-01

    The 1990 federal Clean Air Act Amendments require that many nonattainment areas use gridded, photochemical air quality models to develop compliance plans for meeting the ambient ozone standard. Both industry and regulatory agencies will need to consider explicitly the strengths and limitations of the models. Photochemical air quality models constitute the principal tool available for evaluating the relative effectiveness of alternative emission control strategies. Limitations in the utility of modeling results stem from the uncertainty and bias of predictions for modeled episodes, possible compensating errors, limitations in the number of modeled episodes, and incompatibility between deterministic model predictions and the statistical form of the air quality standard for ozone. If emissions estimates (including naturally produced ''biogenic'' emissions) are accurate, intensive aerometric data are available, and an evaluation of performance (including diagnostic evaluations) is successfully completed, gridded photochemical airquality models can determine (1) the types of emission controls - VOC, NO x , or both - that would be most effective for reducing ozone concentrations, and (2) the approximate magnitudes - to within about 20--40% - of the estimated ozone reductions

  15. PROCEDURE FOR ANALYSIS COMPLIANCE WITH QUALITY STANDARDS OFFER OF THE BUFFET RESTAURANT CASONA MELIA SANTIAGO DE CUBA

    Directory of Open Access Journals (Sweden)

    Oscar Parada-Pérez

    2016-01-01

    Full Text Available The company hotel Cuban faces the challenge of the competitiveness and the client’s satisfaction in an environment that demands of actions that they assure the quality. This article has as objective to show the application of a procedure for the evaluation of the standards of quality of the offer in the restaurant buffet La Casona of the Hotel Meliá Santiago de Cuba. The results achieved by the application of the procedure allow to perfect the process of taking of decisions and it contributes to the efficiency of the hotel and the elevation of the quality of the service. 

  16. Energy Efficiency in Buildings as an Air Quality Compliance Approach: Opportunities for the U.S. Department of Energy

    Energy Technology Data Exchange (ETDEWEB)

    Vine, Edward

    2002-05-01

    Increasing the energy efficiency of end-use equipment in the residential, commercial, and industrial sectors can reduce air pollution emissions and greenhouse gases significantly. Because energy efficiency is an effective means of reducing multi-pollutant emissions, it is important to ensure that energy efficiency is a fully engaged component of emission-reduction programs. However, while energy-efficiency measures are perceived by many stakeholders to be important options for improving air quality, some members in the air quality community are concerned about the ability of these measures to fit in a regulatory framework-in particular, the ability of emissions reductions from energy-efficiency measures to be real, quantifiable, certifiable, and enforceable. Hence, there are few air quality programs that include energy efficiency as a tool for complying with air quality regulations. This paper describes the connection between energy consumption and air quality, the potential role of energy-efficiency measures to meet air quality regulations, the barriers and challenges to the use of these measures in the air quality regulatory environment, and the potential role that the U.S. Department of Energy's (USDOE) Energy Efficiency and Renewable Energy's Building Technology, State and Community Programs (EERE-Buildings) could play in this area. EERE-Buildings can play a very important role in promoting energy efficiency in the air quality community, in ways that are fully consistent with its overall mission. EERE-Buildings will need to work with other stakeholders to aggressively promote energy efficiency via multiple means: publications, analytical tools, pilot programs, demonstrations, and program and policy analysis and evaluation. EERE-Buildings and state energy officials have considerable experience in implementing and monitoring energy-savings projects, as well as in designing documentation and verification requirements of energy-efficiency improvements

  17. Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance): a case-control retrospective study. 2011 SOSORT Award winner.

    Science.gov (United States)

    Tavernaro, Marta; Pellegrini, Anna; Tessadri, Fabrizio; Zaina, Fabio; Zonta, Andrea; Negrini, Stefano

    2012-09-20

    Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace TREATMENT Management Guidelines (SBTMG) have highlighted the perceived importance of the professional teams surrounding braced patients. To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Design. Initial cross-sectional study, followed by a retrospective case-control study. Thirty-eight patients (15.8 ± 1.6 years; 26 females; 10 hyperkyphosis, 28 scoliosis of 29.2 ± 7.9° Cobb) extracted from a single orthotist database (between January 1, 2008 and September 1, 2009) and treated by the same physician; brace wearing at least 15 hours/day for a minimum of 6 months; age 10 or more. Braces: Sforzesco, Sibilla, Lapadula or Maguelone. Exercises: SEAS. Two questionnaires filled in blindly by patients: SRS-22 and one especially developed and validated with 25 questions on adherence to treatment. Groups (main risk factor): TEAM (private institute: satisfied 44/44 SOSORT criteria; grade of teamwork, "excellent") included 13 patients and NOT 25 (National Health Service Rehabilitation Department: 35/44 SOSORT criteria respected; grade, "insufficient"). TEAM was more compliant to bracing than NOT (97 ± 6% vs. 80 ± 24%) and performed nearly double the exercises (38 ± 12 vs. 20 ± 13 minutes/session). The self-reduction of bracing was significant in NOT (from 16.8 ± 3.7 to 14.8 ± 4.9 hours/day, , Pversus 7% of TEAM (P < 0.05). The populations did not differ at the baseline studied outcomes. The absence of a good team surrounding the patient increases by five times the risk of reduced compliance to bracing (odds ratio OR 5.5 - 95% confidence interval 95CI 3.6-7.4), along with more than 15 times that of QoL problems (OR 15.7 - 95CI 13.6-17.9) and pain (OR 16.8 - 95CI 14.5-19.1). Provided the limits of this first study on the topic, the SBTMG seems to be important for brace treatment

  18. Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III

    DEFF Research Database (Denmark)

    Singer, Susanne; Araújo, Cláudia; Arraras, Juan Ignacio

    2015-01-01

    BACKGROUND: The objective of this study was to pilot test an updated version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N60). METHODS: Patients with head and neck cancer were asked to complete a list of 60 head...... and neck cancer-specific items comprising the updated EORTC head and neck module and the core questionnaire EORTC QLQ-C30. Debriefing interviews were conducted to identify any irrelevant items and confusing or upsetting wording. RESULTS: Interviews were performed with 330 patients from 17 countries......, representing different head and neck cancer sites and treatments. Forty-one of the 60 items were retained according to the predefined EORTC criteria for module development, for another 2 items the wording was refined, and 17 items were removed. CONCLUSION: The preliminary EORTC QLQ-H&N43 can now be used...

  19. Parametric Synthesis of Automatic Control System of Industrial Robot Manipulator in Compliance with Requirements of Robust Quality

    Directory of Open Access Journals (Sweden)

    A. A. Nesenchuk

    2004-01-01

    Full Text Available The paper considers an application of a root-locus method for synthesis of dynamic systems with uncertainty that meet the requirements of pre-set quality. This method is used for parametric synthesis of automatic control system of industrial robot manipulator that is used for transportation of engineering products. The synthesis takes place under conditions of substantial changes in inertia moment of robot load. As a result of investigations it is possible to determine range of values of variable parameter that ensures the required quality of control system operation. A system of computer programs has been developed in order to solve the problem.

  20. Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life.

    Science.gov (United States)

    Galvão, Daniel A; Newton, Robert U; Gardiner, Robert A; Girgis, Afaf; Lepore, Stephen J; Stiller, Anna; Occhipinti, Stefano; Chambers, Suzanne K

    2015-06-18

    The purpose of this study was to determine prevalence of Australian prostate cancer survivors meeting contemporary exercise-oncology guidelines and identify associations with distress, unmet supportive care needs, and quality of life. A population-based cohort of 463 prostate cancer survivors who were on 10.8 months post-curative therapy was assessed for compliance with current exercise guidelines for cancer survivors, motivational readiness for physical activity, psychological distress, unmet supportive care needs, and quality of life. Only 57 men (12.3%) reported sufficient exercise levels (150 min of moderate intensity or 75 min of strenuous exercise per week and twice weekly resistance exercise), 186 (40.2%) were insufficiently active, and 220 (47.5%) were inactive. Among inactive men, 99 (45.0%) were in the contemplation or preparation stage of motivation readiness. Inactive men had higher global distress (p = 0.01) and Brief Symptom Inventory-Anxiety (p Australian prostate cancer survivors met contemporary exercise-oncology recommendations despite increasing recognition of exercise to improve patient outcomes. Strategies are urgently required to increase prostate cancer survivors' participation in aerobic and resistance exercise training.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. The Quality of Teaching Staff: Higher Education Institutions' Compliance with the European Standards and Guidelines for Quality Assurance--The Case of Portugal

    Science.gov (United States)

    Cardoso, Sónia; Tavares, Orlanda; Sin, Cristina

    2015-01-01

    In recent years, initiatives for the improvement of teaching quality have been pursued both at European and national levels. Such is the case of the European Standards and Guidelines for Quality Assurance (ESG) and of legislation passed by several European countries, including Portugal, in response to European policy developments driven by the…

  2. A direct sensitivity approach to predict hourly ozone resulting from compliance with the National Ambient Air Quality Standard.

    Science.gov (United States)

    Simon, Heather; Baker, Kirk R; Akhtar, Farhan; Napelenok, Sergey L; Possiel, Norm; Wells, Benjamin; Timin, Brian

    2013-03-05

    In setting primary ambient air quality standards, the EPA's responsibility under the law is to establish standards that protect public health. As part of the current review of the ozone National Ambient Air Quality Standard (NAAQS), the US EPA evaluated the health exposure and risks associated with ambient ozone pollution using a statistical approach to adjust recent air quality to simulate just meeting the current standard level, without specifying emission control strategies. One drawback of this purely statistical concentration rollback approach is that it does not take into account spatial and temporal heterogeneity of ozone response to emissions changes. The application of the higher-order decoupled direct method (HDDM) in the community multiscale air quality (CMAQ) model is discussed here to provide an example of a methodology that could incorporate this variability into the risk assessment analyses. Because this approach includes a full representation of the chemical production and physical transport of ozone in the atmosphere, it does not require assumed background concentrations, which have been applied to constrain estimates from past statistical techniques. The CMAQ-HDDM adjustment approach is extended to measured ozone concentrations by determining typical sensitivities at each monitor location and hour of the day based on a linear relationship between first-order sensitivities and hourly ozone values. This approach is demonstrated by modeling ozone responses for monitor locations in Detroit and Charlotte to domain-wide reductions in anthropogenic NOx and VOCs emissions. As seen in previous studies, ozone response calculated using HDDM compared well to brute-force emissions changes up to approximately a 50% reduction in emissions. A new stepwise approach is developed here to apply this method to emissions reductions beyond 50% allowing for the simulation of more stringent reductions in ozone concentrations. Compared to previous rollback methods, this

  3. Utilization of handheld computing to simplify compliance

    International Nuclear Information System (INIS)

    Galvin, G.; Rasmussen, J.; Haines, A.

    2008-01-01

    Monitoring job site performance and building a continually improving organization is an ongoing challenge for operators of process and power generation facilities. Stakeholders need to accurately capture records of quality and safety compliance, job progress, and operational experiences (OPEX). This paper explores the use of technology-enabled processes as a means for simplifying compliance to quality, safety, administrative, maintenance and operations activities. The discussion will explore a number of emerging technologies and their application to simplifying task execution and process compliance. This paper will further discuss methodologies to further refine processes through trending improvements in compliance and continually optimizing and simplifying through the use of technology. (author)

  4. Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries.

    Science.gov (United States)

    Jackson-Morris, Angela; Bleymann, Kayleigh; Lyall, Elaine; Aslam, Fouad; Bam, Tara Singh; Chowdhury, Ishrat; Daouda, Elhadj Adam; Espinosa, Mariana; Romo, Jonathan; Singh, Rana J; Semple, Sean

    2016-05-01

    Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high. Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day. Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P hospitality venues in LMICs. Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and

  5. Feasibility and difficulties on China new air quality standard compliance: PRD case of PM2.5 and ozone from 2010 to 2025

    Science.gov (United States)

    Liu, H.; Wang, X. M.; Pang, J. M.; He, K. B.

    2013-08-01

    Improving the air quality in China is a long and arduous task. Although China has made very aggressive plan on pollutants control, the difficulties to achieve the new air quality goals are still significant. In north, PM2.5 and PM10 are still far beyond the standards. In south, O3 goal is much challenged. A lot of cities are making their city implementation plan (CIP) for new air quality goals. In this study, a southern city, Guangzhou, is selected to analyze the feasibility and difficulties on new air quality standard compliance, as well as the CIP evaluation. A comprehensive study of air quality status in Guangzhou and surrounding area is conducted based on 22 sites monitoring data of O3, PM2.5 and PM10. The monthly non-attainment rates for O3 vary in 7-25% from May to November. The city average PM2.5 concentration is 41 μg m-3 in Guangzhou in 2010, which needs to be reduced by at least 15% to achieve the target of 35 μg m-3. The PM2.5 high violate months are from November to March. Guangzhou CIP was then evaluated with PM2.5 and O3 placed in a core position. The emission amount of NOx, PM10, PM2.5 and VOC in 2025 would be controlled to 600, 420, 200 and 860 thousand tons respectively. Analysis of air quality using the MM5-STEM model suggests that the long-term control measures would achieve the PM2.5 and PM10 goals successfully by 2025. The PM2.5 annual average concentration would be reduced to 20.8 μg m-3 in 2025. The O3 non-attainment rate would increase from 7.1% in 2010 to 12.9% in 2025 and become the most primary atmospheric environmental problem. Guangzhou needs very strong control on VOCs to reduce its ozone. The VOC / NOx reduction ratio should reach at least 2 : 1 (in California, it is about 3 : 1), instead of the current plan of 0.7 : 1. The evaporative emissions control from vehicle non-tailpipe emission and solvent usage should be enhanced and regional ozone transport must be taken into account.

  6. Federal Facilities Compliance Act, Draft Site Treatment Plan: Compliance Plan Volume. Part 2, Volume 2

    International Nuclear Information System (INIS)

    1994-01-01

    This document presents the details of the implementation of the Site Treatment Plan developed by Ames Laboratory in compliance with the Federal Facilities Compliance Act. Topics discussed in this document include: implementation of the plan; milestones; annual updates to the plan; inclusion of new waste streams; modifications of the plan; funding considerations; low-level mixed waste treatment plan and schedules; and TRU mixed waste streams

  7. Compliance with the annual NO 2 air quality standard in Athens. Required NO x levels and expected health implications

    Science.gov (United States)

    Chaloulakou, A.; Mavroidis, I.; Gavriil, I.

    Recent risk assessment studies have shown that high outdoor NO 2 levels observed in residential areas contribute to increased respiratory and cardiovascular diseases and mortality. Detailed information on present NO 2 levels as well as predictions of NO 2 concentrations corresponding to reduced NO x levels in urban areas are very useful to decision and policy makers in order to protect the public health. In the present paper, monitoring stations of the Athens network are initially classified into two main groups, traffic affected and urban background, using effectively a criterion based on the ratio of annual mean NO:NO 2 concentrations. Two empirical methodologies are then considered and compared for assessing the effect of different NO x levels on the attainment of the annual NO 2 air quality standard at urban-background locations in the Athens area. An interesting finding is that these two methodologies, one more general and one both year and site dependent, give similar results for the specific study area and can be applied alternatively based on the length of available concentration time series. The results show that in order to meet the EU annual mean NO 2 objective at all the urban-background locations of the Athens area, annual NO x concentrations should be reduced to approximately 60 μg m -3, requiring NO x emission reductions of up to 30%. An analysis of the health implications of the currently observed NO 2 levels is conducted, based on a dose-response relationship, and is coupled with available health-related data for the Athens area. This analysis suggests that if NO 2 concentrations were reduced to the levels of the annual EU air quality standard, then a decrease of hospital admissions of up to 2.6% would be observed, depending on the levels of NO 2 measured at different monitoring sites of the Athens conurbation.

  8. Environmental Compliance Mechanisms

    NARCIS (Netherlands)

    Merkouris, Panagiotis; Fitzmaurice, Malgosia

    2017-01-01

    Compliance mechanisms can be found in treaties regulating such diverse issues as human rights, disarmament law, and environmental law. In this bibliography, the focus will be on compliance mechanisms of multilateral environmental agreements (MEAs). Compliance with norms of international

  9. Application of a New Integrated Decision Support Tool (i-DST) for Urban Water Infrastructure: Analyzing Water Quality Compliance Pathways for Three Los Angeles Watersheds

    Science.gov (United States)

    Gallo, E. M.; Hogue, T. S.; Bell, C. D.; Spahr, K.; McCray, J. E.

    2017-12-01

    The water quality of receiving streams and waterbodies in urban watersheds are increasingly polluted from stormwater runoff. The implementation of Green Infrastructure (GI), which includes Low Impact Developments (LIDs) and Best Management Practices (BMPs), within a watershed aim to mitigate the effects of urbanization by reducing pollutant loads, runoff volume, and storm peak flow. Stormwater modeling is generally used to assess the impact of GIs implemented within a watershed. These modeling tools are useful for determining the optimal suite of GIs to maximize pollutant load reduction and minimize cost. However, stormwater management for most resource managers and communities also includes the implementation of grey and hybrid stormwater infrastructure. An integrated decision support tool, called i-DST, that allows for the optimization and comprehensive life-cycle cost assessment of grey, green, and hybrid stormwater infrastructure, is currently being developed. The i-DST tool will evaluate optimal stormwater runoff management by taking into account the diverse economic, environmental, and societal needs associated with watersheds across the United States. Three watersheds from southern California will act as a test site and assist in the development and initial application of the i-DST tool. The Ballona Creek, Dominguez Channel, and Los Angeles River Watersheds are located in highly urbanized Los Angeles County. The water quality of the river channels flowing through each are impaired by heavy metals, including copper, lead, and zinc. However, despite being adjacent to one another within the same county, modeling results, using EPA System for Urban Stormwater Treatment and Analysis INtegration (SUSTAIN), found that the optimal path to compliance in each watershed differs significantly. The differences include varied costs, suites of BMPs, and ancillary benefits. This research analyzes how the economic, physical, and hydrological differences between the three

  10. Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance: a case–control retrospective study. 2011 SOSORT Award winner

    Directory of Open Access Journals (Sweden)

    Tavernaro Marta

    2012-09-01

    Full Text Available Abstract Background Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace Treatment Management Guidelines (SBTMG have highlighted the perceived importance of the professional teams surrounding braced patients. Purpose To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Materials and methods Design. Initial cross-sectional study, followed by a retrospective case–control study. Population: Thirty-eight patients (15.8 ± 1.6 years; 26 females; 10 hyperkyphosis, 28 scoliosis of 29.2 ± 7.9° Cobb extracted from a single orthotist database (between January 1, 2008 and September 1, 2009 and treated by the same physician; brace wearing at least 15 hours/day for a minimum of 6 months; age 10 or more. Treatment: Braces: Sforzesco, Sibilla, Lapadula or Maguelone. Exercises: SEAS. Methods: Two questionnaires filled in blindly by patients: SRS-22 and one especially developed and validated with 25 questions on adherence to treatment. Groups (main risk factor: TEAM (private institute: satisfied 44/44 SOSORT criteria; grade of teamwork, “excellent” included 13 patients and NOT 25 (National Health Service Rehabilitation Department: 35/44 SOSORT criteria respected; grade, “insufficient”. Results TEAM was more compliant to bracing than NOT (97 ± 6% vs. 80 ± 24% and performed nearly double the exercises (38 ± 12 vs. 20 ± 13 minutes/session. The self-reduction of bracing was significant in NOT (from 16.8 ± 3.7 to 14.8 ± 4.9 hours/day, , P Conclusions Provided the limits of this first study on the topic, the SBTMG seems to be important for brace treatment, influencing pain, QoL and compliance (and so, presumably, final results. Future studies on the topic are advisable.

  11. E-health: Web-guided therapy and disease self-management in ulcerative colitis. Impact on disease outcome, quality of life and compliance.

    Science.gov (United States)

    Elkjaer, Margarita

    2012-07-01

    Ulcerative Colitis (UC) together with Crohn's disease (CD) belongs to inflammatory bowel diseases (IBD). IBD is to date as frequent as Insulin Dependent Diabetes (IDDM) and is second to Rheumatoid Arthritis (RA) in its chronicity. The majority (91%) of patients with UC have a mild to moderate disease course eligible for 5-ASA treatment. Poor adherence in UC is a well known phenomenon, which is associated with a 5-fold increased risk of relapse and increased health care costs. Web-based treatment solution with self-initiated 5-ASA treatment in UC based on the patient's pattern recognition of the disease course had not been published previously. The aims of the thesis were: 1) In a European evidence based consensus to assess the IBD patients' need for Quality of Health Care (QoHC); 2) To validate the influence of a Patient Educational Center (PEC) and a web-based treatment solution program, www.constant-care.dk, on patients' disease self-management, adherence, Quality of Life, and disease course after 1 year of self-initiated 5-ASA treatment. UC patients in a conventional out-patient setting were used as controls; 3) To validate two new quantitative rapid tests (RT scanning and HT photo) for Faecal Calprotectin (FC) measurement, and to assess whether HT photo can be useful as a home test to help the patients deciding on self-initiated treatment. The ECCO Consensus found evidence for optimising QoHC by "information"; "education", "benchmarking", and "psychological analysis", which could help to improve patient compliance, QoL, and to decrease depression and anxiety. UC patients, educated in the PEC, significantly improved the level of disease specific knowledge. Patient education and training on www.constant-care.dk, being validated on first 21 Danish patients and subsequently on 233 Danish and 100 Irish patients, showed that the new web guided approach was feasible, safe, and cost effective for the selected group of the patients included in the trial. Use of the web

  12. FRMAC Updates

    International Nuclear Information System (INIS)

    Mueller, P.

    1995-01-01

    This talks describes updates in the following updates in FRMAC publications concerning radiation emergencies: Monitoring and Analysis Manual; Evaluation and Assessment Manual; Handshake Series (Biannual) including exercises participated in; environmental Data and Instrument Transmission System (EDITS); Plume in a Box with all radiological data stored onto a hand-held computer; and courses given

  13. Compliance with removable orthodontic appliances.

    Science.gov (United States)

    Shah, Nirmal

    2017-12-22

    Data sourcesMedline via OVID, PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, LILACS and BBO databases. Unpublished clinical trials accessed using ClinicalTrials.gov, National Research Register, ProQuest Dissertation and Thesis database.Study selectionTwo authors searched studies from inception until May 2016 without language restrictions. Quantitative and qualitative studies incorporating objective data on compliance with removable appliances, barriers to appliance wear compliance, and interventions to improve compliance were included.Data extraction and synthesisQuality of research was assessed using the Cochrane Collaboration's risk of bias tool, the risk of bias in non-randomised studies of interventions (ROBINS-I), and the mixed methods appraisal tool. Statistical heterogeneity was investigated by examining a graphic display of the estimated compliance levels in conjunction with 95% confidence intervals and quantified using the I-squared statistic. A weighted estimate of objective compliance levels for different appliances in relation to stipulated wear and self-reported levels was also calculated. Risk of publication bias was assessed using funnel plots. Meta-regression was undertaken to assess the relative effects of appliance type on compliance levels.ResultsTwenty-four studies met the inclusion criteria. Of these, 11 were included in the quantitative synthesis. The mean duration of objectively measured wear was considerably lower than stipulated wear time amongst all appliances. Headgear had the greatest discrepancy (5.81 hours, 95% confidence interval, 4.98, 6.64). Self-reported wear time was consistently higher than objectively measured wear time amongst all appliances. Headgear had the greatest discrepancy (5.02 hours, 95% confidence interval, 3.64, 6.40). Two studies found an increase in compliance with headgear and Hawley retainers when patients were aware of monitoring. Five studies found younger age groups to

  14. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2015-11-05

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  15. The quality control and management of the updating of the process measurement and protection system of HFETR

    International Nuclear Information System (INIS)

    Cao Junru; Duan Tianyuan; Zhao Zengqiao; Xing Rujun; Xia Guanghua; Jiang Yiqun

    2001-01-01

    The author emphasizes the presentation of the quality control and management of implement process. Owing to the strict and scientific organizing, the field implement was completed only in 4 months, and comprehensive operation test of reactor was successful at one go. The management target that is safety, high efficiency and high quality, success at one go, was hit

  16. Drinking water treatment plant costs and source water quality: An updated case study (2013-2016) Abstract

    Science.gov (United States)

    Watershed protection can play an important role in producing safe drinking water. However, many municipalities and drinking water treatment plants (DWTPs) lack the information on the potential benefits of watershed protection as an approach to improving source water quality. This...

  17. Circular Updates

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Circular Updates are periodic sequentially numbered instructions to debriefing staff and observers informing them of changes or additions to scientific and specimen...

  18. Email Updates

    Science.gov (United States)

    ... of this page: https://medlineplus.gov/listserv.html Email Updates To use the sharing features on this ... view your email history or unsubscribe. Prevent MedlinePlus emails from being marked as "spam" or "junk" To ...

  19. Updated Proposal for a Guide for Quality Management Systems for PV Manufacturing. Supplemental Requirements to ISO 9001-2008

    Energy Technology Data Exchange (ETDEWEB)

    Ramu, Govind [Sun Power, San Jose, CA (United States); Yamamichi, Masaaki [National Inst. of Advanced Industrial Science and Technology (AIST); Zhou, Wei [Trina Solar, San Jose, CA (United States); Mikonowicz, Alex [Powermark, Dallas, TX (United States); Lokanath, Sumanth [First Solar, Tempe, AZ (United States); Eguchi, Yoshihito [Mitsui Chemical, Rye Brook, NY (United States); Norum, Paul [Amonix, Seal Beach, CA (United States); Kurtz, Sarah [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-03-01

    The goal of this Technical Specification is to provide a guideline for manufacturers of photovoltaic (PV) modules to produce modules that, once the design is proven to meet the quality and reliability requirements, replicate the design on an industrial scale without compromising its consistency with the requirements.

  20. Deadline Compliance Status Reports

    Data.gov (United States)

    Department of Housing and Urban Development — These monthly Deadline Compliance Status Reports assist Participating Jurisdictions and HUD Field Offices in monitoring compliance with the 2-year commitment and...

  1. The nutrition of poultry as a factor affecting litter quality and foot pad dermatitis - an updated review.

    Science.gov (United States)

    Swiatkiewicz, S; Arczewska-Wlosek, A; Jozefiak, D

    2017-10-01

    Foot pad dermatitis (FPD), a condition of inflammation and necrotic lesions on the plantar surface of the footpads, is commonly observed in fast-growing broiler chickens and turkeys. FPD negatively affects the welfare of birds, performance indices and the economic profit of poultry meat production. Nutrition is an important factor affecting water intake, excreta moisture and litter quality and, in this way, the occurrence and intensity of FPD in birds. This article reviews and discusses the recent results published in the literature on the effects of nutritional factors on litter quality and FPD severity in broiler chickens and turkeys. Literature data on the efficacy of nutritional methods on the litter quality and FPD occurrence are not consistent. However, the results of several experiments indicate that the optimal level of crude protein, biotin and electrolytes (Na, K) in the diet, as well as feed additives such as feed enzymes hydrolysating non-starch polysaccharides and organic sources of microelements (zinc), may reduce the litter moisture as well as FPD incidence and severity in broiler chickens and turkey. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  2. Update on quality of care in Hispanics and other racial-ethnic groups in the United States discharged with the diagnosis of Acute Myocardial Infarction in 2013.

    Science.gov (United States)

    Romero, Tomás; Greenwood, Kristina L; Glaser, Dale

    2017-12-01

    Disparities in Acute Myocardial Infarction (AMI) care and outcomes have been frequently reported in racial-ethnic minorities in the U.S. Some studies have attributed disparities in Hispanics and other minorities to lower quality of services at hospitals where they seek care. Current information from hospitals with large Hispanic representations and updated quality resources is needed. Retrospective observational study of 839 AMI patients discharged in 2013 from three Southern California Hospitals (A, B, C) with tertiary cardiac care level. Non-Hispanic Whites (NHW) and Hispanics (H) were the larger racial-ethnic groups (68.3%), and the comparison of these two groups constitutes the focus of the study. Mortality, 30day readmissions, medication/performance measures (PRx); aspirin, statins/anti-lipids, beta-blockers, ACEI/ARB for LV systolic dysfunction, time, and revascularization procedures were compared between hospitals, NHW and H, using Chi-squared tests (χ 2 ), Odds Ratios (OR) with 95% confidence intervals (CI), and Z tests for proportions - independent groups. No significant differences in hospital, 30day mortality, PRx or procedures were observed between NHW, H and other racial-ethnic minority groups, or hospitals. Hospital C had 47.3% H and Hospitals A+B 14.6% (p<0.001, effect size=0.430). AMI performance measures exceeded 2013 national rates across all facilities. NHW had more private/commercial insurance (52.5% vs. 25.4%, OR 3.24, 95% CI 2.19-4.80, p<0.001) than H. Equitable access to quality hospital services in three Southern California hospitals offset previously reported disparities in AMI management in Hispanics. These results may not necessarily reflect the reality of AMI care for Hispanics in other U.S. regions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Updated methods for assessing the impacts of nearby gas drilling and production on neighborhood air quality and human health.

    Science.gov (United States)

    Olaguer, Eduardo P; Erickson, Matthew; Wijesinghe, Asanga; Neish, Brad; Williams, Jeff; Colvin, John

    2016-02-01

    An explosive growth in natural gas production within the last decade has fueled concern over the public health impacts of air pollutant emissions from oil and gas sites in the Barnett and Eagle Ford shale regions of Texas. Commonly acknowledged sources of uncertainty are the lack of sustained monitoring of ambient concentrations of pollutants associated with gas mining, poor quantification of their emissions, and inability to correlate health symptoms with specific emission events. These uncertainties are best addressed not by conventional monitoring and modeling technology, but by increasingly available advanced techniques for real-time mobile monitoring, microscale modeling and source attribution, and real-time broadcasting of air quality and human health data over the World Wide Web. The combination of contemporary scientific and social media approaches can be used to develop a strategy to detect and quantify emission events from oil and gas facilities, alert nearby residents of these events, and collect associated human health data, all in real time or near-real time. The various technical elements of this strategy are demonstrated based on the results of past, current, and planned future monitoring studies in the Barnett and Eagle Ford shale regions. Resources should not be invested in expanding the conventional air quality monitoring network in the vicinity of oil and gas exploration and production sites. Rather, more contemporary monitoring and data analysis techniques should take the place of older methods to better protect the health of nearby residents and maintain the integrity of the surrounding environment.

  4. Updated estimates of HAL n and RN- effects on pork quality: fresh and processed loin and ham.

    Science.gov (United States)

    Cherel, P; Glénisson, J; Figwer, P; Pires, J; Damon, M; Franck, M; Le Roy, P

    2010-12-01

    A 1000-pig F2 intercross QTL detection experimental population was generated using two commercial sire lines. Independent carriers of HAL n and RN- mutations (10% and 14%, respectively) were included in this population as control genotypes. The effects of HAL n and RN- heterozygous genotypes on fresh and transformed loins and hams were estimated using a mixed model methodology. The results document the unfavorable effects of both mutations on meat quality. Smaller effects of HAL Nn genotype compared to HAL nn or RN-rn+ genotypes were estimated. Interestingly, effects of HAL Nn genotype on meat pH and loin color could be insignificant at 24-h postmortem, but translate into higher water losses on storage and cooking, and result in tougher cooked loin. Using the same methodology, significant effects of the PRKAG3 (RN) I199 allele on ultimate pH values but not on glycolytic potential were observed. Copyright © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

  5. QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFULTRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED FLUVASTATIN EXTENDED RELEASE ADDED TO STANDARD THERAPY. PROTOCOL OF THE OPEN-LABEL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2010-01-01

    Full Text Available Aim. To evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who have indications for fluvastatin extended release in addition to standard treatment.Material and methods. This is a national observational multicenter study. An inclusion of 60 investigator centers is planned (out-patient medical centers, the total number of patients to be included is 600. Patients (men and women with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatinextended release (Lescol Forte, Novartis 80 mg once daily will be included in the observation. The following efficacy and safety parameters will be evaluated: quality of life assessed with SF-36 scale before and during treatment; compliance to therapy; adverse events and serious adverse events. Observation period is planned for 6 months. During this period patient is expected to make 4 visits to treating physician. According to the physician’s decision, observation period can be extended to 12 months.Present study status. The study is completed. 524 patients completed the observation, including 116 patients who were followed up for 12 months. There are 414 men (79% and 110 women (21% among patients enrolled into the study.

  6. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

    Directory of Open Access Journals (Sweden)

    Huas Dominique

    2010-08-01

    Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

  7. An updated status of Department of Energy safety reviews of packages for transporting radioactive material

    International Nuclear Information System (INIS)

    Kapoor, A.

    1995-01-01

    The Department of Energy conducts conformance reviews and issues Certificates of Compliance for Type B packaging for radioactive materials. Several offices within DOE perform these reviews which are required by the Department of Transportation to be to the regulations promulgated by the Nuclear Regulatory Commission or their safety equivalent. This paper focuses on one of these offices, the Office of Facility Safety Analysis, EH-32, which is responsible for reviewing and certifying packages other than those used for weapons and weapons component, for Naval Reactors, and for Civilian Radioactive Waste Management. This paper gives the background and organizational history of EH-32, discusses the version of regulations to which the packaging is reviewed, updates the status of these reviews, describes the effectiveness of the reviews, updates the training courses sponsored by EH-32, and mentions the new Quality Assurance Evaluations being started by EH-32

  8. Directory of Certificates of Compliance for radioactive materials packages: Report of NRC approved quality assurance programs for radioactive materials packages. Volume 3, Revision 15

    International Nuclear Information System (INIS)

    1995-10-01

    The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 of approved QA programs. The reports include a listing of all users of each package design and approved QA programs prior to the publication date

  9. Mapping Tax Compliance

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... compliance is constructed, challenges the explanatory reaches of today's social science approaches, arguing that an alternative approach to understanding tax compliance is worthwhile exploring. This other choice of approach, inspired by actor–network theory (ANT), adopts a more practice-oriented focus...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

  10. Los Alamos Climatology 2016 Update

    Energy Technology Data Exchange (ETDEWEB)

    Bruggeman, David Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-10

    The Los Alamos National Laboratory (LANL or the Laboratory) operates a meteorology monitoring network to support LANL emergency response, engineering designs, environmental compliance, environmental assessments, safety evaluations, weather forecasting, environmental monitoring, research programs, and environmental restoration. Weather data has been collected in Los Alamos since 1910. Bowen (1990) provided climate statistics (temperature and precipitation) for the 1961– 1990 averaging period, and included other analyses (e.g., wind and relative humidity) based on the available station locations and time periods. This report provides an update to the 1990 publication Los Alamos Climatology (Bowen 1990).

  11. WTO Compliance Status of the Conservation Security Program (CSP) and the Conservation Reserve Program (CRP)

    National Research Council Canada - National Science Library

    Schnepf, Randy

    2007-01-01

    .... This report is not a legal opinion, but describes both the CSP and CRP programs, the WTO Annex II provisions that govern compliance, and the potential issues involved in evaluating the compliance status of the two programs. This report will be updated as events warrant.

  12. QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFUL TRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED LESCOL XL (FLUVASTATIN ADDED TO STANDARD THERAPY. RESULTS OF THE LESQOL OPEN-LABEL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2010-01-01

    Full Text Available Aim. The main aim of the present study was to evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who were prescribed fluvastatin extended release in addition to standard treatment.Material and methods. This was a national prospective multicenter observational study. Patients with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatin extended release (Lescol Forte, Novartis 80 mg QD were included in the present observation. The following efficacy and safety parameters were evaluated: quality of life evaluated with SF-36 scale before and during treatment; hypolipidemic efficacy, compliance to therapy; adverse events and serious adverse events. Observation period was 6 months in all patients and 12 months in some patients at the discretion of the investigator.Results. 524 patients (79% men and 21% women completed the 6 months observation period and 116 patients were followed up for 12 months. Significant increase of all measures of SF-36 scales, physical and mental health was observed in 6 and 12 months of fluvastatin extended release treatment. Total and low density lipoprotein cholesterol reduction was 30.5% and 54.9% respectively, p<0.01, in 6 months and 34.2% and 34.3% respectively in 12 months of treatment, p<0.01. High density lipoprotein cholesterol was significantly increased by 22.5% in 12 months of treatment, p<0.01. There were very few adverse events and laboratory changes during the course of treatment.Conclusion. LESQOL study showed significant increase in quality of life and good hypolipidemic efficacy as well as good tolerability of fluvastatin extended release in patients after coronary angioplasty.

  13. 77 FR 59675 - Compliance With Information Request, Flooding Hazard Reevaluation

    Science.gov (United States)

    2012-09-28

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0222] Compliance With Information Request, Flooding Hazard... was needed in the areas of seismic and flooding design, and emergency preparedness. In addition to... licensees reevaluate flooding hazards at nuclear power plant sites using updated flooding hazard information...

  14. Choices that increase compliance

    International Nuclear Information System (INIS)

    Edwards, P.R.

    1991-01-01

    A compliance model is developed and tested using a survey of corporate officials and the regulatory arena of equal employment opportunity. Findings support the economic model of compliance in its conclusion that probability of detection and probable level of sanctions influence compliance decisions. Results also indicate that adjustments to the model that account for bounded rationality are valid. The key outcome, however, is that although all types of investigations play some role in enhancing compliance, those that stress sanctions and thus severity rather than certainty of detection may have the greatest positive influence on compliance. Enforcement programs attempting to operate simply as investigators of small-scale complaints will have less success than those with different types of investigations or a balanced type of single investigation. The results also suggest a more complex cognitive process on the part of regulated individuals than initially theorized. 34 refs., 3 tabs

  15. Compliance and Enforcement Actions (CEA) -

    Data.gov (United States)

    Department of Transportation — Compliance and Enforcement Actions application provides process assistance / improvements for conducting investigation and enforcement activities. The Compliance and...

  16. Quality assurance plan for Final Waste Forms project in support of the development, demonstration, testing and evaluation efforts associated with the Oak Ridge reservation's LDR/FFCA compliance

    International Nuclear Information System (INIS)

    Gilliam, T.M.; Mattus, C.H.

    1994-07-01

    This quality assurance project plan specifies the data quality objectives for Phase I of the Final Waste Forms Project and defines specific measurements and processes required to achieve those objectives. Although the project is funded by the U.S. Department of Energy (DOE), the ultimate recipient of the results is the U.S. Environmental Protection Agency (EPA). Consequently, relevant quality assurance requirements from both organizations must be met. DOE emphasizes administrative structure to ensure quality; EPA's primary focus is the reproducibility of the generated data. The ten criteria of DOE Order 5700.6C are addressed in sections of this report, while the format used is that prescribed by EPA for quality assurance project plans

  17. Regulatory Enforcement and Compliance

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren

    1999-01-01

    This study of municipal enforcement of agro-environmental regulations in Denmark provides an empirical understanding of how enforcement affects compliance. A key contribution is sorting out the relative influence of inspectors' different styles of enforcement and choices made by enforcement...... agencies. The latter are shown to be more important in bringing about compliance than are inspectors' enforcement styles. Municipal agencies are shown to increase compliance through the use of third parties, more frequent inspection, and setting priorities for inspection of major items. The findings about...

  18. National Environmental Policy Act compliance guide. Volume II (reference book)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    This document (Volume II of the National Environmental Policy Act Compliance Guide) contains current copies of regulations and guidance from the Council on Environmental Quality, the Department of Energy, the Department of State, and the Environmental Protection Agency, related to compliance with the National Environmental Policy Act of 1969 (NEPA).

  19. 28 CFR 73.4 - Partial compliance not deemed compliance.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Partial compliance not deemed compliance. 73.4 Section 73.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NOTIFICATIONS TO THE ATTORNEY GENERAL BY AGENTS OF FOREIGN GOVERNMENTS § 73.4 Partial compliance not deemed compliance. The fact...

  20. Family compliance with counseling for children traveling to the tropics.

    Science.gov (United States)

    Caillet-Gossot, Stéphanie; Laporte, Rémi; Noël, Guilhem; Gautret, Philippe; Soula, Georges; Delmont, Jean; Faucher, Benoit; Parola, Philippe; Osei, Lindsay; Minodier, Philippe

    2013-01-01

    The number of people, both adults and children, traveling abroad, is on the rise. Some seek counseling at travel medicine centers before departure. A prospective study was conducted among children travel medicine center in Marseille, France, from February 2010 to February 2011. Parents were contacted by telephone 4 weeks after their return, and asked about compliance with pre-travel advice. One hundred sixty-seven children were evaluated after their trip. Compliance with immunizations, malaria chemoprophylaxis, and food-borne disease prevention was 71, 66, and 31%, respectively. Compliance with malaria chemoprophylaxis varied significantly with destination, and was higher for African destinations. Significant features associated with poor compliance with chemoprophylaxis were a trip to Asia or the Indian Ocean, age travel counseling in children traveling overseas was achieved only for drinking bottled water, using repellents, a routine vaccine update, and yellow fever immunization. © 2013 International Society of Travel Medicine.

  1. Environmental Management Department Quality Assurance Project Plan for Radionuclide Emission Measurements Project for compliance with National Emission Standards for Hazardous Air Pollutants (NESHAP)

    Energy Technology Data Exchange (ETDEWEB)

    Poole, D A

    1992-06-01

    This Quality Assurance Project Plan (QAPP) satisfies the quality assurance (QA) requirements in 40 CFR Part 61, Method 114, for ensuring that the radionuclide air emission measurements from the Y-12 Plant are representative; of a known precision and accuracy; and include administrative controls to ensure prompt response when emission measurements indicate an increase over normal radionuclide emissions. The QAPP ensures the quality of the Y-12 Plant radionuclide emission measurements data from the continuous samplers, breakthrough monitors, and minor radionuclide release points. The plan specifies the procedures for the management of the activities affecting the quality of the data for the Y-12 Plant Environmental Management Department (EMD) within the Health, Safety, Environment, and Accountability Division (HSEA).

  2. Environmental Management Department Quality Assurance Project Plan for Radionuclide Emission Measurements Project for compliance with National Emission Standards for Hazardous Air Pollutants (NESHAP)

    International Nuclear Information System (INIS)

    Poole, D.A.

    1992-06-01

    This Quality Assurance Project Plan (QAPP) satisfies the quality assurance (QA) requirements in 40 CFR Part 61, Method 114, for ensuring that the radionuclide air emission measurements from the Y-12 Plant are representative; of a known precision and accuracy; and include administrative controls to ensure prompt response when emission measurements indicate an increase over normal radionuclide emissions. The QAPP ensures the quality of the Y-12 Plant radionuclide emission measurements data from the continuous samplers, breakthrough monitors, and minor radionuclide release points. The plan specifies the procedures for the management of the activities affecting the quality of the data for the Y-12 Plant Environmental Management Department (EMD) within the Health, Safety, Environment, and Accountability Division (HSEA)

  3. Environmental Compliance Guide

    International Nuclear Information System (INIS)

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects

  4. 340 Facility compliance assessment

    International Nuclear Information System (INIS)

    English, S.L.

    1993-10-01

    This study provides an environmental compliance evaluation of the RLWS and the RPS systems of the 340 Facility. The emphasis of the evaluation centers on compliance with WAC requirements for hazardous and mixed waste facilities, federal regulations, and Westinghouse Hanford Company (WHC) requirements pertinent to the operation of the 340 Facility. The 340 Facility is not covered under either an interim status Part A permit or a RCRA Part B permit. The detailed discussion of compliance deficiencies are summarized in Section 2.0. This includes items of significance that require action to ensure facility compliance with WAC, federal regulations, and WHC requirements. Outstanding issues exist for radioactive airborne effluent sampling and monitoring, radioactive liquid effluent sampling and monitoring, non-radioactive liquid effluent sampling and monitoring, less than 90 day waste storage tanks, and requirements for a permitted facility

  5. Environmental Compliance Issue Coordination

    Science.gov (United States)

    An order to establish the Department of Energy (DOE) requirements for coordination of significant environmental compliance issues to ensure timely development and consistent application of Departmental environmental policy and guidance

  6. Environmental Compliance Guide

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects.

  7. Quality of life, compliance, safety and effectiveness in fit older metastatic colorectal patients with cancer treated in first-line with chemotherapy plus cetuximab: A restrospective analysis from the ObservEr study.

    Science.gov (United States)

    Rosati, Gerardo; Pinto, Carmine; Di Fabio, Francesca; Chiara, Silvana; Lolli, Ivan R; Ruggeri, Enzo M; Ciuffreda, Libero; Ferrara, Raimondo; Antonuzzo, Lorenzo; Adua, Daniela; Racca, Patrizia; Bilancia, Domenico; Benincasa, Elena; Stroppolo, Maria Elena; Di Costanzo, Francesco

    2018-05-01

    The influence of age (<70 years and ≥70 years) was retrospectively studied on the quality of life (QoL), incidence of side effects (including skin reactions) and efficacy of chemotherapy plus cetuximab in patients with KRAS wild type (WT) metastatic colorectal cancer (mCRC). 225 patients of the Observed study (PS 0-1) were retrieved based on age (< 70 and ≥70 years) and evaluated through EORTC QLQ-C30 and DLQI questionnaires. The two patient groups (141 < 70 and 84 ≥ 70 years, respectively) were balanced with no differences in any of the clinical and pathological characteristics considered. Both groups underwent similar type of first-line chemotherapy plus cetuximab, treatment duration and compliance. Cetuximab therapy caused similar incidence of side effects and impact on QoL in older and younger patients. No difference was observed in progression free survival (PFS) and in disease control rates between the two patient populations. Median overall survival (OS) was higher in patients <70 (27 months, 95% CI: 22.7-31.27) than in patients ≥70 (19 months, 95% CI: 14.65-23.35) (p = 0.002), which is likely due to higher proportions of metastatic resection (27.0% vs 8.3%; p = 0.001) and utilization of second-line therapy in younger group (58.9% vs 42.9%; p = 0.028). The current data suggest that fit older patients with mCRC can be safely treated with a cetuximab-based therapy, as QoL and safety profile do not seem to be affected by age. In addition, age did not impact the choice of chemotherapy to be associated to cetuximab and treatment compliance. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. A Three Month Home Exercise Programme Augmented with Nordic Poles for Patients with Intermittent Claudication Enhances Quality of Life and Continues to Improve Walking Distance and Compliance After One Year.

    Science.gov (United States)

    Oakley, C; Spafford, C; Beard, J D

    2017-05-01

    The objective of this study was to collect 1 year follow-up information on walking distance, speed, compliance, and cost in patients with intermittent claudication who took part in a previously reported 12 week randomised clinical trial of a home exercise programme augmented with Nordic pole walking versus controls who walked normally. A second objective was to look at quality of life and ankle brachial pressure indices (ABPIs) after a 12 week augmented home exercise programme. Thirty-two of the 38 patients who completed the original trial were followed-up after 6 and 12 months. Frequency, duration, speed, and distance of walking were recorded using diaries and pedometers. A new observational cohort of 29 patients was recruited to the same augmented home exercise programme. ABPIs, walking improvement, and quality of life questionnaire were recorded at baseline and 12 weeks (end of the programme). Both groups in the follow-up study continued to improve their walking distance and speed over the following year. Compliance was excellent: 98% of the augmented group were still walking with poles at both 6 and 12 months, while 74% of the control group were still walking at the same point. The augmented group increased their mean walking distance to 17.5 km by 12 months, with a mean speed of 4.2 km/hour. The control group only increased their mean walking distance from 4.2 km to 5.6 km, and speed to 3.3 km/hour. Repeated ANOVA showed the results to be highly significant (p = .002). The 21/29 patients who completed the observational study showed a statistically significant increase in resting ABPIs from baseline (mean ± SD 0.75 ± 0.12) to week 12 (mean ± SD 0.85 ± 0.12) (t = (20) -8.89, p = .000 [two-tailed]). All their walking improvement and quality of life parameters improved significantly (p = .002 or less in the six categories) over the same period and their mean health scores improved by 79%. Following a 12 week augmented home exercise

  9. Chlorine and Solute Transport and Reactions in Drinking Water Distribution: The Role of Flow Hydrodynamics on Water Quality Changes and Multi-Criteria Compliance

    Science.gov (United States)

    Safe drinking water supply is one of the most notable modern engineering achievements in the 20th century. It is a centerpiece of the U.S. environmental protection effort under the federal Safe Drinking Water Act (SDWA) and its amendments. In this chapter, water quality changes a...

  10. Effectiveness of the GAEC cross compliance standards Rational management of set aside, Grass strips to control soil erosion and Vegetation buffers along watercourses on surface animal diversity and biological quality of soil

    Directory of Open Access Journals (Sweden)

    Marta Biaggini

    2011-08-01

    Full Text Available Landscape simplification and loss of natural and semi-natural habitats are the major causes of biodiversity decrease in agricultural landscapes. In order to mitigate the effects of intensive agricultural management the Ministry of Agricultural, Food and Forestry Policies in Italy has included the agronomic measures Rational management of set aside, Grass strips to control soil erosion and Vegetation buffers along watercourses in the decree on cross compliance. In this paper we review the results of a field research performed in Central Italy. The aim of the study was to evaluate the efficacy of the above mentioned GAEC standards for animal diversity enhancement. Using different animal groups as indicators, superficial Arthropod fauna and Herpetofauna, we found striking differences in the biodiversity levels of areas characterized by the application or by the lack of GAEC standards, with the latter being characterized by a significatively impoverished fauna. In particular, the set aside area and the buffer of riparian vegetation resulted of primary importance to allow higher biodiversity levels. Also the analysis of the biological quality of the soil, as assessed through the QBS-ar index based on edaphic micro-Arthropod fauna, indicated a higher quality of semi-natural habitats with respect to arable lands.

  11. Temporal assessment of copper speciation, bioavailability and toxicity in UK freshwaters using chemical equilibrium and biotic ligand models: Implications for compliance with copper environmental quality standards.

    Science.gov (United States)

    Lathouri, Maria; Korre, Anna

    2015-12-15

    Although significant progress has been made in understanding how environmental factors modify the speciation, bioavailability and toxicity of metals such as copper in aquatic environments, the current methods used to establish water quality standards do not necessarily consider the different geological and geochemical characteristics of a given site and the factors that affect copper fate, bioavailability potential and toxicity. In addition, the temporal variation in the concentration and bioavailable metal fraction is also important in freshwater systems. The work presented in this paper illustrates the temporal and seasonal variability of a range of water quality parameters, and Cu speciation, bioavailability and toxicity at four freshwaters sites in the UK. Rivers Coquet, Cree, Lower Clyde and Eden (Kent) were selected to cover a broad range of different geochemical environments and site characteristics. The monitoring data used covered a period of around six years at almost monthly intervals. Chemical equilibrium modelling was used to study temporal variations in Cu speciation and was combined with acute toxicity modelling to assess Cu bioavailability for two aquatic species, Daphnia magna and Daphnia pulex. The estimated copper bioavailability, toxicity levels and the corresponding ecosystem risks were analysed in relation to key water quality parameters (alkalinity, pH and DOC). Although copper concentrations did not vary much during the sampling period or between the seasons at the different sites; copper bioavailability varied markedly. In addition, through the chronic-Cu BLM-based on the voluntary risk assessment approach, the potential environmental risk in terms of the chronic toxicity was assessed. A much higher likelihood of toxicity effects was found during the cold period at all sites. It is suggested that besides the metal (copper) concentration in the surface water environment, the variability and seasonality of other important water quality

  12. 5. Clinical-Demographic Variables and Compliance with Home ...

    African Journals Online (AJOL)

    user

    not been studied among Nigerian informal ... abilities, behaviour and communication. ... accelerate improvement in a child with cerebral palsy ... siblings of the children with CP and the compliance ..... O.O. Comparative quality of life of Nigerian.

  13. PADSTE Update

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Alan [Los Alamos National Laboratory

    2012-09-17

    In the first Principal Associate Director Science, Technology and Engineering (PADSTE) all-employees meeting since Alan Bishop was selected as principal associate director, Dr Bishop reviews the state of the organization as FY12 nears completion and sets a vision for the coming year. He highlights the people in our organization and their accomplishments, the quality of ST&E, the impact of capabilities and programs, strategic directions and investments, and sets the stage and expectations for FY13.

  14. Automatic Rapid Updating of ATR Target Knowledge Bases

    National Research Council Canada - National Science Library

    Wells, Barton

    1999-01-01

    .... Methods of comparing infrared images with CAD model renderings, including object detection, feature extraction, object alignment, match quality evaluation, and CAD model updating are researched and analyzed...

  15. Compliance with physical exercise

    DEFF Research Database (Denmark)

    Gram, Anne Sofie; Bønnelycke, Julie; Rosenkilde Larsen, Mads

    2014-01-01

    Aims: Sixty-one healthy, sedentary, moderately overweight young men participated in a randomised controlled trial to examine the effects of two different doses of endurance exercise on health behaviour and exercise compliance. Methods: Participants were randomised to a sedentary control group......), a post hoc thematic analysis was conducted to connect qualitative and quantitative data in a joint analysis. Results: Of the subjects interviewed, exercise compliance expressed as 95% CI was [96.8; 103%] in the MOD group and [82.9; 99.6%] in the HIGH group. The different doses of daily exercise equally...... or quantitative methodology alone. The preconditions of the TBP were fulfilled, and it represents a methodological model to explain the high degree of compliance and motivation to exercise....

  16. Directory of certificates of compliance for radioactive materials packages: Summary report of NRC approved quality assurance programs for radioactive material packages

    International Nuclear Information System (INIS)

    1987-11-01

    This directory contains a Summary Report of the US Nuclear Regulatory Commission's Summary Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective October 1, 1987. This directory makes available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Summary Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  17. The Amsterdam Hip Protector Study: Compliance and determinants of compliance

    NARCIS (Netherlands)

    van Schoor, N.M.; Asma, G.; Smit, J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2003-01-01

    Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from

  18. PCI compliance understand and implement effective PCI data security standard compliance

    CERN Document Server

    Williams, Branden R

    2012-01-01

    The credit card industry established the PCI Data Security Standards to provide a minimum standard for how vendors should protect data to ensure it is not stolen by fraudsters. PCI Compliance, 3e, provides the information readers need to understand the current PCI Data Security standards, which have recently been updated to version 2.0, and how to effectively implement security within your company to be compliant with the credit card industry guidelines and protect sensitive and personally identifiable information. Security breaches continue to occur on a regular basis, affecting millions of

  19. Rocky Flats Compliance Program

    International Nuclear Information System (INIS)

    1994-02-01

    The Department of Energy (DOE) established the Office of Technology Development (EM-50) (OTD) as an element of Environmental Restoration and Waste Management (EM) in November 1989. The primary objective of the Office of Technology Development, Rocky Flats Compliance Program (RFCP), is to develop altemative treatment technologies for mixed low-level waste (wastes containing both hazardous and radioactive components) to use in bringing the Rocky Flats Plant (RFP) into compliance with Federal and state regulations and agreements. Approximately 48,000 cubic feet of untreated low-level mixed waste, for which treatment has not been specified, are stored at the RFP. The cleanup of the Rocky Flats site is driven by agreements between DOE, the Environmental Protection Agency (EPA), and the Colorado Department of Health (CDH). Under these agreements, a Comprehensive Treatment and Management Plan (CTMP) was drafted to outline the mechanisms by which RFP will achieve compliance with the regulations and agreements. This document describes DOE's strategy to treat low-level mixed waste to meet Land Disposal Restrictions and sets specific milestones related to the regulatory aspects of technology development. These milestones detail schedules for the development of technologies to treat all of the mixed wastes at the RFP. Under the Federal Facilities Compliance Act (FFCA), the CTMP has been incorporated into Rocky Flats Plant Conceptual Site Treatment Plan (CSTP). The CSTP will become the Rocky Flats Plant site Treatment Plan in 1995 and will supersede the CTMP

  20. Environmental compliance and cleanup

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the roles of the principal agencies, organizations, and public in environmental compliance and cleanup of the Hanford Site. Regulatory oversight, the Federal Facility Agreement and Consent Order, the role of Indian tribes, public participation, and CERCLA Natural Resource Damage Assessment Trustee Activities are all discussed.

  1. Strategisk compliance og regulering

    DEFF Research Database (Denmark)

    Kühn Pedersen, Mogens

    2016-01-01

    Denne artikel introducerer strategisk compliance og påpeger dens samspil med klassiske og nyere former for reguleringer i digital værdiskabelse. Konteksten er den digitale økonomi, som vokser frem imellem den materielle økonomis bærepiller: Virksomheder og markeder, men består af en helt ny...... materialitet, som er det digitale univers og dets modsvarighed i nye krav til compliance. Den nye materialitet stiller nye krav, hvad angår digitale processer og transaktioner. Klassisk regulering, som aktører ikke selv kan ændre, støder på egenregulering, hvor aktørerne selv opsætter regler for at skabe...... digital værdi. Dette kalder på strategisk compliance. Med digitalisering er strategisk compliance sat på dagsordnen i reguleringsdebatten. Vi hævder, at regulering og egenregulering kan komme til at virke komplementært i det post-industrielle, digitaliserede samfund....

  2. Environmental compliance and cleanup

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the roles of the principal agencies, organizations, and public in environmental compliance and cleanup of the Hanford Site. Regulatory oversight, the Federal Facility Agreement and Consent Order, the role of Indian tribes, public participation, and CERCLA Natural Resource Damage Assessment Trustee Activities are all discussed

  3. Financial Markets and Compliance

    NARCIS (Netherlands)

    van de Laar, T.A.H.M.; Bleker, Sylvie; Houben, Raf

    2017-01-01

    This chapter will focus on the goals of financial market regulation through the rules of economics, the strategies financial regulation employs to achieve these goals and the insights this provides for the compliance profession. For an overview of the goals and strategies of financial regulation

  4. Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.

    Science.gov (United States)

    Saiz, A; Mora, S; Blanco, J

    2015-05-01

    Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies. A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires. A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches. The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  5. The USAID Environmental Compliance Database

    Data.gov (United States)

    US Agency for International Development — The Environmental Compliance Database is a record of environmental compliance submissions with their outcomes. Documents in the database can be found by visiting the...

  6. Agent Architectures for Compliance

    Science.gov (United States)

    Burgemeestre, Brigitte; Hulstijn, Joris; Tan, Yao-Hua

    A Normative Multi-Agent System consists of autonomous agents who must comply with social norms. Different kinds of norms make different assumptions about the cognitive architecture of the agents. For example, a principle-based norm assumes that agents can reflect upon the consequences of their actions; a rule-based formulation only assumes that agents can avoid violations. In this paper we present several cognitive agent architectures for self-monitoring and compliance. We show how different assumptions about the cognitive architecture lead to different information needs when assessing compliance. The approach is validated with a case study of horizontal monitoring, an approach to corporate tax auditing recently introduced by the Dutch Customs and Tax Authority.

  7. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  8. Compliance with Adult Congenital Heart Disease Guidelines: Are We Following the Recommendations?

    Science.gov (United States)

    Gerardin, Jennifer F; Menk, Jeremiah S; Pyles, Lee A; Martin, Cindy M; Lohr, Jamie L

    2016-05-01

    As the adult congenital heart disease population increases, poor transition from pediatric to adult care can lead to suboptimal quality of care and an increase in individual and institutional costs. In 2008, the American College of Cardiology and American Heart Association updated the adult congenital heart disease practice guidelines and in 2011, the American Heart Association recommended transition guidelines to standardize and encourage appropriate timing of transition to adult cardiac services. The objective of this study was to evaluate if patient age or complexity of congenital heart disease influences pediatric cardiologists' decision to transfer care to adult providers and to evaluate the compliance of different types of cardiology providers with current adult congenital heart disease treatment guidelines. A single-center retrospective review of 991 adult congenital heart disease patients identified by ICD-9 code from 2010 to 2012. Academic and community outpatient cardiology clinics. Nine hundred ninety-one patients who are 18 years and older with congenital heart disease. None. The compliance with health maintenance and transfer of care recommendations in the outpatient setting. For patients seen by pediatric cardiologists, only 20% had transfer of care discussions documented, most often in younger simple patients. Significant differences in compliance with preventative health guidelines were found between cardiology provider types. Even though a significant number of adults with congenital heart disease are lost to appropriate follow-up in their third and fourth decades of life, pediatric cardiologists discussed transfer of care with moderate and complex congenital heart disease patients less frequently. Appropriate transfer of adults with congenital heart disease to an adult congenital cardiologist provides an opportunity to reinforce the importance of regular follow-up in adulthood and may improve outcomes as adult congenital cardiologists followed the

  9. Quality

    International Nuclear Information System (INIS)

    Burnett, N.; Jeffries, J.; Mach, J.; Robson, M.; Pajot, D.; Harrigan, J.; Lebsack, T.; Mullen, D.; Rat, F.; Theys, P.

    1993-01-01

    What is quality? How do you achieve it? How do you keep it once you have got it. The answer for industry at large is the three-step hierarchy of quality control, quality assurance and Total quality Management. An overview is given of the history of quality movement, illustrated with examples from Schlumberger operations, as well as the oil industry's approach to quality. An introduction of the Schlumberger's quality-associated ClientLink program is presented. 15 figs., 4 ills., 16 refs

  10. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology.

    Science.gov (United States)

    Wijdicks, Eelco F M; Varelas, Panayiotis N; Gronseth, Gary S; Greer, David M

    2010-06-08

    To provide an update of the 1995 American Academy of Neurology guideline with regard to the following questions: Are there patients who fulfill the clinical criteria of brain death who recover neurologic function? What is an adequate observation period to ensure that cessation of neurologic function is permanent? Are complex motor movements that falsely suggest retained brain function sometimes observed in brain death? What is the comparative safety of techniques for determining apnea? Are there new ancillary tests that accurately identify patients with brain death? A systematic literature search was conducted and included a review of MEDLINE and EMBASE from January 1996 to May 2009. Studies were limited to adults. In adults, there are no published reports of recovery of neurologic function after a diagnosis of brain death using the criteria reviewed in the 1995 American Academy of Neurology practice parameter. Complex-spontaneous motor movements and false-positive triggering of the ventilator may occur in patients who are brain dead. There is insufficient evidence to determine the minimally acceptable observation period to ensure that neurologic functions have ceased irreversibly. Apneic oxygenation diffusion to determine apnea is safe, but there is insufficient evidence to determine the comparative safety of techniques used for apnea testing. There is insufficient evidence to determine if newer ancillary tests accurately confirm the cessation of function of the entire brain.

  11. Personal hand gel for improved hand hygiene compliance on the regional anesthesia team.

    Science.gov (United States)

    Parks, Colby L; Schroeder, Kristopher M; Galgon, Richard E

    2015-12-01

    Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution's policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team. Healthcare providers assigned to the Acute Pain Service were observed for compliance with hand hygiene policy during a quality improvement initiative. Provider type and compliance were prospectively recorded in a database. Team members were then given a personal gel dispensing device and again observed for compliance. We have retrospectively reviewed this database to determine the effects of this intervention. Of the 307 encounters observed, 146 were prior to implementing personal gel dispensers. Compliance was 34%. Pre- and post-patient contact compliances were 23 and 43%, respectively. For 161 encounters after individual gel dispensers were provided, compliance was 63%. Pre- and post-patient contact compliances were 53 and 72%, respectively. Improvement in overall compliance from 34 to 63% was significant. On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.

  12. Compliance. Regulatory policy P-211

    International Nuclear Information System (INIS)

    2001-05-01

    This regulatory policy describes the basic principles and directives for establishing and conducting the Canadian Nuclear Safety Commission (CNSC) Compliance Program. The program is aimed at securing compliance by regulated persons with regulatory requirements made under the Nuclear Safety and Control Act ('the Act'). The policy applies to persons who are regulated by the CNSC through the Act, regulations and licences, as well as by decisions and orders made under the Act. The policy applies to officers and employees of the CNSC, and its authorized representatives or agents, who are involved in developing and carrying out compliance activities. Compliance, in the context of this policy, means conformity by regulated persons with the legally binding requirements of the Act, and the CNSC regulations, licences, decisions, and orders made under the Act. Compliance activities are CNSC measures of promotion, verification and enforcement aimed at securing compliance by regulated person with the applicable legally binding requirements. (author)

  13. Compliance to antihypertensive therapy

    International Nuclear Information System (INIS)

    Almas, A.; Hameed, A.; Ahmed, B.; Islam, M.

    2006-01-01

    Objective: To determine compliance, factors affecting compliance to antihypertensive therapy and to compare compliant and non-compliant groups, in a tertiary care setting. Study Design: Analytical (cross-sectional) study. Place and Duration of Study: The outpatient clinics at the Aga Khan University from May 2004 to February 2005. Patients and Methods: Two hundred patients presenting to the outpatients clinic were included. All patients 18 years and above, who had stage 1 and 2 hypertension, had one clinic visit to a medicine clinic, 6 months prior to presentation and started on antihypertensive medicines, were included. Results: Sixty-six percent were males and 33.5 % were females. Mean age was 58.1 ( +- 12) years and mean duration of hypertension was 7.2 (+- 6.7) years. Fifty-seven percent were compliant and 43% were noncompliant. In the noncompliant group, 53.4 % had mild noncompliance, 24.4 % had severe non-compliance, while 22% had moderate noncompliance. Factors of noncompliance were 56.8% missed doses due to forgetfulness, 12.7% deliberately missed their doses, 11.6% could not take the medicine due to side effects, 10.4% did not take the dose due to increased number of tablets, 4.6% were not properly counseled by the physician and 3.48% did not take medicines due to cost issues. The mean systolic blood pressure was 126 +- 19.2 mmHg in the compliant group while it was 133 +- 16.5 mmHg in the noncompliant group (p-value 0.004). The mean diastolic blood pressure in the compliant group was 76 +- 11.9 mmHg, while in the noncompliant group it was 81.9 +- 10.9 mmHg (p-value 0.001). Conclusion: Compliance to antihypertensive therapy in a tertiary care center is significantly good. Forgetfulness was the major reason for noncompliance. The mean blood pressure control was better in the compliant group. (author)

  14. Control quality and performance measurement of gamma cameras. S.F.P.M. report nr 28. Updating of S.F.P.H. reports Performance assessment and quality control of scintillation cameras: plane mode (1992), tomographic mode (1996) whole-body mode (1997)

    International Nuclear Information System (INIS)

    Petegnief, Yolande; Barrau, Corinne; Coulot, Jeremy; Guilhem, Marie Therese; Hapdey, Sebastien; Vrigneaud, Jean-Marc; Metayer, Yann; Picone, Magali; Ricard, Marcel; Salvat, Cecile; Bouchet, Francis; Ferrer, Ludovic; Murat, Caroline

    2012-01-01

    This report aims at providing students and professionals with a comprehensive guide related to quality control and to performance measurement on gamma cameras. It completes and updates three previous reports published by the SFPM during the 1990's related to the different acquisition modes for this modality of medical imagery: plane imagery, whole-body scanning, and tomography. The authors present the operation principle of scintillation cameras, the characteristics of a scintillation camera, analytic and algebraic algorithms of tomographic reconstruction, and the various software corrections applied in mono-photonic imagery (corrections of the attenuation effect, of the scattering effect, of the collimator response effect, and of the partial volume effect). In the next part, the present the various characteristics, parameters and issues related to performance measurement for the three addressed modes (plane, whole body, tomographic). The last part presents various aspects of the organisation of quality control and of performance follow-up: regulatory context, reference documents, internal quality control program

  15. Extrinsic incentives and tax compliance

    OpenAIRE

    Sour, Laura; Gutiérrez Andrade, Miguel Ángel

    2011-01-01

    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  16. Managing compliance risk after Mifid

    OpenAIRE

    P. Musile Tanzi; G. Gabbi; D. Previati; P. Schwizer

    2013-01-01

    Purpose – The purpose of this paper is to focus on changes in the compliance function within major European banks and other financial intermediaries and on the effects of Markets in Financial Instruments Directive (MiFID) implementation. Design/methodology/approach – The four areas of research seek to answer the following questions: Is the positioning of the compliance function “at the top” of the organizational structure? Are the roles attributed to the compliance function, th...

  17. Patient satisfaction with psychotropic drugs: sensitivity to change and relationship to clinical status, quality-of-life, compliance and effectiveness of treatment. Results from a nation-wide 6-month prospective study.

    Science.gov (United States)

    Gasquet, Isabelle; Tcherny-Lessenot, Stéphanie; Lépine, Jean-Pierre; Falissard, Bruno

    2006-12-01

    To see if patient satisfaction with psychotropics (PSP) could be used as a patient-oriented outcome variable in the evaluation of PSP drugs in clinical epidemiological studies, relationships between PSP, clinical status, QoL, compliance and the type of antipsychotic were analyzed. Elements of validation of PSP were also assessed. In a 6-month prospective study, 933 schizophrenic outpatients with initiation or change to their antipsychotic treatment were enrolled. Psychiatrists completed five CGI-SCH scales (positive, negative, cognitive, depressive and global), hospitalization, compliance, and prescription variables. Patients completed PSP, EuroQoL scales, sexual function and compliance variables. A satisfactory structural equation model was obtained showing significant relationships PSP/compliance (coef.=0.16), QoL/PSP (coef.=0.37), clinical status/QoL (coef.=0.61), clinical status/compliance (coef.=0.09). Patients receiving olanzapine were more satisfied than patients receiving other atypicals (coef.=012) and had better clinical status than patients treated with typicals (coef.=0.08). Evolution of PSP was related to clinical status, QoL, and continuation of treatment (all Pmeasure was not sufficiently sensitive to change. Multi-item questionnaires evaluating different dimensions are needed.

  18. [Drinking water quality and safety].

    Science.gov (United States)

    Gómez-Gutiérrez, Anna; Miralles, Maria Josepa; Corbella, Irene; García, Soledad; Navarro, Sonia; Llebaria, Xavier

    2016-11-01

    The purpose of drinking water legislation is to guarantee the quality and safety of water intended for human consumption. In the European Union, Directive 98/83/EC updated the essential and binding quality criteria and standards, incorporated into Spanish national legislation by Royal Decree 140/2003. This article reviews the main characteristics of the aforementioned drinking water legislation and its impact on the improvement of water quality against empirical data from Catalonia. Analytical data reported in the Spanish national information system (SINAC) indicate that water quality in Catalonia has improved in recent years (from 88% of analytical reports in 2004 finding drinking water to be suitable for human consumption, compared to 95% in 2014). The improvement is fundamentally attributed to parameters concerning the organoleptic characteristics of water and parameters related to the monitoring of the drinking water treatment process. Two management experiences concerning compliance with quality standards for trihalomethanes and lead in Barcelona's water supply are also discussed. Finally, this paper presents some challenges that, in the opinion of the authors, still need to be incorporated into drinking water legislation. It is necessary to update Annex I of Directive 98/83/EC to integrate current scientific knowledge, as well as to improve consumer access to water quality data. Furthermore, a need to define common criteria for some non-resolved topics, such as products and materials in contact with drinking water and domestic conditioning equipment, has also been identified. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Environmental compliance considerations for the management of cultural resources

    International Nuclear Information System (INIS)

    Curtis, S.A.; Whitfield, S.; McGinnis, K.

    1987-01-01

    This paper examines three key considerations underlying the programmatic management of cultural resources that may be affected by a large federal project. These considerations are statutory background and the compliance process, cultural resource compliance tasks, and quality assurance. The first consideration addresses the legal requirements and steps that must be met and taken for federal agencies to fulfill their cultural resource compliance responsibilities. The second consideration focuses on the tasks that must be performed by technical specialists to facilitate related federal and state compliance actions. The third consideration ensures that compliance requirements are being properly fulfilled. In the technical literature and compliance planning, archaeological and historic sites and Native American cultural resources are grouped under the general heading of cultural resources. Also included under this heading are the traditions and resources of Folk societies. Cultural resources encompass both material and nonmaterial aspects of our cultural heritage and include buildings, structures, objects, sites, districts, archaeological resources, places of religious importance, and unique, distinctive, or unusual lifeways. For compliance purposes, it is useful to treat these resources within four roughly chronological culture-historical periods: prehistoric, ethnohistoric, historic, and contemporary. 6 refs., 6 tabs

  20. Proactive compliance report 2004

    International Nuclear Information System (INIS)

    2005-01-01

    The Alberta Energy and Utilities Board (EUB) stipulates requirements to protect public safety, minimize environmental impacts, improve conservation, and ensure equity by promoting orderly and responsible energy development. Surveillance activities by the EUB, such as inspections and audits, ensures compliance with these requirements. This report presents statistical results of the enforcement ladder process (inspections, complaints, activities, major initiatives, and enforcement) for 2004 across ten EUB groups, including, Field Surveillance, Resources Applications Group, Operations Group, Environment Group, Utilities Branch, Facilities Applications Group, Corporate Compliance Group, Fort McMurray, Information and Dissemination Group, and Financial Management Group. When a noncompliance is identified, the EUB uses a process that has an established policy for EUB enforcement actions. Enforcement actions are determined by the severity of the noncompliance event and are escalated for subsequent noncompliance or failure to comply with the EUB's corrective order. Within the process, the EUB provides a grace period after an initial enforcement action. During this period, the EUB will take appropriate enforcement actions for subsequent noncompliances but will not escalate enforcement consequences. Enforcement consequences are escalated after the grace period has expired. 72 tabs

  1. Formalizing and appling compliance patterns for business process compliance

    NARCIS (Netherlands)

    Elgammal, A.; Turetken, O.; van den Heuvel, W.; Papazoglou, M.

    2016-01-01

    Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

  2. Formalizing and applying compliance patterns for business process compliance

    NARCIS (Netherlands)

    Elgammal, A.F.S.A.; Türetken, O.; van den Heuvel, W.J.A.M.; Papazoglou, M.

    Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

  3. Diagnostic information for compliance checking of temporal compliance requirements

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Dongen, van B.F.; Aalst, van der W.M.P.; Salinesi, C.; Norrie, M.C.; Pastor, O.

    2013-01-01

    Compliance checking is gaining importance as today’s organizations need to show that operational processes are executed in a controlled manner while satisfying predefined (legal) requirements or service level agreements. Deviations may be costly and expose an organization to severe risks. Compliance

  4. Environmental Compliance Audit Handbook (ECAH): U.S. Fish and Wildlife Service. (Revision)

    National Research Council Canada - National Science Library

    Schell, Donna

    1998-01-01

    .... The concept was to combine the Code of Federal Regulations with good management practices and risk-management issues into a series of checklists that show legal requirements and specific items of operations to review. This handbook is continually updated to address new environmental compliance laws and regulations.

  5. Environmental Compliance Audit Handbook (ECAH): U.S. Fish and Wildlife Service

    National Research Council Canada - National Science Library

    Schell, Donna

    2000-01-01

    .... The concept was to combine the Code of Federal Regulations with good management practices and risk management issues into a series of checklists that show legal requirements and specific items of operations to review. This handbook is continually updated to address new environmental compliance laws and regulations.

  6. Environmental Compliance Audit Handbook (ECAH): U.S. Fish and Wildlife Service (FWS) (Revision)

    National Research Council Canada - National Science Library

    Schell, Donna

    1999-01-01

    .... The concept was to combine the Code of Federal Regulations with good management practices and risk-management issues into a series of checklists that show legal requirements and specific items of operations to review. This handbook is continually updated to address new environmental compliance laws and regulations.

  7. Continuous quality improvement using intelligent infusion pump data analysis.

    Science.gov (United States)

    Breland, Burnis D

    2010-09-01

    The use of continuous quality-improvement (CQI) processes in the implementation of intelligent infusion pumps in a community teaching hospital is described. After the decision was made to implement intelligent i.v. infusion pumps in a 413-bed, community teaching hospital, drug libraries for use in the safety software had to be created. Before drug libraries could be created, it was necessary to determine the epidemiology of medication use in various clinical care areas. Standardization of medication administration was performed through the CQI process, using practical knowledge of clinicians at the bedside and evidence-based drug safety parameters in the scientific literature. Post-implementation, CQI allowed refinement of clinically important safety limits while minimizing inappropriate, meaningless soft limit alerts on a few select agents. Assigning individual clinical care areas (CCAs) to individual patient care units facilitated customization of drug libraries and identification of specific CCA compliance concerns. Between June 2007 and June 2008, there were seven library updates. These involved drug additions and deletions, customization of individual CCAs, and alterations of limits. Overall compliance with safety software use rose over time, from 33% in November 2006 to over 98% in December 2009. Many potentially clinically significant dosing errors were intercepted by the safety software, prompting edits by end users. Only 4-6% of soft limit alerts resulted in edits. Compliance rates for use of infusion pump safety software varied among CCAs over time. Education, auditing, and refinement of drug libraries led to improved compliance in most CCAs.

  8. a Bottom-Up Geosptial Data Update Mechanism for Spatial Data Infrastructure Updating

    Science.gov (United States)

    Tian, W.; Zhu, X.; Liu, Y.

    2012-08-01

    Currently, the top-down spatial data update mechanism has made a big progress and it is wildly applied in many SDI (spatial data infrastructure). However, this mechanism still has some issues. For example, the update schedule is limited by the professional department's project, usually which is too long for the end-user; the data form collection to public cost too much time and energy for professional department; the details of geospatial information does not provide sufficient attribute, etc. Thus, how to deal with the problems has become the effective shortcut. Emerging Internet technology, 3S technique and geographic information knowledge which is popular in the public promote the booming development of geoscience in volunteered geospatial information. Volunteered geospatial information is the current "hotspot", which attracts many researchers to study its data quality and credibility, accuracy, sustainability, social benefit, application and so on. In addition to this, a few scholars also pay attention to the value of VGI to support the SDI updating. And on that basis, this paper presents a bottom-up update mechanism form VGI to SDI, which includes the processes of match homonymous elements between VGI and SDI vector data , change data detection, SDI spatial database update and new data product publication to end-users. Then, the proposed updating cycle is deeply discussed about the feasibility of which can detect the changed elements in time and shorten the update period, provide more accurate geometry and attribute data for spatial data infrastructure and support update propagation.

  9. Diagnostic information in compliance checking

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Aalst, van der W.M.P.

    2012-01-01

    Compliance checking is gaining importance as today's organizations need to show that operational processes are executed in a controlled manner while satisfying predefined (legal) requirements. Deviations may be costly and expose the organization to severe risks. Compliance checking is of growing

  10. Are Forecast Updates Progressive?

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); Ph.H.B.F. Franses (Philip Hans); M.J. McAleer (Michael)

    2010-01-01

    textabstractMacro-economic forecasts typically involve both a model component, which is replicable, as well as intuition, which is non-replicable. Intuition is expert knowledge possessed by a forecaster. If forecast updates are progressive, forecast updates should become more accurate, on average,

  11. Environmental compliance assessment review

    International Nuclear Information System (INIS)

    Hilliday, G.H.

    1991-01-01

    During the period 1972-1991, The United States Congress passed stringent environmental statues which the Environment Protection Agency implemented via regulations. The statues and regulations contain severe civil and criminal penalties. Civil violations resulted in fines, typically payable by the company. The act of willfully and knowingly violating the permit conditions or regulations can result in criminal charges being imposed upon the responsible part, i.e., either the company or individual. Criminal charges can include fines, lawyer fees, court costs and incarceration. This paper describes steps necessary to form an effective Environmental Compliance Assessment Review [CAR] program, train field and engineering personnel and perform a CAR audit. Additionally, the paper discusses the findings of a number of Exploration and Production [E and P] field audits

  12. Impaired fasting pyloric compliance in gastroparesis and the therapeutic response to pyloric dilatation.

    Science.gov (United States)

    Gourcerol, G; Tissier, F; Melchior, C; Touchais, J Y; Huet, E; Prevost, G; Leroi, A M; Ducrotte, P

    2015-02-01

    Pyloric pressure and compliance have never been investigated in health nor gastroparesis. We hypothesised that pyloric pressure and/or compliance may be altered in gastroparesis. Fasting pyloric pressure and compliance were investigated in 21 healthy volunteers (HV), 27 gastroparetic patients (GP) and 5 patients who had undergone oesophagectomy without pyloroplasty as positive controls. Under videofluoroscopic control, pyloric compliance and pressure were measured by the EndoFLIP technique. Gastric emptying half time (T1/2 ) using (13) C-octanoic acid breath test, as well as symptoms and quality of life (GIQLI score) were also monitored. Mean fasting pyloric compliance was measured at 25.2 ± 2.4 mm²/mmHg in HV, and was lower both in GP (16.9 ± 2.1 mm²/mmHg; P fasting pyloric pressure was not different among groups. Fasting pyloric compliance and pressure correlated with T1/2 in GP (R = -0.43; P = 0.04). Fasting pyloric compliance, but not pressure, correlated with symptoms and GIQLI score. Pyloric dilation in 10 GP with low fasting pyloric compliance (fasting pyloric compliance is decreased in gastroparetic patients and is associated with T1/2 , symptoms and quality of life. This suggests that pyloric compliance may be a new relevant metric in gastroparetic patients, and may be useful to target patients for pyloric dilation or botulinum toxin injection. © 2014 John Wiley & Sons Ltd.

  13. Short- and long-term effects of clinical audits on compliance with procedures in CT scanning.

    Science.gov (United States)

    Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

    2016-08-01

    To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific "paediatric brain CT" procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. • Compliance with CT procedures is operator-dependent and not perfect. • Compliance differs between procedures and hospitals, even within a unified department. • Compliance is improved through audits followed by communication to the stakeholders. • This improvement is sustainable over a one-year period.

  14. Updating of states in operational hydrological models

    Science.gov (United States)

    Bruland, O.; Kolberg, S.; Engeland, K.; Gragne, A. S.; Liston, G.; Sand, K.; Tøfte, L.; Alfredsen, K.

    2012-04-01

    Operationally the main purpose of hydrological models is to provide runoff forecasts. The quality of the model state and the accuracy of the weather forecast together with the model quality define the runoff forecast quality. Input and model errors accumulate over time and may leave the model in a poor state. Usually model states can be related to observable conditions in the catchment. Updating of these states, knowing their relation to observable catchment conditions, influence directly the forecast quality. Norway is internationally in the forefront in hydropower scheduling both on short and long terms. The inflow forecasts are fundamental to this scheduling. Their quality directly influence the producers profit as they optimize hydropower production to market demand and at the same time minimize spill of water and maximize available hydraulic head. The quality of the inflow forecasts strongly depends on the quality of the models applied and the quality of the information they use. In this project the focus has been to improve the quality of the model states which the forecast is based upon. Runoff and snow storage are two observable quantities that reflect the model state and are used in this project for updating. Generally the methods used can be divided in three groups: The first re-estimates the forcing data in the updating period; the second alters the weights in the forecast ensemble; and the third directly changes the model states. The uncertainty related to the forcing data through the updating period is due to both uncertainty in the actual observation and to how well the gauging stations represent the catchment both in respect to temperatures and precipitation. The project looks at methodologies that automatically re-estimates the forcing data and tests the result against observed response. Model uncertainty is reflected in a joint distribution of model parameters estimated using the Dream algorithm.

  15. Update on the Methodological Quality of Research Published in The American Journal of Sports Medicine: Comparing 2011-2013 to 10 and 20 Years Prior.

    Science.gov (United States)

    Brophy, Robert H; Kluck, Dylan; Marx, Robert G

    2016-05-01

    In recent years, the number of articles in The American Journal of Sports Medicine (AJSM) has risen dramatically, with an increasing emphasis on evidence-based medicine in orthopaedics and sports medicine. Despite the increase in the number of articles published in AJSM over the past decade, the methodological quality of articles in 2011-2013 has improved relative to those in 2001-2003 and 1991-1993. Meta-analysis. All articles published in AJSM during 2011-2013 were reviewed and classified by study design. For each article, the use of pertinent methodologies, such as prospective data collection, randomization, control groups, and blinding, was recorded. The frequency of each article type and the use of evidence-based techniques were compared relative to 1991-1993 and 2001-2003 by use of Pearson χ(2) testing. The number of research articles published in AJSM more than doubled from 402 in 1991-1993 and 423 in 2001-2003 to 953 in 2011-2013. Case reports decreased from 15.2% to 10.6% to 2.1% of articles published over the study period (P < .001). Cadaveric/human studies and meta-analysis/literature review studies increased from 5.7% to 7.1% to 12.4% (P < .001) and from 0.2% to 0.9% to 2.3% (P = .01), respectively. Randomized, prospective clinical trials increased from 2.7% to 5.9% to 7.4% (P = .007). Fewer studies used retrospective compared with prospective data collection (P < .001). More studies tested an explicit hypothesis (P < .001) and used controls (P < .001), randomization (P < .001), and blinding of those assessing outcomes (P < .001). Multi-investigator trials increased (P < .001), as did the proportion of articles citing a funding source (P < .001). Despite a dramatic increase in the number of published articles, the research published in AJSM shifted toward more prospective, randomized, controlled, and blinded designs during 2011-2013 compared with 2001-2003 and 1991-1993, demonstrating a continued improvement in methodological quality. © 2015 The

  16. Frequency Dependence of Damping and Compliance in Loudspeaker Suspensions

    DEFF Research Database (Denmark)

    Thorborg, Knud; Tinggaard, Carsten; Agerkvist, Finn T.

    2010-01-01

    ]. It is an empirical model mathematically describing the effects of visco-elasticity in loudspeaker suspensions. The evaluation is to a high degree based on test loudspeakers with rubber surrounds with a high content of plasticizer combining high compliance and high damping. This is very effective to reduce rim...... resonances, but less used in high quality loudspeakers today – where “Low Loss Rubber Surround” is currently seen as a marketing feature, as it is expected to have positive impact on sound quality. The plasticized type of surround shows significant creep, followed by compliance and damping increasing towards...... - with the additives normally used to adjust stiffness and damping - neither frequency dependency of compliance nor creep are significant problems. Despite this, experience shows that frequency dependent mechanical damping nevertheless might be present. In this paper some modifications to the LOG-model are proposed...

  17. Analysis of Potential Benefits and Costs of Updating the Commercial Building Energy Code in North Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Cort, Katherine A.; Belzer, David B.; Winiarski, David W.; Richman, Eric E.

    2004-04-30

    The state of North Dakota is considering updating its commercial building energy code. This report evaluates the potential costs and benefits to North Dakota residents from updating and requiring compliance with ASHRAE Standard 90.1-2001. Both qualitative and quantitative benefits and costs are assessed in the analysis. Energy and economic impacts are estimated using the Building Loads Analysis and System Thermodynamics (BLAST simulation combined with a Life-cycle Cost (LCC) approach to assess correspodning economic costs and benefits.

  18. A new approach for monthly updates of anthropogenic sulfur dioxide emissions from space: Application to China and implications for air quality forecasts

    Science.gov (United States)

    Wang, Yi; Wang, Jun; Xu, Xiaoguang; Henze, Daven K.; Wang, Yuxuan; Qu, Zhen

    2016-09-01

    SO2 emissions, the largest source of anthropogenic aerosols, can respond rapidly to economic and policy driven changes. However, bottom-up SO2 inventories have inherent limitations owing to 24-48 months latency and lack of month-to-month variation in emissions (especially in developing countries). This study develops a new approach that integrates Ozone Monitoring Instrument (OMI) SO2 satellite measurements and GEOS-Chem adjoint model simulations to constrain monthly anthropogenic SO2 emissions. The approach's effectiveness is demonstrated for 14 months in East Asia; resultant posterior emissions not only capture a 20% SO2 emission reduction in Beijing during the 2008 Olympic Games but also improve agreement between modeled and in situ surface measurements. Further analysis reveals that posterior emissions estimates, compared to the prior, lead to significant improvements in forecasting monthly surface and columnar SO2. With the pending availability of geostationary measurements of tropospheric composition, we show that it may soon be possible to rapidly constrain SO2 emissions and associated air quality predictions at fine spatiotemporal scales.

  19. Effect of hand sanitizer location on hand hygiene compliance.

    Science.gov (United States)

    Cure, Laila; Van Enk, Richard

    2015-09-01

    Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

  1. The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

    Science.gov (United States)

    Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

    2008-06-01

    Background  Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. Objectives  This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. Search strategy  A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. Selection criteria  All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Data collection and analysis  Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Results  Seven studies met the inclusion criteria. Given the small number of included studies and variable

  2. Oil Mist Compliance

    International Nuclear Information System (INIS)

    Lazarus, Lloyd

    2009-01-01

    This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that 'Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace', and subsection 9 contains the following applicable standard: 'American Congress of Governmental Industrial Hygienists (ACGIH), 'Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,' (2005) (incorporated by reference, see (section)851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910'. In the 2005 ACGIH Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified

  3. Oil Mist Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Lazarus, Lloyd

    2009-02-02

    This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that “Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace”, and subsection 9 contains the following applicable standard: “American Congress of Governmental Industrial Hygienists (ACGIH), ‘Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,’ (2005) (incorporated by reference, see §851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910.” In the 2005 ACGIH – Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified.

  4. Environmental Compliance Management System

    International Nuclear Information System (INIS)

    Brownson, L.W.; Krsul, T.; Peralta, R.A.; Knudson, D.A.; Rosignolo, C.L.

    1992-01-01

    Argonne National Laboratory (ANL) is developing the Environmental Compliance Management System (ECMS) as a comprehensive, cost-effective tool to ensure (1) that the Laboratory complies with all applicable federal and state environmental laws and regulations, (2) that environmental issues and concerns are recognized and considered in the early phases of projects; and (3) that Laboratory personnel conduct Laboratory operations in the most environmentally acceptable manner. The ECMS is an expert computer system which is designed to allow project engineers to perform an environmental evaluation of their projects. The system includes a Master Program which collects basic project information, provide utility functions, and access the environmental expert modules, environmental expert system modules for each federal and state environmental law which allows the user to obtain specific information on how an individual law may affect his project; and site-specific databases which contain information necessary for effective management of the site under environmental regulations. The ECMS will have the capability to complete and print many of the necessary environmental forms required by federal and state agencies, including the Department of Energy

  5. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

    Science.gov (United States)

    Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

    2007-11-23

    Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common

  6. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

    Directory of Open Access Journals (Sweden)

    Burgers Jako S

    2007-11-01

    Full Text Available Abstract Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes

  7. National Pediatric Program Update

    International Nuclear Information System (INIS)

    2008-01-01

    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis. [es

  8. Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy.

    Science.gov (United States)

    Makhni, Eric C; Higgins, John D; Hamamoto, Jason T; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

    2017-11-01

    To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. Level IV, case series. Copyright © 2017 Arthroscopy Association of North

  9. Y2K compliance countdown.

    Science.gov (United States)

    Arlotto, P W

    1999-01-01

    The new century brings unique challenges--especially Y2K compliance. This article presents nurse managers and executives with an overview of the issues and action steps to keep their organizations on track.

  10. Air Compliance Complaint Database (ACCD)

    Data.gov (United States)

    U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Air Compliance Complaint Database (ACCD) which logs all air pollution complaints...

  11. The Italian compliance assurance programme

    International Nuclear Information System (INIS)

    Trivelloni, S.

    1999-01-01

    An overview is given of the compliance assurance programme that is applied in Italy and the role of the different competent authorities that have responsibilities for the transport of radioactive materials is described. (author)

  12. Integrated Compliance Information System (ICIS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data...

  13. The Strategic Nature of Compliance

    DEFF Research Database (Denmark)

    König, Thomas; Mäder, Lars Kai

    2014-01-01

    by the anticipated enforcement decision of the monitoring agency and whether this agency is responsive to the probability of enforcement success and the potential sanctioning costs produced by noncomplying implementers. Compared to other monitoring systems, the centralized monitoring system of the European Union (EU......This compliance study models correct and timely implementation of policies in a multilevel system as a strategic game between a central monitoring agency and multiple implementers and evaluates statistically the empirical implications of this model. We test whether compliance is determined......) is praised for exemplary effectiveness, but our findings reveal that the monitoring agency refrains from enforcing compliance when the probability of success is low, and the sanctioning costs are high. This results in a compliance deficit, even though the selective enforcement activities of the monitoring...

  14. Directory of certificates of compliance for radioactive materials packages, Certificates of compliance

    International Nuclear Information System (INIS)

    1990-10-01

    This directory contains a Report of the US Nuclear Regulatory Commissions's Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Materials Packages effective October 1, 1990. The purpose of this directory is to make available a convenient source of information on packaging which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Reports include a listing of all users of easy package design and approved QA programs prior to the publication date of the directory

  15. Directory of Certificates of Compliance for Radioactive Materials Packages: Certificates of Compliance

    International Nuclear Information System (INIS)

    1988-12-01

    This directory contains a Report of the US Nuclear Regulatory Commission's Approved Packages (Volume 1), all Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective October 1, 1988. The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  16. Directory of Certificates of Compliance for Radioactive-Materials Packages. Certificates of Compliance

    International Nuclear Information System (INIS)

    1983-01-01

    This directory contains a Summary Report of the US Nuclear Regulatory Commission's Approved Packages (Volume I), all Certificates of Compliance (Volume 2), and Summary Report of NRC Approved Quality Assurance Programs (Volume 3) for Radioactive Material Packages effective December 31, 1982. The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the back of Volumes 1 and 2 of the directory. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The Summary Reports include a listing of all users of each package design and approved QA programs prior to the publication date of the directory

  17. An Updated Performance Assessment For A New Low-Level Radioactive Waste Disposal Facility In West Texas - 12192

    Energy Technology Data Exchange (ETDEWEB)

    Dornsife, William P.; Kirk, J. Scott; Shaw, Chris G. [Waste Control Specialists LLC, Andrews, Texas (United States)

    2012-07-01

    This Performance Assessment (PA) submittal is an update to the original PA that was developed to support the licensing of the Waste Control Specialists LLC Low-Level Radioactive Waste (LLRW) disposal facility. This update includes both the Compact Waste Facility (CWF) and the Federal Waste Facility (FWF), in accordance with Radioactive Material License (RML) No. R04100, License Condition (LC) 87. While many of the baseline assumptions supporting the initial license application PA were incorporated in this update, a new transport code, GoldSim, and new deterministic groundwater flow codes, including HYDRUS and MODFLOWSURFACT{sup TM}, were employed to demonstrate compliance with the performance objectives codified in the regulations and RML No. R04100, LC 87. A revised source term, provided by the Texas Commission on Environmental Quality staff, was used to match the initial 15 year license term. This updated PA clearly confirms and demonstrates the robustness of the characteristics of the site's geology and the advanced engineering design of the disposal units. Based on the simulations from fate and transport models, the radiation doses to members of the general public and site workers predicted in the initial and updated PA were a small fraction of the criterion doses of 0.25 mSv and 50 mSv, respectively. In a comparison between the results of the updated PA against the one developed in support of the initial license, both clearly demonstrated the robustness of the characteristics of the site's geology and engineering design of the disposal units. Based on the simulations from fate and transport models, the radiation doses to members of the general public predicted in the initial and updated PA were a fraction of the allowable 25 mrem/yr (0.25 m sievert/yr) dose standard for tens-of-thousands of years into the future. Draft Texas guidance on performance assessment (TCEQ, 2004) recommends a period of analysis equal to 1,000 years or until peak doses from

  18. Experiences with Software Quality Metrics in the EMI middleware

    International Nuclear Information System (INIS)

    Alandes, M; Meneses, D; Pucciani, G; Kenny, E M

    2012-01-01

    The EMI Quality Model has been created to define, and later review, the EMI (European Middleware Initiative) software product and process quality. A quality model is based on a set of software quality metrics and helps to set clear and measurable quality goals for software products and processes. The EMI Quality Model follows the ISO/IEC 9126 Software Engineering – Product Quality to identify a set of characteristics that need to be present in the EMI software. For each software characteristic, such as portability, maintainability, compliance, etc, a set of associated metrics and KPIs (Key Performance Indicators) are identified. This article presents how the EMI Quality Model and the EMI Metrics have been defined in the context of the software quality assurance activities carried out in EMI. It also describes the measurement plan and presents some of the metrics reports that have been produced for the EMI releases and updates. It also covers which tools and techniques can be used by any software project to extract “code metrics” on the status of the software products and “process metrics” related to the quality of the development and support process such as reaction time to critical bugs, requirements tracking and delays in product releases.

  19. Year 2000 (Y2K) computer compliance guide; guidance for FDA personnel. Food and Drug Administration. Notice.

    Science.gov (United States)

    1999-05-14

    The Food and Drug Administration (FDA) is announcing the availability of a new compliance policy guide (CPG) entitled "Year 2000 (Y2K) Computer Compliance" (section 160-800). This guidance document represents the agency's current thinking on the manufacturing and distribution of domestic and imported products regulated by FDA using computer systems that may not perform properly before, or during, the transition to the year 2000 (Y2K). The text of the CPG is included in this notice. This compliance guidance document is an update to the Compliance Policy Guides Manual (August 1996 edition). It is a new CPG, and it will be included in the next printing of the Compliance Policy Guides Manual. This CPG is intended for FDA personnel, and it is available electronically to the public.

  20. A Provenance Tracking Model for Data Updates

    Directory of Open Access Journals (Sweden)

    Gabriel Ciobanu

    2012-08-01

    Full Text Available For data-centric systems, provenance tracking is particularly important when the system is open and decentralised, such as the Web of Linked Data. In this paper, a concise but expressive calculus which models data updates is presented. The calculus is used to provide an operational semantics for a system where data and updates interact concurrently. The operational semantics of the calculus also tracks the provenance of data with respect to updates. This provides a new formal semantics extending provenance diagrams which takes into account the execution of processes in a concurrent setting. Moreover, a sound and complete model for the calculus based on ideals of series-parallel DAGs is provided. The notion of provenance introduced can be used as a subjective indicator of the quality of data in concurrent interacting systems.

  1. Evaluating impacts of Clean Air Act compliance strategies

    International Nuclear Information System (INIS)

    Shirer, D.A.; Evans, R.J.; Harrison, C.D.; Kehoe, D.B.

    1993-01-01

    The Clean Air Act Amendments of 1990 requires that by the year 2000, US SO 2 emissions must be reduced by 10 million tons. This requirement will have significant impact on coal-fired electric utilities. As a result, most utilities are currently evaluating numerous compliance options, including buying allowances, coal cleaning/blending/switching, and flue gas scrubbing. Moreover, each utility must address its own unique circumstances with regard to competition, efficiency, capital expenditures, reliability, etc. and many utilities may choose a combination of compliance options to simultaneously satisfy their environmental, performance, and financial objectives. The Coal Quality Expert, which is being developed under a clean coal technology project funded by US DOE and EPRI, will predict the economic, operational, and environmental benefits of using higher-quality coals and provides an assessment of the merits of various post-combustion control technologies for specific utility applications. This paper presents background on how utilities evaluate their compliance options, and it describes how the Coal Quality Expert could be used for such evaluations in the future to assure that each utility can select the best combination of coal specifications and emission control technologies to meet its compliance objectives

  2. ICF's Plant Compliance Assessment System

    International Nuclear Information System (INIS)

    Baker, S.M.

    1989-01-01

    Government and private industrial facilities must manage wastes that are both radioactive and (chemically) hazardous. Until recently, these mixed wastes have been managed under rules established under the Atomic Energy Act (AEA) and the Low-Level Waste Policy At, and rules that derive from environmental legislation have not been applied. Both sets of rules now apply to mixed wastes, creating situations in which significant changes to waste steams must be made in order to bring them into compliance with environmental regulations. The first step in bringing waste streams into compliance is to determine their status with respect to the newly-applicable regulations. This process of compliance assessment is difficult because requirements to minimize human exposure to radiation can conflict with requirements of environmental regulations, many regulations are potentially applicable, the regulations are changing rapidly, and because waste streams designed to operate under AEA rules frequently cannot be easily modified to incorporate the additional regulations. Modern personal computer (PC) tools are being developed to help regulatory analysts manage the large amounts of information required to asses the compliance status of complex process plants. This paper presents the Plant Compliance Assessment System (PCAS), which performs this function by relating a database containing references to regulatory requirements to databases created to describe relevant aspects of the facility to be assessed

  3. Experiences with Software Quality Metrics in the EMI Middleware

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    The EMI Quality Model has been created to define, and later review, the EMI (European Middleware Initiative) software product and process quality. A quality model is based on a set of software quality metrics and helps to set clear and measurable quality goals for software products and processes. The EMI Quality Model follows the ISO/IEC 9126 Software Engineering – Product Quality to identify a set of characteristics that need to be present in the EMI software. For each software characteristic, such as portability, maintainability, compliance, etc, a set of associated metrics and KPIs (Key Performance Indicators) are identified. This article presents how the EMI Quality Model and the EMI Metrics have been defined in the context of the software quality assurance activities carried out in EMI. It also describes the measurement plan and presents some of the metrics reports that have been produced for the EMI releases and updates. It also covers which tools and techniques can be used by any software project t...

  4. National Environmental Policy Act (NEPA) Compliance Guide, Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

    1995-08-01

    This report contains a comprehensive National Environmental Policy Act (NEPA) Compliance Guide for the Sandia National Laboratories. It is based on the Council on Environmental Quality (CEQ) NEPA regulations in 40 CFR Parts 1500 through 1508; the US Department of Energy (DOE) N-EPA implementing procedures in 10 CFR Part 102 1; DOE Order 5440.1E; the DOE ``Secretarial Policy Statement on the National Environmental Policy Act`` of June 1994- Sandia NEPA compliance procedures-, and other CEQ and DOE guidance. The Guide includes step-by-step procedures for preparation of Environmental Checklists/Action Descriptions Memoranda (ECL/ADMs), Environmental Assessments (EAs), and Environmental Impact Statements (EISs). It also includes sections on ``Dealing With NEPA Documentation Problems`` and ``Special N-EPA Compliance Issues.``

  5. Quality Systems Manual (QSM) Version 5: Update

    Science.gov (United States)

    2012-03-01

    Rei Mao; Charles Stoner  Air Force: John (Seb) Gillette  DOE: Joe Pardue; Todd Hardt  Contractor: Alyssa Wingard Questions ??? We have answers* Do...labs must be approved by appropriate DOE representative • Outsourced QS elements (such as data review) must comply with the standard and are subject to

  6. Update of European bioethics

    DEFF Research Database (Denmark)

    Rendtorff, Jacob Dahl

    2015-01-01

    This paper presents an update of the research on European bioethics undertaken by the author together with Professor Peter Kemp since the 1990s, on Basic ethical principles in European bioethics and biolaw. In this European approach to basic ethical principles in bioethics and biolaw......, the principles of autonomy, dignity, integrity and vulnerability are proposed as the most important ethical principles for respect for the human person in biomedical and biotechnological development. This approach to bioethics and biolaw is presented here in a short updated version that integrates the earlier...... research in a presentation of the present understanding of the basic ethical principles in bioethics and biolaw....

  7. Caregivers' compliance with referral advice

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2018-01-01

    BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance...... in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18......,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings

  8. Compliance als Schutz vor Verbandsverantwortlichkeit?

    Directory of Open Access Journals (Sweden)

    Alexander Tipold

    2016-05-01

    Full Text Available Compliance bedeutet nicht nur Einhaltung und Beachtung von Vorschriften, sondern betrifft auch Maßnahmen, die die Einhaltung der Rechtsnormen absichern sollen und läuft somit auf eine Übererfüllung von Verpflichtungen hinaus. Wenn es keinen klaren Maßstab für Kontroll- und Überwachungspflichten gibt, besteht die Gefahr, dass Strafverfolgungsbehörden die Compliance-Maßnahmen als Maßstab heranziehen und so eine Verschärfung der Pflichten erzeugen. Nach den Regeln des Verbandsverantwortlichkeitsgesetzes schließt im Übrigen das beste Compliance-System nicht zwingend die Verbandsverantwortlichkeit aus, steht aber unter Umständen einem Verfahren gegen den Verband entgegen.

  9. Contemplating compliance: European compliance mechanisms in international perspective

    NARCIS (Netherlands)

    Koops, C.E.

    2014-01-01

    How can international organizations make their Member States comply with the rules of the organization? Which is the more effective method: to coax and entice, to argue and persuade, or to threaten and punish? On the basis of which criteria should a compliance mechanism be construed and applied,

  10. Methodological update in Medicina Intensiva.

    Science.gov (United States)

    García Garmendia, J L

    2018-04-01

    Research in the critically ill is complex by the heterogeneity of patients, the difficulties to achieve representative sample sizes and the number of variables simultaneously involved. However, the quantity and quality of records is high as well as the relevance of the variables used, such as survival. The methodological tools have evolved to offering new perspectives and analysis models that allow extracting relevant information from the data that accompanies the critically ill patient. The need for training in methodology and interpretation of results is an important challenge for the intensivists who wish to be updated on the research developments and clinical advances in Intensive Medicine. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  11. Directory of certificates of compliance for radioactive materials packages. Volume 2, Revision 17: Certificates of compliance

    International Nuclear Information System (INIS)

    1994-10-01

    This directory contains a Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs for Radioactive Materials Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  12. Sugammadex: An Update

    Directory of Open Access Journals (Sweden)

    Ezri Tiberiu

    2016-01-01

    Full Text Available The purpose of this update is to provide recent knowledge and debates regarding the use of sugammadex in the fields of anesthesia and critical care. The review is not intended to provide a comprehensive description of sugammadex and its clinical use.

  13. Supreme Court Update

    Science.gov (United States)

    Taylor, Kelley R.

    2009-01-01

    "Chief Justice Flubs Oath." "Justice Ginsburg Has Cancer Surgery." At the start of this year, those were the news headlines about the U.S. Supreme Court. But January 2009 also brought news about key education cases--one resolved and two others on the docket--of which school administrators should take particular note. The Supreme Court updates on…

  14. Update of telephone exchange

    CERN Multimedia

    2006-01-01

    As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation.We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

  15. Update of telephone exchange

    CERN Multimedia

    2006-01-01

    As part of the upgrade of telephone services, the CERN switching centre will be updated on Wednesday 14 June between 8.00 p.m. and midnight. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

  16. Update of telephone exchange

    CERN Multimedia

    2006-01-01

    As part of the upgrade of telephone services, the CERN switching centre will be updated on between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

  17. Update of telephone exchange

    CERN Multimedia

    2006-01-01

    As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

  18. [Cardiology update in 2016].

    Science.gov (United States)

    Gabus, Vincent; Tran, Van Nam; Regamey, Julien; Pascale, Patrizio; Monney, Pierre; Hullin, Roger; Vogt, Pierre

    2017-01-11

    In 2016 the European Society of Cardiology (ESC) published new guidelines. These documents update the knowledge in various fields such as atrial fibrillation, heart failure, cardiovascular prevention and dyslipidemia. Of course it is impossible to summarize these guidelines in detail. Nevertheless, we decided to highlight the major modifications, and to emphasize some key points that are especially useful for the primary care physician.

  19. OSATE Overview & Community Updates

    Science.gov (United States)

    2015-02-15

    update 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Delange /Julien 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK...main language capabilities Modeling patterns & model samples for beginners Error-Model examples EMV2 model constructs Demonstration of tools Case

  20. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-06-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

  1. Project Compliance with Enterprise Architecture

    NARCIS (Netherlands)

    Foorthuis, R.M.

    2012-01-01

    This research project set out to identify effective practices and models for working with projects that are required to comply with Enterprise Architecture (EA), and investigate the benefits and drawbacks brought about by compliance. Research methods used are canonical action research, a statistical

  2. ETHICS AND COMPLIANCE IN BUSINESS

    Directory of Open Access Journals (Sweden)

    ANDREESCU Nicoleta Alina

    2015-05-01

    Full Text Available In this paper, we have studied the evolution of the business ethics concept through the prism of definitions from some renowned authors in the field and through the approach model of the business ethics and by implementing it in the company level. We have found out that in the last 40 years this concept has evolved from a theoretical aspect, as well as a practical one. Companies are motivated to implement ethics and compliance programs in business so that they can manage the changes that come from society. If, until recently, all that mattered for a company was profit, in the last decades, the situation changed. In order to develop a durable business, it is essential to have a good reputation. Owning and implementing an ethics and compliance program in business has become an imperative for companies, regardless of their activity sector. The role of the compliance department becomes more pregnant in each company: the employees need safety, the existence of communication lines provides comfort. From the partners in business’ point of view, owning such a program is a necessity, a condition, and not conforming to the principles of business ethics can lead to the isolation of the company. The ethics and compliance programs in business are instruments that protect the company by implementing certain proactive identification mechanisms that ensure the development of an ethical organizational culture.

  3. Audit-based compliance control

    NARCIS (Netherlands)

    Cederquist, J.G.; Dimitrakos, T.; Corin, R.J.; Martinelli, F.; Ryan, P.Y.A.; Dekker, M.A.C.; Etalle, Sandro; Schneider, S.; den Hartog, Jeremy; Lenzini, Gabriele

    2007-01-01

    In this paper we introduce a new framework for controlling compliance to discretionary access control policies [Cederquist et al. in Proceedings of the International Workshop on Policies for Distributed Systems and Networks (POLICY), 2005; Corin et al. in Proceedings of the IFIP Workshop on Formal

  4. Context-aware compliance checking

    NARCIS (Netherlands)

    Werf, van der J.M.E.M.; Verbeek, H.M.W.; Aalst, van der W.M.P.; Barros, A.; Gal, A.; Kindler, E.

    2012-01-01

    Organizations face more and more the burden to show that their business is compliant with respect to many different boundaries. The activity of compliance checking is commonly referred to as auditing. As information systems supporting the organization’s business record their usage, process mining

  5. Clean Air Markets - Compliance Query Wizard

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides...

  6. 300 area TEDF permit compliance monitoring plan

    International Nuclear Information System (INIS)

    BERNESKI, L.D.

    1998-01-01

    This document presents the permit compliance monitoring plan for the 300 Area Treated Effluent Disposal Facility (TEDF). It addresses the compliance with the National Pollutant Discharge Elimination System (NPDES) permit and Department of Natural Resources Aquatic Lands Sewer Outfall Lease

  7. Mobile Source Emissions Regulatory Compliance Data Inventory

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Mobile Source Emissions Regulatory Compliance Data Inventory data asset contains measured summary compliance information on light-duty, heavy-duty, and non-road...

  8. 300 area TEDF permit compliance monitoring plan

    Energy Technology Data Exchange (ETDEWEB)

    BERNESKI, L.D.

    1998-11-20

    This document presents the permit compliance monitoring plan for the 300 Area Treated Effluent Disposal Facility (TEDF). It addresses the compliance with the National Pollutant Discharge Elimination System (NPDES) permit and Department of Natural Resources Aquatic Lands Sewer Outfall Lease.

  9. Mobile Source Emissions Regulatory Compliance Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Engine and Vehicle Compliance Certification and Fuel Economy Inventory contains measured emissions and fuel economy compliance information for all types of...

  10. Corporate compliance: framework and implementation.

    Science.gov (United States)

    Fowler, N

    1999-01-01

    The federal government has created numerous programs to combat fraud and abuse. The government now encourages healthcare facilities to have a corporate compliance program (CCP), a plan that reduces the chances that the facility will violate laws or regulations. A CCP is an organization-wide program comprised of a code of conduct and written policies, internal monitoring and auditing standards, employee training, feedback mechanisms and other features, all designed to prevent and detect violations of governmental laws, regulations and policies. It is a system or method ensuring that employees understand and will comply with laws that apply to what they do every day. Seven factors, based on federal sentencing guidelines, provide the framework for developing a CCP. First, a facility must establish rules that are reasonably capable of reducing criminal conduct. Second, high-level personnel must oversee the compliance effort. Third, a facility must use due care in delegating authority in the compliance initiative. Fourth, standards must be communicated effectively to employees, and fifth, a facility must take reasonable steps to achieve compliance. Sixth, standards must be enforced consistently across the organization and last, standards must be modified or changed for reported concerns, to ensure they are not repeated. PROMINA Health System, Inc. in Atlanta, Ga., designed a program to meet federal guidelines. It started with a self-assessment to define its areas or risk. Next, it created the internal structure and assigned organizational responsibility for running the CCP. PROMINA then developed standards of business and professional conduct, established vehicles of communication and trained employees on the standards. Finally, it continues to develop evidence of the program's effectiveness by monitoring and documenting its compliance activities.

  11. 14 CFR 26.49 - Compliance plan.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Compliance plan. 26.49 Section 26.49... Data for Repairs and Alterations § 26.49 Compliance plan. (a) Compliance plan. Except for applicants... January 11, 2008, each person identified in §§ 26.43, 26.45, and 26.47, must submit a compliance plan...

  12. GENDER AND ETHNICITY DIFFERENCES IN TAX COMPLIANCE

    OpenAIRE

    Jeyapalan Kasipillai; Hijattulah Abdul Jabbar

    2006-01-01

    The purpose of this study is to investigate whether gender and ethnicity differences occur in relation to tax compliance attitude and behavior. Prior studies on tax compliance have focused little on gender as a predictor of compliance. In Malaysia, ethnic background of a taxpayer could be a major determinant of tax compliance. A personal interview approach is used to obtain information from taxpayers in urban towns. A t-test suggests that males and females were found to have similar compliant...

  13. State regulatory issues in acid rain compliance

    International Nuclear Information System (INIS)

    Solomon, B.D.; Brick, S.

    1992-01-01

    This article discusses the results of a US EPA workshop for state regulators and commission staff on acid rain compliance concerns. The topics of the article include the results of market-based emissions control, how emissions trading is expected to reduce emissions, public utility commissions approval of compliance plans, the purposes of the workshop, market information, accounting issues, regulatory process and utility planning, multi-state compliance planning, and relationship to other compliance issues

  14. Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

    Science.gov (United States)

    Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

    Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.

  15. 42 CFR 124.503 - Compliance level.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance level. 124.503 Section 124.503 Public... Unable To Pay § 124.503 Compliance level. (a) Annual compliance level. Subject to the provisions of this... persons unable to pay if it provides for the fiscal year uncompensated services at a level not less than...

  16. 24 CFR 107.40 - Compliance meeting.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 107.40 Section... NONDISCRIMINATION AND EQUAL OPPORTUNITY IN HOUSING UNDER EXECUTIVE ORDER 11063 § 107.40 Compliance meeting. (a... allegedly in violation (respondent) shall be sent a Notice of Compliance Meeting and requested to attend a...

  17. 24 CFR 108.25 - Compliance meeting.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 108.25 Section... COMPLIANCE PROCEDURES FOR AFFIRMATIVE FAIR HOUSING MARKETING § 108.25 Compliance meeting. (a) Scheduling meeting. If an applicant fails to comply with requirements under § 108.15 or § 108.20 or it appears that...

  18. 22 CFR 209.6 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 209.6 Section 209.6... § 209.6 Compliance information. (a) Cooperation and assistance. The Administrator shall to the fullest... and accurate compliance reports at such times, and in such form and containing such information, as...

  19. Type B Package Radioactive Material Contents Compliance

    International Nuclear Information System (INIS)

    HENSEL, STEVE

    2006-01-01

    Implementation of packaging and transportation requirements can be subdivided into three categories; contents compliance, packaging closure, and transportation or logistical compliance. This paper addresses the area of contents compliance within the context of regulations, DOE Orders, and appropriate standards. Common practices and current pitfalls are also discussed

  20. Compliance assurance in the safe transport of radioactive materials in Switzerland

    International Nuclear Information System (INIS)

    Smith, L.

    1994-01-01

    Quality Assurance in the transport of radioactive materials (RAM) has been a legal requirement in Switzerland since 1 January 1990. Some four years later, Switzerland is well on the way to having a comprehensive system of Compliance Assurance covering the transport of RAM. By the end of 1994 Compliance Assurance will be fully operational with regard to nuclear fuel cycle shipments which account for over 90% of all radioactivity transported in Switzerland. Compliance Assurance has been delayed in Switzerland for non-fuel-cycle radioactive material shipments. This has been due to the need to modify the legal infrastructure for the relevant supervisory authorities. Nevertheless, it is hoped to have Compliance Assurance related to Radiation Units (large sources in Type B packages) operational before the end of 1994. Systematic progress is being made regarding Compliance Assurance relating to the movement of smaller sources. This involves a very large number of smaller organisations and will take some time to become routine. (author)

  1. Quality assurance plan for Final Waste Forms project in support of the development, demonstration, testing and evaluation efforts associated with the Oak Ridge reservation`s LDR/FFCA compliance

    Energy Technology Data Exchange (ETDEWEB)

    Gilliam, T.M.; Mattus, C.H.

    1994-07-01

    This quality assurance project plan specifies the data quality objectives for Phase I of the Final Waste Forms Project and defines specific measurements and processes required to achieve those objectives. Although the project is funded by the U.S. Department of Energy (DOE), the ultimate recipient of the results is the U.S. Environmental Protection Agency (EPA). Consequently, relevant quality assurance requirements from both organizations must be met. DOE emphasizes administrative structure to ensure quality; EPA`s primary focus is the reproducibility of the generated data. The ten criteria of DOE Order 5700.6C are addressed in sections of this report, while the format used is that prescribed by EPA for quality assurance project plans.

  2. Sequence History Update Tool

    Science.gov (United States)

    Khanampompan, Teerapat; Gladden, Roy; Fisher, Forest; DelGuercio, Chris

    2008-01-01

    The Sequence History Update Tool performs Web-based sequence statistics archiving for Mars Reconnaissance Orbiter (MRO). Using a single UNIX command, the software takes advantage of sequencing conventions to automatically extract the needed statistics from multiple files. This information is then used to populate a PHP database, which is then seamlessly formatted into a dynamic Web page. This tool replaces a previous tedious and error-prone process of manually editing HTML code to construct a Web-based table. Because the tool manages all of the statistics gathering and file delivery to and from multiple data sources spread across multiple servers, there is also a considerable time and effort savings. With the use of The Sequence History Update Tool what previously took minutes is now done in less than 30 seconds, and now provides a more accurate archival record of the sequence commanding for MRO.

  3. Compliance Groundwater Monitoring of Nonpoint Sources - Emerging Approaches

    Science.gov (United States)

    Harter, T.

    2008-12-01

    Groundwater monitoring networks are typically designed for regulatory compliance of discharges from industrial sites. There, the quality of first encountered (shallow-most) groundwater is of key importance. Network design criteria have been developed for purposes of determining whether an actual or potential, permitted or incidental waste discharge has had or will have a degrading effect on groundwater quality. The fundamental underlying paradigm is that such discharge (if it occurs) will form a distinct contamination plume. Networks that guide (post-contamination) mitigation efforts are designed to capture the shape and dynamics of existing, finite-scale plumes. In general, these networks extend over areas less than one to ten hectare. In recent years, regulatory programs such as the EU Nitrate Directive and the U.S. Clean Water Act have forced regulatory agencies to also control groundwater contamination from non-incidental, recharging, non-point sources, particularly agricultural sources (fertilizer, pesticides, animal waste application, biosolids application). Sources and contamination from these sources can stretch over several tens, hundreds, or even thousands of square kilometers with no distinct plumes. A key question in implementing monitoring programs at the local, regional, and national level is, whether groundwater monitoring can be effectively used as a landowner compliance tool, as is currently done at point-source sites. We compare the efficiency of such traditional site-specific compliance networks in nonpoint source regulation with various designs of regional nonpoint source monitoring networks that could be used for compliance monitoring. We discuss advantages and disadvantages of the site vs. regional monitoring approaches with respect to effectively protecting groundwater resources impacted by nonpoint sources: Site-networks provide a tool to enforce compliance by an individual landowner. But the nonpoint source character of the contamination

  4. Penerapan Jurnalistik Televisi Pada Program School Update Di Riau Televisi

    OpenAIRE

    ", Suyanto; Putri, Vika Gusria

    2015-01-01

    School update program is the only Riau Television progam which its production procces done by students. School update program present as a medium of creativity learning and development of Pekanbaru Senior High School in term of early television journalism implementation to create a young and high quality journalist. The implementation of this television journalism done through basic television journalism training program and practice on the field. The aim of this research is to determine how ...

  5. Annual Pension Fund Update

    CERN Multimedia

    Pension Fund

    2011-01-01

    All members and beneficiaries of the Pension Fund are invited to attend the Annual Pension Fund Update to be held in the CERN Council Chamber on Tuesday 20 September 2011 from 10-00 to 12-00 a.m. Copies of the 2010 Financial Statements are available from departmental secretariats. Coffee and croissants will be served prior to the meeting as of 9-30 a.m.

  6. Medi SPICE : an update

    OpenAIRE

    Mc Caffery, Fergal; Dorling, Alec; Casey, Valentine

    2010-01-01

    peer-reviewed This paper provides an update on the development of a software process assessment and improvement model (Medi SPICE) specifically for the medical device industry. The development of Medi SPICE was launched at the SPICE 2009 Conference. Medi SPICE will consist of a Process Reference Model and a Process Assessment Model. The Medi SPICE Process Assessment Model will be used to perform conformant assessments of the software process capability of medical device suppliers in accord...

  7. Ontario Hydro's DSP update

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Ontario Hydro's Demand/Supply Plan (DSP), the 25 year plan which was submitted in December 1989, is currently being reviewed by the Environmental Assessment Board (EAB). Since 1989 there have been several changes which have led Ontario Hydro to update the original Demand/Supply Plan. This information sheet gives a quick overview of what has changed and how Ontario Hydro is adapting to that change

  8. Directory of certificates of compliance for radioactive materials packages. Certificates of compliance. Volume 2. Revision 9

    International Nuclear Information System (INIS)

    1986-10-01

    This directory contains a Summary Report of NRC Approved Packages (Volume 1). Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volumes 3). The purpose of this directory is make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure them that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR 71.12 does not authorize the receipt, possession, use or transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR 30 to 36, 40, 50, or 70

  9. Directory of Certificates of Compliance for Radioactive Materials Packages. Certificates of Compliance. Volume 2, Revision 8

    International Nuclear Information System (INIS)

    1985-10-01

    This directory contains a Summary Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure them that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note that the general license of 10 CFR 71.12 does not authorize the receipt, possession, use or transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, 50, or 70

  10. Directory of certificates of compliance for radioactive materials packages: certificates of compliance. Volume 2, Revision 7

    International Nuclear Information System (INIS)

    1984-11-01

    This directory contains a Summary Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Summary Report of NRC Approved Quality Assurance Programs for Radioactive Material Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory. The Summary Report includes a listing of all users of each package design prior to the publication date of the directory. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program. Copies of the current approval may be obtained from the US Nuclear Regulatory Commission Public Document Room files (see Docket No. listed on each certificate) at 1717 H Street, Washington, DC 20555. Note the general license of 10 CFR 71.12 does not authorize the receipt, possession, use or transfer of byproduct source, or special nuclear material; such authorization must be obtained pursuant to 10 CFR Parts 30 to 36, 40, 50, or 70

  11. Laboratory quality improvement in Thailand's northernmost provinces.

    Science.gov (United States)

    Kanitvittaya, S; Suksai, U; Suksripanich, O; Pobkeeree, V

    2010-01-01

    In Thailand nearly 1000 public health laboratories serve 65 million people. A qualified indicator of a good quality laboratory is Thailand Medical Technology Council certification. Consequently, Chiang Rai Regional Medical Sciences Center established a development program for laboratory certification for 29 laboratories in the province. This paper seeks to examine this issue. The goal was to improve laboratory service quality by voluntary participation, peer review, training and compliance with standards. The program consisted of specific activities. Training and workshops to update laboratory staffs' quality management knowledge were organized. Staff in each laboratory performed a self-assessment using a standard check-list to evaluate ten laboratory management areas. Chiang Rai Regional Medical Sciences Center staff supported the distribution of quality materials and documents. They provided calibration services for laboratory equipment. Peer groups performed an internal audit and successful laboratories received Thailand Medical Technology Council certification. By December 2007, eight of the 29 laboratories had improved quality sufficiently to be certified. Factors that influenced laboratories' readiness for quality improvement included the number of staff, their knowledge, budget and staff commitment to the process. Moreover, the support of each hospital's laboratory working group or network was essential for success. There was no clear policy for supporting the program. Laboratories voluntarily conducted quality management using existing resources. A bottom-up approach to this kind of project can be difficult to accomplish. Laboratory professionals can work together to illustrate and highlight outcomes for top-level health officials. A top-down, practical approach would be much less difficult to implement. Quality certification is a critical step for laboratory staff, which also encourages them to aspire to international quality standards like ISO. The

  12. Motivation for Compliance with Environmental Regulation

    DEFF Research Database (Denmark)

    Winter, Søren; May, Peter J.

    2001-01-01

    A combination of calculated, normative, and social motivations as well as awareness of rules and capacity to comply are thought to foster compliance with regulations. Hypotheses about these factors were tested with data concerning Danish farmers’ compliance with agro-environmental regulations....... Three key findings emerge: that farmers’ awareness of rules plays a critical role; that normative and social motivations are as influential as calculated motivations in enhancing compliance; and that inspectors’ enforcement style affects compliance differently from that posited in much of the literature...... compliance with social and environmental regulations....

  13. [Insufficient medication compliance in Parkinson's disease].

    Science.gov (United States)

    Aerts, Marjolein B; van der Eijk, Martijn; Kramers, Kees; Bloem, Bastiaan R

    2011-01-01

    Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of symptoms. However, recent research has revealed that PD patients demonstrate poor medication compliance. Poor medication compliance is particularly undesirable for patients with PD because regular intake of medication is required for optimal treatment effect. Possible ways of improving medication compliance are pharmacotherapeutic measures and behavioural interventions. Modern methods of communication (text message reminders) and 'smart' pill dispensers may be beneficial, but the advantages of such interventions have not yet been scientifically studied.

  14. Stuttering: Clinical and research update.

    Science.gov (United States)

    Perez, Hector R; Stoeckle, James H

    2016-06-01

    To provide an update on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. The MEDLINE and Cochrane databases were searched for past and recent studies on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Most recommendations are based on small studies, limited-quality evidence, or consensus. Stuttering is a speech disorder, common in persons of all ages, that affects normal fluency and time patterning of speech. Stuttering has been associated with differences in brain anatomy, functioning, and dopamine regulation thought to be due to genetic causes. Attention to making a correct diagnosis or referral in children is important because there is growing consensus that early intervention with speech therapy for children who stutter is critical. For adults, stuttering can be associated with substantial psychosocial morbidity including social anxiety and low quality of life. Pharmacologic treatment has received attention in recent years, but clinical evidence is limited. The mainstay of treatment for children and adults remains speech therapy. A growing body of research has attempted to uncover the pathophysiology of stuttering. Referral for speech therapy remains the best option for children and adults. Copyright© the College of Family Physicians of Canada.

  15. 300 Area TEDF NPDES Permit Compliance Monitoring Plan

    International Nuclear Information System (INIS)

    Loll, C.M.

    1994-01-01

    This monitoring plan describes the activities and methods that will be employed at the 300 Area Treated Effluent Disposal Facility (TEDF) in order to ensure compliance with the National Discharge Elimination System (NPDES) permit. Included in this document are a brief description of the project, the specifics of the sampling effort, including the physical location and frequency of sampling, the support required for sampling, and the Quality Assurance (QA) protocols to be followed in the sampling procedures

  16. Narratives of empowerment and compliance

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2013-01-01

    Purpose: New technologies enable new forms of patient participation in health care. Thearticle discusses whether communication in online patient support groups is a source ofindividual as well as collective empowerment or to be understood within the tradition ofcompliance. The discussion is based...... of empowerment and compliance in patient care. On a collective level, the site isempowering the individual users to comply with ‘doctor’s recommendations’ as a group....

  17. Short- and long-term effects of clinical audits on compliance with procedures in CT scanning

    International Nuclear Information System (INIS)

    Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

    2016-01-01

    To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific ''paediatric brain CT'' procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from <0.001 to 0.031) in both hospitals and remained unchanged during the third audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. (orig.)

  18. [Resistant hypertension: An update].

    Science.gov (United States)

    Renna, N F

    2018-02-04

    An estimated 10% to 20% of hypertensive patients could be considered resistant to treatment (RH). These are patients who are not controlled using three drugs, at the maximum tolerated doses, including a diuretic, as well as those with high blood pressure controlled using four or more drugs. The term is used to identify patients that might benefit from special diagnostic and/or therapeutic consideration. The term 'refractory hypertension' has recently been proposed as a novel phenotype of antihypertensive failure. It refers to patients whose blood pressure cannot be controlled with maximum treatment. The first studies of this phenotype indicate that it is rare and affects less than 5% of patients with RH. Adherence to or compliance with medical treatment is key to defining resistant hypertension. Closer attention has been paid to clinical and experimental research since the first scientific statement for the diagnosis, assessment and treatment of RH from the American Heart Association, and in the European guidelines, was published in 2008. This review will set out the concepts relating to prevalence, prognosis and compliance and cover the latest developments on this subject. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Amblyopia therapy: an update.

    Science.gov (United States)

    Stewart, Catherine E; Moseley, Merrick J; Fielder, Alistair R

    2011-09-01

    We review the findings of trials of mainstay amblyopia treatment conducted within the last 5 years. These have confirmed that an initial period of full-time refractive correction is beneficial in all types of amblyopia. Adopting this practice may allow up to 30% of children to avoid any further treatment. Studies that have investigated the role of atropine occlusion as a first-line treatment for amblyopia have shown "weekend atropine" to be as effective as patching for children with both moderate and severe amblyopia. Where patching is prescribed, 2-4 hours/day of occlusion appears sufficient to provide an optimum outcome for the majority of children, although those over 6 years tend to require a larger dose to achieve best outcome, their amblyopia being more resistant to treatment. Educational interventions such as cartoons and written and video explanations of treatment aimed at improving compliance appear to raise it to a therapeutic level in those who may otherwise have poor compliance or drop out from treatment. Formal, evidence-based practice guidelines for the management of amblyopia have emerged although their adoption by practitioners, at least in the United Kingdom, has been questioned.

  20. An application of ETICS Co-Scheduling Mechanism to Interoperability and Compliance Validation of Grid Services

    CERN Document Server

    Ronchieri, Elisabetta; Diez-andino Sancho, Guillermo; DI Meglio, Alberto; Marzolla, Moreno

    2008-01-01

    Grid software projects require infrastructures in order to evaluate interoperability with other projects and compliance with predefined standards. Interoperability and compliance are quality attributes that are expected from all distributed projects. ETICS is designed to automate the investigation of this kind of problems. It integrates well-established procedures, tools and resources in a coherent framework and adaptes them to the special needs of these projects. Interoperability and compliance to standards are important quality attributes of software developed for Grid environments where many different parts of an interconnected system have to interact. Compliance to standard is one of the major factors in making sure that interoperating parts of a distributed system can actually interconnect and exchange information. Taking the case of the Grid environment (Foster and Kesselman, 2003), most of the projects that are developing software have not reached the maturity level of other communities yet and have di...

  1. A compliance testing program for diagnostic X-ray equipment

    International Nuclear Information System (INIS)

    Hutchinson, D.E.; Cobb, B.J.; Jacob, C.S.

    1999-01-01

    Compliance testing is nominally that part of a quality assurance program dealing with those aspects of X-ray equipment performance that are subject to radiation control legislation. Quality assurance programs for medical X-ray equipment should be an integral part of the quality culture in health care. However while major hospitals and individual medical centers may implement such programs with some diligence, much X-ray equipment can remain unappraised unless there is a comprehensive regulatory inspection program or some form of compulsion on the equipment owner to implement a testing program. Since the late 1950s all X-ray equipment in the State of Western Australia has been inspected by authorized officers acting on behalf of the Radiological Council, the regulatory authority responsible for administration of the State's Radiation Safety Act. However, economic constraints, coupled with increasing X-ray equipment numbers and a geographically large State have significantly affected the inspection rate. Data available from inspections demonstrate that regular compliance and performance checks are essential in order to ensure proper performance and to minimize unnecessary patient and operator dose. To ensure that diagnostic X-ray equipment complies with accepted standards and performance criteria, the regulatory authority introduced a compulsory compliance testing program for all medical, dental and chiropractic diagnostic X-ray equipment effective from 1 January 1997

  2. Traceability and retrievability: Documentation, the bridge from science to compliance

    International Nuclear Information System (INIS)

    Warner, P.J.

    1997-01-01

    In this day of regulatory compliance, the fact that good science was practiced and documented is, in and of itself, not enough to assure a successful licensing or permitting result. A new level of documentation, that clearly walks a non-project reviewer through the traceability of all activities and decisions is required for successful acceptance of scientific results. Compliance reviewers (whether the Nuclear Regulatory Commission (NRC), Environmental Protection Agency (EPA), etc.) expect to verify the results of the scientific and program activities without the physical presence of the person or persons that conducted the activity. Traceability of activities and associated decisions through the retrieval of all associated records is a must. This presentation is based on lessons learned from the various quality assurance (QA) audits and program reviews of Sandia National Laboratories, Nuclear Waste Management Programs Center, scientific and programmatic documentation. The authors build a bridge from science to compliance from lessons learned. Here now is a somewhat fictional rendition of actual scientific testing and compliance support activities

  3. Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance

    Directory of Open Access Journals (Sweden)

    Guenter Karl Schiepek

    2016-05-01

    Full Text Available AbstractObjective. The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients’ compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific surveys. Methods. The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic. Results. We found high compliance rates (mean: 78.3%, median: 89.4% amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders. Conclusion. The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities.

  4. Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance

    Science.gov (United States)

    Schiepek, Günter; Aichhorn, Wolfgang; Gruber, Martin; Strunk, Guido; Bachler, Egon; Aas, Benjamin

    2016-01-01

    Objective: The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients' compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific) surveys. Methods: The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic. Results: We found high compliance rates (mean: 78.3%, median: 89.4%) amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders. Conclusion: The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for the assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities). PMID:27199837

  5. Using behavioural insights for citizen compliance and cooperation

    Directory of Open Access Journals (Sweden)

    Jane Robb

    2017-03-01

    Full Text Available In recent years, public agencies have frequently deployed behavioural insights to generate benefits for society, through encouraging citizens to comply with official requests, and more generally encouraging them to cooperate with public agencies to help deliver outcomes of collective benefit. In parallel, there has been a large increase in the amount and quality of the research evidence available on behavioural public policy. This review takes two contrasting areas where behavioural insights have been used: tax collection where government policy is compulsory (i.e. requiring compliance, and energy use where social objectives are non-compulsory, and achieved more by persuasion and encouragement. Processes of modifying and changing behaviour require different approaches whether the change is deemed necessary by the state or not. In taxes, the sole use of enforcement is rarely efficacious, whereas increasing the uncertainty of follow-up and audit increases compliance. Offering discounts for energy bills appears to be an effective method for achieving cooperation. However, the use of social norms and increased information and professional advice is effective for both compulsory and non-compulsory areas of compliance and cooperation. This has important implications for policymakers, who may be seeking effective methods of encouraging behaviour change. While there are differences in approaches for compulsory and non-compulsory areas of policy, there may be areas that move from non-statutory to statutory in the future. In this case, the development of desired social norms appears to be the most effective method of ensuring overall compliance.

  6. Update in women's health.

    Science.gov (United States)

    Ganschow, Pamela S; Jacobs, Elizabeth A; Mackinnon, Jennifer; Charney, Pamela

    2009-06-01

    The aim of this clinical update is to summarize articles and guidelines published in the last year with the potential to change current clinical practice as it relates to women's health. We used two independent search strategies to identify articles relevant to women's health published between March 1, 2007 and February 29, 2008. First, we reviewed the Cochrane Database of Systematic Reviews and journal indices from the ACP Journal Club, Annals of Internal Medicine, Archives of Internal Medicine, British Medical Journal, Circulation, Diabetes, JAMA, JGIM, Journal of Women's Health, Lancet, NEJM, Obstetrics and Gynecology, and Women's Health Journal Watch. Second, we performed a MEDLINE search using the medical subject heading term "sex factors." The authors, who all have clinical and/or research experience in the area of women's health, reviewed all article titles, abstracts, and, when indicated, full publications. We excluded articles related to obstetrical aspects of women's health focusing on those relevant to general internists. We had two acceptance criteria, scientific rigor and potential to impact women's health. We also identified new and/or updated women's health guidelines released during the same time period. We identified over 250 publications with potential relevance to women's health. Forty-six articles were selected for presentation as part of the Clinical Update, and nine were selected for a more detailed discussion in this paper. Evidence-based women's health guidelines are listed in Table 1. Table 1 Important Women's Health Guidelines in 2007-2008: New or Updated Topic Issuing organization Updated recommendations and comments Mammography screening in women 40-4917 ACP Individualized risk assessment and informed decision making should be used to guide decisions about mammography screening in this age group. To aid in the risk assessment, a discussion of the risk factors, which if present in a woman in her 40s increases her risk to above that of an

  7. Non-compliance with a postmastectomy radiotherapy guideline: Decision tree and cause analysis

    OpenAIRE

    Razavi, Amir R; Gill, Hans; Åhlfeldt, Hans; Shahsavar, Nosrat

    2008-01-01

    Background: The guideline for postmastectomy radiotherapy (PMRT), which is prescribed to reduce recurrence of breast cancer in the chest wall and improve overall survival, is not always followed. Identifying and extracting important patterns of non-compliance are crucial in maintaining the quality of care in Oncology. Methods: Analysis of 759 patients with malignant breast cancer using decision tree induction (DTI) found patterns of non-compliance with the guideline. The PMRT guideline was us...

  8. Citizenship and Power in an Agent-based Model of Tax Compliance with Public Expenditure

    OpenAIRE

    Paolo Pellizzari; Dino Rizzi

    2012-01-01

    In this paper we present a model of tax compliance with heterogeneous agents who maximize their individual utility based on income and the conjectured level of per capita public expenditure. We formally include psychological drivers in this model. These drivers affect individual behavior, such as risk aversion, together with appreciation of public expenditure, expectations about peers� compliance and a natural inclination to comply, all of which we summarize in a quality termed �citizenship�....

  9. UPDATING UNDER RISK CONDITION

    Directory of Open Access Journals (Sweden)

    VĂDUVA CECILIA ELENA

    2018-02-01

    Full Text Available The foundation for future firm development is investment. Agents have a risk aversion requiring higher returns as the risks associated with the project will be greater. The investment decision determines the market firm's affirmation, increasing the market share, dominating the market. Making an investment at a certain point will determine certain cash flows throughout the life of the project, and a residual value can be obtained when it is taken out of service. The flows and payments for the investment project can be more easily tracked if we are proposing a constant update rate. We will be able to analyze, based on various factors, three techniques for determining the discount rate for investment projects: the opportunity cost, the risk-free rate, and a series of risk premiums, the weighted average cost of capital. People without financial training make value judgments for investment projects based on other market opportunities, comparing the returns that any investment offers to other pay options. An investor has a sum of money he wants to make - if he does not invest in a project, he will invest in another, that will bring him a certain amount of money, choosing the most advantageous project by comparison. All projects are characterized by identical risks, and the agents are considered indifferent to the risks. The answer given by financial theory and practice to the disadvantage of rates in the opportunity cost category is the discount rate calculated as a sum of the risk-free rate and a risk premium, defining the risk as a factor whose action may cause a possible decrease in cash of the available flows. Higher objectivity is presented by the opportunity cost update rates of update because it refers to known variables but cannot be perfectly matched to the performance of the investment process.

  10. WIMS Library updating

    International Nuclear Information System (INIS)

    Ravnik, M.; Trkov, A.; Holubar, A.

    1992-01-01

    At the end of 1990 the WIMS Library Update Project (WLUP) has been initiated at the International Atomic Energy Agency. The project was organized as an international research project, coordinated at the J. Stefan Institute. Up to now, 22 laboratories from 19 countries joined the project. Phase 1 of the project, which included WIMS input optimization for five experimental benchmark lattices, has been completed. The work presented in this paper describes also the results of Phase 2 of the Project, in which the cross sections based on ENDF/B-IV evaluated nuclear data library have been processed. (author) [sl

  11. Fusion Energy Update

    International Nuclear Information System (INIS)

    Whitson, M.O.

    1982-01-01

    Fusion Energy Update (CFU) provides monthly abstracting and indexing coverage of current scientific and technical reports, journal articles, conference papers and proceedings, books, patents, theses, and monographs for all sources on fusion energy. All information announced in CFU, plus additional backup information, is included in the energy information data base of the Department of Energy's Technical Information Center. The subject matter covered by CFU includes plasma physics, the physics and engineering of blankets, magnet coils and fields, power supplies and circuitry, cooling systems, fuel systems, radiation hazards, power conversion systems, inertial confinement systems, and component development and testing

  12. Astrophysics Update 2

    CERN Document Server

    Mason, John W

    2006-01-01

    "Astrophysics Updates" is intended to serve the information needs of professional astronomers and postgraduate students about areas of astronomy, astrophysics and cosmology that are rich and active research spheres. Observational methods and the latest results of astronomical research are presented as well as their theoretical foundations and interrelations. The contributed commissioned articles are written by leading exponents in a format that will appeal to professional astronomers and astrophysicists who are interested in topics outside their own specific areas of research. This collection of timely reviews may also attract the interest of advanced amateur astronomers seeking scientifically rigorous coverage.

  13. Context updates are hierarchical

    Directory of Open Access Journals (Sweden)

    Anton Karl Ingason

    2016-10-01

    Full Text Available This squib studies the order in which elements are added to the shared context of interlocutors in a conversation. It focuses on context updates within one hierarchical structure and argues that structurally higher elements are entered into the context before lower elements, even if the structurally higher elements are pronounced after the lower elements. The crucial data are drawn from a comparison of relative clauses in two head-initial languages, English and Icelandic, and two head-final languages, Korean and Japanese. The findings have consequences for any theory of a dynamic semantics.

  14. Shipment security update - 2003

    International Nuclear Information System (INIS)

    Patterson, John; Anne, Catherine

    2003-01-01

    At the 2002 RERTR, NAC reported on the interim measures taken by the U.S. Nuclear Regulatory Commission to enhance the security afforded to shipments of spent nuclear fuel. Since that time, there have been a number of additional actions focused on shipment security including training programs sponsored by the U.S. Department of Transportation and the Electric Power Research Council, investigation by the Government Accounting Office, and individual measures taken by shippers and transportation agents. The paper will present a status update regarding this dynamic set of events and provide an objective assessment of the cost, schedule and technical implications of the changing security landscape. (author)

  15. CESM/CAM5 improvement and application: comparison and evaluation of updated CB05_GE and MOZART-4 gas-phase mechanisms and associated impacts on global air quality and climate

    Science.gov (United States)

    He, J.; Zhang, Y.; Tilmes, S.; Emmons, L.; Lamarque, J.-F.; Glotfelty, T.; Hodzic, A.; Vitt, F.

    2015-12-01

    Atmospheric chemistry plays a key role in determining the amounts and distributions of oxidants and gaseous precursors that control the formation of secondary gaseous and aerosol pollutants; all of those species can interact with the climate system. To understand the impacts of different gas-phase mechanisms on global air quality and climate predictions, in this work, a comprehensive comparative evaluation is performed using the Community Atmosphere Model (CAM) Version 5 with comprehensive tropospheric and stratospheric chemistry (CAM5-chem) within the Community Earth System Model (CESM) with the two most commonly used gas-phase chemical mechanisms: the 2005 Carbon Bond mechanism with Global Extension (CB05_GE) and the Model of OZone and Related chemical Tracers version 4 (MOZART-4) mechanism with additional updates (MOZART-4x). MOZART-4x and CB05_GE use different approaches to represent volatile organic compounds (VOCs) and different surrogates for secondary organic aerosol (SOA) precursors. MOZART-4x includes a more detailed representation of isoprene chemistry compared to CB05_GE. CB05_GE includes additional oxidation of SO2 by O3 over the surface of dust particles, which is not included in MOZART-4x. The results show that the two CAM5-chem simulations with CB05_GE and MOZART-4x predict similar chemical profiles for major gases (e.g., O3, CO, and NOx) compared to the aircraft measurements, with generally better agreement for NOy profiles by CB05_GE than MOZART-4x. The concentrations of SOA at four sites in the continental US (CONUS) and organic carbon (OC) over the IMPROVE sites are well predicted by MOZART-4x (with normalized mean biases (NMBs) of -1.9 and 2.1 %, respectively) but moderately underpredicted by CB05_GE (with NMBs of -23.1 and -20.7 %, respectively). This is mainly due to the higher biogenic emissions and OH levels simulated with MOZART-4x than with CB05_GE. The concentrations of OC over Europe are largely underpredicted by both MOZART-4x and CB05

  16. Compliance management and corporate governance; Compliance Management und Corporate Governance

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Uwe [Stadt Frankfurt am Main (Germany); Alsheimer, Constantin; Kassebohm, Kristian; Reutler, Susanne [Mainova AG, Frankfurt (Germany)

    2009-08-15

    Starting in the year 2009, numerous changes in the financial system and accountancy a well as in the corporate law come into effect for enterprises. Thereby, the requirements substantially are intensified to their corporate governance. The actual well-known reproaches of bribery, corruption and injuries of data protection intensify the pressure on executive committees and supervisory boards in order to meet normative and ethical requirements. All the more is valid for power suppliers whose reputation can already carry damage out with the first suspicion. Already in 2008, Mainova AG (Frnkfurt/Main, Federal Republic of Germany) implemented a compliance management.

  17. WIMS Library updating

    Energy Technology Data Exchange (ETDEWEB)

    Ravnik, M; Trkov, A [Inst. Jozef Stefan, Ljubljana (Slovenia); Holubar, A [Ustav Jaderneho Vyzkumu CSKAE, Rez (Serbia and Montenegro)

    1992-07-01

    At the end of 1990 the WIMS Library Update Project (WLUP) has been initiated at the International Atomic Energy Agency. The project was organized as an international research project, coordinated at the J. Stefan Institute. Up to now, 22 laboratories from 19 countries joined the project. Phase 1 of the project, which included WIMS input optimization for five experimental benchmark lattices, has been completed. The work presented in this paper describes also the results of Phase 2 of the Project, in which the cross sections based on ENDF/B-IV evaluated nuclear data library have been processed. (author) [Slovenian] Konec 1990 se je na Mednarodni agenciji za atomsko energijo zacel projekt obnove knjiznice presekov programa WIMS (WIMS Library Updating Project, WLUP). V projektu sodeluje 22 laboratorijev iz 19 drzav, koordiniramo pa ga na Institutu Jozef Stefan. Doslej je koncana faza 1 tega projekta, ki obsega optimizacijo vhodnega modela programa WIMS za pet eksperimentalnih testnih problemov. Podani so tudi rezultati faze 2, v kateri so se procesirali preseki na osnovi ENDF/B-IV datoteke. (author)

  18. Low-Activity Waste Feed Data Quality Objectives

    Energy Technology Data Exchange (ETDEWEB)

    MJ Truex; KD Wiemers

    1998-12-11

    This document describes characterization requirements for the Tank Waste Remediation System (TWRS) Waste Disposal Program's privatization efforts in support of low-activity waste (LAW) treatment and immobilization, This revised Data Quality Objective (DQO) replaces earlier documents (PNNL 1997; DOE-W 1998zq Wiemers 1996). Revision O of this DQO was completed to meet Tri-Party Agreement (TPA) target milestone M-60-14-TO1. Revision 1 updates the data requirements based on the contract issued `August 1998 (DOE-RL 1998b). In addition, sections of Revision O pertaining to "environmental planning" were not acceptable to the Washington State Department of Ecology (Ecology) and have been removed. Regulatory compliance for TWRS Privatization is being addressed in a separate DQO (Wiemers et al. 1998). The Project Hanford Management Contract (PHMC) Contractors and the private contractor may elect to complete issue-specific DQOS to accommodate their individual work scope.

  19. Compliance with adjuvant treatment guidelines in endometrial cancer: room for improvement in high risk patients.

    Science.gov (United States)

    Eggink, F A; Mom, C H; Boll, D; Ezendam, N P M; Kruitwagen, R F P M; Pijnenborg, J M A; van der Aa, M A; Nijman, H W

    2017-08-01

    Compliance of physicians with guidelines has emerged as an important indicator for quality of care. We evaluated compliance of physicians with adjuvant therapy guidelines for endometrial cancer patients in the Netherlands in a population-based cohort over a period of 10years. Data from all patients diagnosed with endometrial cancer between 2005 and 2014, without residual tumor after surgical treatment, were extracted from the Netherlands Cancer Registry (N=14,564). FIGO stage, grade, tumor type and age were used to stratify patients into risk groups. Possible changes in compliance over time and impact of compliance on survival were assessed. Patients were stratified into low/low-intermediate (52%), high-intermediate (21%) and high (20%) risk groups. Overall compliance with adjuvant therapy guidelines was 85%. Compliance was highest in patients with low/low-intermediate risk (98%, no adjuvant therapy indicated). The lowest compliance was determined in patients with high risk (61%, external beam radiotherapy with/without chemotherapy indicated). Within this group compliance decreased from 64% in 2005-2009 to 57% in 2010-2014. In high risk patients with FIGO stage III serous disease compliance was 55% (chemotherapy with/without radiotherapy indicated) and increased from 41% in 2005-2009 to 66% in 2010-2014. While compliance of physicians with adjuvant therapy guidelines is excellent in patients with low and low-intermediate risk, there is room for improvement in high risk endometrial cancer patients. Eagerly awaited results of ongoing randomized clinical trials may provide more definitive guidance regarding adjuvant therapy for high risk endometrial cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Vanilla Teaching as a Rational Choice: The Impact of Research and Compliance on Teacher Development

    Science.gov (United States)

    Harland, Tony; Wald, Navé

    2018-01-01

    This paper examines the proposition that the quality of university teaching in the research-intensive university is affected by various compliance demands on academic work that are meant to either enhance or be complementary to teaching. These include holding academics to account for the quality of both research and teaching. Our research aims to…

  1. Directory of Certificates of Compliance for Radioactive Materials Packages

    International Nuclear Information System (INIS)

    1993-10-01

    This directory contains Certificates of Compliance (Volume 2), for NRC Approved Packages. The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, is applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  2. Directory of certificates of compliance for radioactive materials packages

    International Nuclear Information System (INIS)

    1991-10-01

    This directory contains Certificates of Compliance (Volume 2) for Radioactive Materials Packages. The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12, it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  3. Management of pediatric keratoconus - Evolving role of corneal collagen cross-linking: An update

    Directory of Open Access Journals (Sweden)

    Vardhaman P Kankariya

    2013-01-01

    Full Text Available Pediatric keratoconus demonstrates several distinctive management issues in comparison with adult keratoconus with respect to under-diagnosis, poor compliance and modifications in treatment patterns. The major concerns comprise of the accelerated progression of the disease in the pediatric age group and management of co-morbidities such as vernal keratoconjuntivitis. Visual impairment in pediatric patients may affect social and educational development and overall negatively impact their quality of life. The treatment algorithm between adults and pediatric keratoconus has been similar; comprising mainly of visual rehabilitation with spectacles, contacts lenses (soft or rigid and keratoplasty (lamellar or penetrating depending on the stage of the disease. There is a paradigm shift in the management of keratoconus, a new treatment modality, corneal collagen crosslinking (CXL, has been utilized in adult keratoconic patients halting the progression of the disease. CXL has been utilized for over a 10 year period and based on the evidence of efficacy and safety in the adult population; this treatment has been recently utilized in management of pediatric keratoconus. This article will present an update about current management of pediatric keratoconus with special focus on CXL in this age group.

  4. Evaluation of Lower East Fork Poplar Creek Mercury Sources - Model Update

    Energy Technology Data Exchange (ETDEWEB)

    Ketelle, Richard [East Tennessee Technology Park (ETTP), Oak Ridge, TN (United States); Brandt, Craig C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peterson, Mark J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Bevelhimer, Mark S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Watson, David B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brooks, Scott C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Mayes, Melanie [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); DeRolph, Christopher R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dickson, Johnbull O. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Olsen, Todd A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-08-01

    The purpose of this report is to assess new data that has become available and provide an update to the evaluations and modeling presented in the Oak Ridge National Laboratory (ORNL) Technical Manuscript Evaluation of lower East Fork Poplar Creek (LEFPC) Mercury Sources (Watson et al., 2016). Primary sources of field and laboratory data for this update include multiple US Department of Energy (DOE) programs including Environmental Management (EM; e.g., Biological Monitoring and Abatement Program, Mercury Remediation Technology Development [TD], and Applied Field Research Initiative), Office of Science (Mercury Science Focus Areas [SFA] project), and the Y-12 National Security Complex (Y-12) Compliance Department.

  5. Tax compliance costs: a business administration perspective

    OpenAIRE

    Eichfelder, Sebastian; Schorn, Michael

    2009-01-01

    The paper analyses the relationship of tax compliance costs and business strategy. Due to instruments, like information technology, simplified cash accounting or outsourcing compliance activities to tax advisers, private businesses have a set of strategies to optimize their tax compliance cost burden. Under the assumption of rational choice a private business should choose a cost-optimal administration strategy. In spite of that we find empirical evidence for small German businesses using onl...

  6. From Policy to Compliance: Federal Energy Efficient Product Procurement

    Energy Technology Data Exchange (ETDEWEB)

    DeMates, Laurèn [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Scodel, Anna [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-09-06

    than $25,000. In 2010, ASE estimated a compliance rate of 46% in 2010, up from an estimate of 12% in 2008. Our work updates and expands on ASE’s 2010 analysis to gauge agency compliance with EEPP requirements.

  7. The creep compliance, the relaxation modulus and the complex compliance of linear viscoelastic, homogeneous, isotropic materials

    International Nuclear Information System (INIS)

    Wong, P.K.

    1989-01-01

    This paper reports on a study to obtain the creep compliance, the relaxation modulus and the complex compliance derived from the concept of mechanical resistance for the constitutive equation of a class of linear viscoelastic, homogeneous, isotropic materials

  8. 12 CFR 1710.19 - Compliance and risk management programs; compliance with other laws.

    Science.gov (United States)

    2010-01-01

    ... OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS CORPORATE GOVERNANCE Corporate Practices and Procedures § 1710.19 Compliance and risk management programs; compliance with other laws. (a...

  9. EPA Enforcement and Compliance History Online

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Environmental Protection Agency's Enforcement and Compliance History Online (ECHO) website provides customizable and downloadable information about environmental...

  10. Update on equine allergies.

    Science.gov (United States)

    Fadok, Valerie A

    2013-12-01

    Horses develop many skin and respiratory disorders that have been attributed to allergy. These disorders include pruritic skin diseases, recurrent urticaria, allergic rhinoconjunctivitis, and reactive airway disease. Allergen-specific IgE has been detected in these horses, and allergen-specific immunotherapy is used to ameliorate clinical signs. The best understood atopic disease in horses is insect hypersensitivity, but the goal of effective treatment with allergen-specific immunotherapy remains elusive. In this review, updates in pathogenesis of allergic states and a brief mention of the new data on what is known in humans and dogs and how that relates to equine allergic disorders are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Hypertrophic Cardiomyopathy: Clinical Update.

    Science.gov (United States)

    Geske, Jeffrey B; Ommen, Steve R; Gersh, Bernard J

    2018-05-01

    Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy, manifesting as left ventricular hypertrophy in the absence of a secondary cause. The genetic underpinnings of HCM arise largely from mutations of sarcomeric proteins; however, the specific underlying mutation often remains undetermined. Patient presentation is phenotypically diverse, ranging from asymptomatic to heart failure or sudden cardiac death. Left ventricular hypertrophy and abnormal ventricular configuration result in dynamic left ventricular outflow obstruction in most patients. The goal of therapeutic interventions is largely to reduce dynamic obstruction, with treatment modalities spanning lifestyle modifications, pharmacotherapies, and septal reduction therapies. A small subset of patients with HCM will experience sudden cardiac death, and risk stratification remains a clinical challenge. This paper presents a clinical update for diagnosis, family screening, clinical imaging, risk stratification, and management of symptoms in patients with HCM. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Y2K UPDATE

    CERN Multimedia

    Sverre JARP

    1999-01-01

    Concerning Y2K preparation, please note the following:Everybody, who has a NICE installation on his/her PC, needs to log in to NICE at least once before Xmas to get the Y2K update installed. This applies especially to dual boot systems.The test schedule on Y2Kplus.cern.ch will be prolonged. The last restart took place on 10 November and two more will take place on 24 November and 8 December, respectively. The Oracle users responsible for the maintenance of Oracle Forms applications which include PL/SQL blocks where date fields are handled with the default format are requested to contact oracle.support@cern.ch at their earliest convenience.Sverre Jarp (CERN Y2K co-ordinator, phone: 74944)

  13. Amblyopia update: new treatments.

    Science.gov (United States)

    Vagge, Aldo; Nelson, Leonard B

    2016-09-01

    This review article is an update on the current treatments for amblyopia. In particular, the authors focus on the concepts of brain plasticity and their implications for novel treatment strategies for both children and adults affected by amblyopia. A variety of strategies has been developed to treat amblyopia in children and adults. New evidence on the pathogenesis of amblyopia has been obtained both in animal models and in clinical trials. Mainly, these studies have challenged the classical concept that amblyopia becomes untreatable after the 'end' of the sensitive or critical period of visual development, because of a lack of sufficient plasticity in the adult brain. New treatments for amblyopia in children and adults are desirable and should be encouraged. However, further studies should be completed before such therapies are widely accepted into clinical practice.

  14. Memory updating and mental arithmetic

    Directory of Open Access Journals (Sweden)

    Cheng-Ching eHan

    2016-02-01

    Full Text Available Is domain-general memory updating ability predictive of calculation skills or are such skills better predicted by the capacity for updating specifically numerical information? Here, we used multidigit mental multiplication (MMM as a measure for calculating skill as this operation requires the accurate maintenance and updating of information in addition to skills needed for arithmetic more generally. In Experiment 1, we found that only individual differences with regard to a task updating numerical information following addition (MUcalc could predict the performance of MMM, perhaps owing to common elements between the task and MMM. In Experiment 2, new updating tasks were designed to clarify this: a spatial updating task with no numbers, a numerical task with no calculation, and a word task. The results showed that both MUcalc and the spatial task were able to predict the performance of MMM but only with the more difficult problems, while other updating tasks did not predict performance. It is concluded that relevant processes involved in updating the contents of working memory support mental arithmetic in adults.

  15. ENHANCING VOLUNTARY COMPLIANCE BY REDUCING COMPLIANCE COSTS: A TAXPAYER SERVICE APPROACH

    OpenAIRE

    Glenn Jenkins; EDWIN FORLEMU

    1993-01-01

    In this paper an overview is made of the determinants of voluntary tax compliance. Unlike previous treatments of this subject, the cost of taxpayer compliance is considered as an important determinant of overall level of voluntary compliance in a country. A number of ways that tax authorities reduce compliance are discussed, and the most common uses of information technology in providing taxpayer service is described. Finally, the paper considers some of the ways that such activities might be...

  16. Oil sands development update

    International Nuclear Information System (INIS)

    1999-01-01

    A detailed review and update of oil sands development in Alberta are provided covering every aspect of the production and economic aspects of the industry. It is pointed out that at present oil sands account for 28 per cent of Canadian crude oil production, expected to reach 50 per cent by 2005. Based on recent announcements, a total of 26 billion dollars worth of projects are in progress or planned; 20 billion dollars worth of this development is in the Athabasca area, the remainder in Cold Lake and other areas. The current update envisages up to 1,800,000 barrels per day by 2008, creating 47,000 new jobs and total government revenues through direct and indirect taxes of 118 billion dollars. Provinces other than Alberta also benefit from these development, since 60 per cent of all employment and income created by oil sands production is in other parts of Canada. Up to 60 per cent of the expansion is for goods and services and of this, 50 to 55 per cent will be purchased from Canadian sources. The remaining 40 per cent of the new investment is for engineering and construction of which 95 per cent is Canadian content. Aboriginal workforce by common consent of existing operators matches regional representation (about 13 per cent), and new developers are expected to match these standards. Planned or ongoing development in environmental protection through improved technologies and optimization, energy efficiency and improved tailings management, and active support of flexibility mechanisms such as emission credits trading, joint implementation and carbon sinks are very high on the industry's agenda. The importance of offsets are discussed extensively along with key considerations for international negotiations, as well as further research of other options such as sequestration, environmentally benign disposal of waste, and enhanced voluntary action

  17. ADAS Update and Maintainability

    Science.gov (United States)

    Watson, Leela R.

    2010-01-01

    Since 2000, both the National Weather Service Melbourne (NWS MLB) and the Spaceflight Meteorology Group (SMG) have used a local data integration system (LOIS) as part of their forecast and warning operations. The original LOIS was developed by the Applied Meteorology Unit (AMU) in 1998 (Manobianco and Case 1998) and has undergone subsequent improvements. Each has benefited from three-dimensional (3-D) analyses that are delivered to forecasters every 15 minutes across the peninsula of Florida. The intent is to generate products that enhance short-range weather forecasts issued in support of NWS MLB and SMG operational requirements within East Central Florida. The current LDIS uses the Advanced Regional Prediction System (ARPS) Data Analysis System (AD AS) package as its core, which integrates a wide variety of national, regional, and local observational data sets. It assimilates all available real-time data within its domain and is run at a finer spatial and temporal resolution than current national or regional-scale analysis packages. As such, it provides local forecasters with a more comprehensive understanding of evolving fine-scale weather features. Over the years, the LDIS has become problematic to maintain since it depends on AMU-developed shell scripts that were written for an earlier version of the ADAS software. The goals of this task were to update the NWS MLB/SMG LDIS with the latest version of ADAS, incorporate new sources of observational data, and upgrade and modify the AMU-developed shell scripts written to govern the system. In addition, the previously developed ADAS graphical user interface (GUI) was updated. Operationally, these upgrades will result in more accurate depictions of the current local environment to help with short-range weather forecasting applications, while also offering an improved initialization for local versions of the Weather Research and Forecasting (WRF) model used by both groups.

  18. Risk aversion and compliance in markets for pollution control.

    Science.gov (United States)

    Stranlund, John K

    2008-07-01

    This paper examines the effects of risk aversion on compliance choices in markets for pollution control. A firm's decision to be compliant or not is independent of its manager's risk preference. However, non-compliant firms with risk-averse managers will have lower violations than otherwise identical firms with risk-neutral managers. The violations of non-compliant firms with risk-averse managers are independent of differences in their profit functions and their initial allocations of permits if and only if their managers' utility functions exhibit constant absolute risk aversion. However, firm-level characteristics do impact violation choices when managers have coefficients of absolute risk aversion that are increasing or decreasing in profit levels. Finally, in the equilibrium of a market for emissions rights with widespread non-compliance, risk aversion is associated with higher permit prices, better environmental quality, and lower aggregate violations.

  19. Directory of certificates of compliance for radioactive materials packages

    International Nuclear Information System (INIS)

    1992-10-01

    This directory contains a Report of the US Nuclear Regulatory Commission's Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs (Volume 3), for Radioactive Materials Packages effective October 1, 1992. The purpose of this directory is to make available a convenient source of information on packaging which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The reports include a listing of all users of each package-design and approved QA programs prior to the publication date of the directory

  20. Directory of Certificates of Compliance for Radioactive Materials Packages

    International Nuclear Information System (INIS)

    1992-10-01

    This directory contains a Report of the US Nuclear Regulatory Commission's Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and a Report of NRC Approved Quality Assurance Programs (Volume 3), for Radioactive Materials Packages effective October 1, 1992. The purpose of this directory is to make available a convenient source of information on packaging which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. A listing by packaging types is included in the back of Volume 2. An alphabetical listing by Company name is included in the back of Volume 3 for approved QA programs. The reports include a listing of all users of each package-design and approved QA programs prior to the publication date of the directory

  1. 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.

  2. Interventions to improve hand hygiene compliance in patient care.

    Science.gov (United States)

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica

    2017-09-01

    Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review. To assess the short- and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016. We included randomised trials, non-randomised trials, controlled before-after studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcohol-based hand rub (ABHR), or both. Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Meta-analysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table. This review includes 26 studies: 14 randomised trials, two non-randomised trials and 10 ITS studies. Most studies were conducted in hospitals or long-term care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such

  3. Perspectives on compliance: non-compliance with environmental licenses in the Netherlands

    NARCIS (Netherlands)

    van Snellenberg, A.H.L.M.; van de Peppel, R.A.

    2002-01-01

    Compliance with environmental law is not self-evident. In many instances enforcement of environmental regulations is a necessary means for achieving compliance. Assuming that an enforcement strategy, in order to be effective, has to fit the type of non-compliance, we integrate six different

  4. Working Memory Updating Latency Reflects the Cost of Switching between Maintenance and Updating Modes of Operation

    Science.gov (United States)

    Kessler, Yoav; Oberauer, Klaus

    2014-01-01

    Updating and maintenance of information are 2 conflicting demands on working memory (WM). We examined the time required to update WM (updating latency) as a function of the sequence of updated and not-updated items within a list. Participants held a list of items in WM and updated a variable subset of them in each trial. Four experiments that vary…

  5. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-01-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

  6. Georgia Compliance Review Self-Study FY 01.

    Science.gov (United States)

    Georgia State Dept. of Education, Atlanta.

    Intended for evaluation of local compliance with special education federal and state legal requirements, this compliance review document includes both the compliance requirements and the criteria by which compliance is determined during the onsite compliance review of Georgia local school systems and state-operated programs. Each legal requirement…

  7. Choreographies and Behavioural Contracts on the Way to Dynamic Updates

    Directory of Open Access Journals (Sweden)

    Mario Bravetti

    2014-11-01

    Full Text Available We survey our work on choreographies and behavioural contracts in multiparty interactions. In particular theories of behavioural contracts are presented which enable reasoning about correct service composition (contract compliance and service substitutability (contract refinement preorder under different assumptions concerning service communication: synchronous address or name based communication with patient non-preemptable or impatient invocations, or asynchronous communication. Correspondingly relations between behavioural contracts and choreographic descriptions are considered, where a contract for each communicating party is, e.g., derived by projection. The considered relations are induced as the maximal preoders which preserve contract compliance and global traces: we show maximality to hold (permitting services to be discovered/substituted independently for each party when contract refinement preorders with all the above asymmetric communication means are considered and, instead, not to hold if the standard symmetric CCS/pi-calculus communication is considered (or when directly relating choreographies to behavioral contracts via a preorder, no matter the communication mean. The obtained maximal preorders are then characterized in terms of a new form of testing, called compliance testing, where not only tests must succeed but also the system under test (thus relating to controllability theory, and compared with classical preorders such as may/must testing, trace inclusion, etc. Finally, recent work about adaptable choreographies and behavioural contracts is presented, where the theory above is extended to update mechanisms allowing choreographies/contracts to be modified at run-time by internal (self-adaptation or external intervention.

  8. Explaining G20 and BRICS Compliance

    Directory of Open Access Journals (Sweden)

    Marina Larionova

    2016-11-01

    Full Text Available This article explores the internal and external factors influencing the compliance performance of the Group of 20 (G20 and the BRICS. The authors start with an overview of the G20 and BRICS compliance patterns using comparative data onthe number of commitments made by the two institutions, the level of institutional compliance, and distribution of commitments and compliance across issue areas. G20 compliance is traced since the leaders’ first 2008 summit in Washington. The BRICS compliance performance record includes data since the third stand alone summit in Sanya in 2011.The study then takes stock of compliance catalysts embedded in the summits’ discourse: priority placements, numerical targets, timelines, self-accountability pledges and mandates to implement and/or monitor implementation. The authors review trends in the use of catalysts in different years and issue areas and identify commonalities and differences.The analysis then turns to external causes of compliance and focuses on demand for collective actions and members’ collective power to respond and deliver on their pledges. Here the study explores whether the self-accountability mechanisms created by the institutions in response to the demand for effectiveness and legitimacy facilitate compliance.The article concludes by highlighting catalysts, causes of compliance and their combinations with the greatest power to encourage implementation, explaining trends in G20 and BRICS compliance performance. The data sets on G20 and BRICS differ in terms of scale. The G20 data set contains 1,511 commitments of which 114 have been monitored, and the BRICS data set contains 231 commitments of which 23 have been monitored.

  9. Switzerland; Financial Sector Assessment Program: Factual Update: Basel Core Principles for Effective Banking Supervision

    OpenAIRE

    International Monetary Fund

    2007-01-01

    This technical note presents a factual update of the 2001 assessment of Switzerland’s compliance with the 1997 Basel Core Principles for Effective Banking Supervision (BCP), including a follow-up on implementation of the 2001 BCP assessment, undertaken in the context of the original Financial Sector Assessment Program in 2001. The note discusses that the Swiss Federal Banking Commission (SFBC) has made impressive progress both organizationally and to its supervisory practices to strengthen Sw...

  10. 43 CFR 414.5 - Water quality.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Water quality. 414.5 Section 414.5 Public... APPORTIONMENT IN THE LOWER DIVISION STATES Water Quality and Environmental Compliance § 414.5 Water quality. (a) Water Quality is not guaranteed. The Secretary does not warrant the quality of water released or...

  11. Prediction of compliance with MRI procedures among children of ages 3 years to 12 years

    International Nuclear Information System (INIS)

    Cahoon, Glenn D.; Davison, Tanya E.

    2014-01-01

    A number of children are unable to comply with an MRI procedure and require general anesthetic. However, we lack information about which factors are associated with MRI compliance in young children. To determine the strongest predictors of MRI compliance, focusing on variables that can be easily rated by patients' parents. A sample of 205 children ages 3-11 years (mean age 6.6 years) who were at risk of non-compliance were recruited from a children's hospital. Their parents completed a behavior assessment scale for children as well as a questionnaire that assessed their expectations of compliance and perception of their child's typical medical compliance. The children subsequently completed a mock MRI with an educational play therapist and a clinical MRI, with the quality of the scan scored by the MRI technologist. Overall, 88.3% of children complied with the clinical scan and achieved diagnostic images, with age unrelated to compliance in this well-prepared patient group. The strongest predictors of MRI compliance were parental expectations and ratings of how well the child typically copes with medical procedures. Non-compliance was related to child attention problems and to poor adaptability among children. A total of 64 preschool-age children (91.4%) and 110 school-age children (95.7%) were correctly classified as compliant or non-compliant based on these predictor variables. A child's temperament, medical experiences and parental expectations provide important information in predicting which children successfully comply with an MRI procedure and which require general anesthesia. Further study is needed to explore the utility of these variables in predicting compliance at sites that do not have access to an MRI simulator. (orig.)

  12. Prediction of compliance with MRI procedures among children of ages 3 years to 12 years

    Energy Technology Data Exchange (ETDEWEB)

    Cahoon, Glenn D. [The Royal Children' s Hospital Melbourne, Medical Imaging Department, Parkville (Australia); Davison, Tanya E. [Monash University, Melbourne (Australia)

    2014-10-15

    A number of children are unable to comply with an MRI procedure and require general anesthetic. However, we lack information about which factors are associated with MRI compliance in young children. To determine the strongest predictors of MRI compliance, focusing on variables that can be easily rated by patients' parents. A sample of 205 children ages 3-11 years (mean age 6.6 years) who were at risk of non-compliance were recruited from a children's hospital. Their parents completed a behavior assessment scale for children as well as a questionnaire that assessed their expectations of compliance and perception of their child's typical medical compliance. The children subsequently completed a mock MRI with an educational play therapist and a clinical MRI, with the quality of the scan scored by the MRI technologist. Overall, 88.3% of children complied with the clinical scan and achieved diagnostic images, with age unrelated to compliance in this well-prepared patient group. The strongest predictors of MRI compliance were parental expectations and ratings of how well the child typically copes with medical procedures. Non-compliance was related to child attention problems and to poor adaptability among children. A total of 64 preschool-age children (91.4%) and 110 school-age children (95.7%) were correctly classified as compliant or non-compliant based on these predictor variables. A child's temperament, medical experiences and parental expectations provide important information in predicting which children successfully comply with an MRI procedure and which require general anesthesia. Further study is needed to explore the utility of these variables in predicting compliance at sites that do not have access to an MRI simulator. (orig.)

  13. Compliance with Private Food Safety Standards among ...

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

    ... and the livelihood impact of compliance. In addition, the project aims to build the capacity of farmers and other locally based actors to enhance compliance and thereby contribute to increased welfare in the project area. Expected outputs include one PhD thesis, five master's theses, and various journal publications and ...

  14. 14 CFR 431.83 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 431.83 Section 431.83 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... Requirements-Reusable Launch Vehicle Mission License Terms and Conditions § 431.83 Compliance monitoring. A...

  15. 14 CFR 417.23 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 417.23 Section 417... Compliance monitoring. (a) A launch operator must allow access by, and cooperate with, Federal officers or... launch operator must provide the FAA with a console for monitoring the progress of the countdown and...

  16. 14 CFR 437.93 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 437.93 Section 437.93 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT....93 Compliance monitoring. A permittee must allow access by, and cooperate with, federal officers or...

  17. 14 CFR 420.49 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 420.49 Section 420.49 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... Compliance monitoring. A licensee shall allow access by and cooperate with federal officers or employees or...

  18. 49 CFR 21.9 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance information. 21.9 Section 21.9 Transportation Office of the Secretary of Transportation NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS OF THE DEPARTMENT OF TRANSPORTATION-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 21.9 Compliance information. (a) Cooperation and...

  19. 49 CFR 27.121 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance information. 27.121 Section 27.121 Transportation Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Enforcement § 27.121 Compliance information. (a) Cooperation and assistance. The...

  20. 40 CFR 425.05 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 425.05 Section 425.05 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.05 Compliance dates...

  1. Patient compliance and effect of orthopaedic shoes

    DEFF Research Database (Denmark)

    Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R

    1999-01-01

    Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...

  2. Diagnostic information in temporal compliance checking

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Dongen, van B.F.; Aalst, van der W.M.P.

    2012-01-01

    Compliance checking is gaining importance as today’s organizations need to show that operational processes are executed in a controlled manner while satisfying prede¿ned (legal) requirements. Deviations may be costly and expose the organization to severe risks. Compliance checking is of growing

  3. [Insufficient medication compliance in Parkinson's disease

    NARCIS (Netherlands)

    Aerts, M.B.; Eijk, M. van der; Kramers, C.; Bloem, B.R.

    2011-01-01

    Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of

  4. 7 CFR 772.3 - Compliance.

    Science.gov (United States)

    2010-01-01

    ... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... parts 15d and 15e. (b) Reviews. In accordance with Title VI of the Civil Rights Act of 1964, the Agency will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

  5. 30 CFR 90.207 - Compliance sampling.

    Science.gov (United States)

    2010-07-01

    ... MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.207 Compliance sampling. (a) The operator shall take five valid respirable dust samples for... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance sampling. 90.207 Section 90.207...

  6. 5 CFR 900.406 - Compliance information.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance information. 900.406 Section... Compliance information. (a) Cooperation and assistance. OPM, to the fullest extent practicable, shall seek... at the times, and in the form and containing the information OPM may determine necessary to enable it...

  7. 22 CFR 141.5 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 141.5 Section 141.5... DEPARTMENT OF STATE-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 141.5 Compliance information... such information, as a responsible Departmental official or his designee may determine to be necessary...

  8. 45 CFR 80.6 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compliance information. 80.6 Section 80.6 Public... THE CIVIL RIGHTS ACT OF 1964 § 80.6 Compliance information. (a) Cooperation and assistance. The... reports at such times, and in such form and containing such information, as the responsible Department...

  9. 34 CFR 1200.170 - Compliance procedures.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Compliance procedures. 1200.170 Section 1200.170 Education Regulations of the Offices of the Department of Education (Continued) NATIONAL COUNCIL ON... agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of any...

  10. 49 CFR 28.170 - Compliance procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance procedures. 28.170 Section 28.170 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.170 Compliance...

  11. 40 CFR 73.35 - Compliance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance... in § 73.34(a) of this part, the Administrator will deduct allowances for each source with excess...

  12. Report: Quality Control Review of EPA OIG Reports Issued in Fiscal Year 2015

    Science.gov (United States)

    Report #16-N-0223, July 18, 2016. OIG reports issued in FY 2015 demonstrated high levels of compliance with OIG quality assurance procedures, and received average compliance scores of 90 percent or greater.

  13. Update of CERN exchange network

    CERN Multimedia

    2003-01-01

    An update of the CERN exchange network will be done next April. Disturbances or even interruptions of telephony services may occur from 4th to 24th April during evenings from 18:30 to 00:00 but will not exceed more than 4 consecutive hours (see tentative planning below). CERN divisions are invited to avoid any change requests (set-ups, move or removals) of telephones and fax machines from 4th to 25th April. Everything will be done to minimize potential inconveniences which may occur during this update. There will be no loss of telephone functionalities. CERN GSM portable phones won't be affected by this change. Should you need more details, please send us your questions by email to Standard.Telephone@cern.ch. DateChange typeAffected areas April 11 Update of switch in LHC 4 LHC 4 Point April 14 Update of switch in LHC 5 LHC 5 Point April 15 Update of switches in LHC 3 and LHC 2 Points LHC 3 and LHC 2 April 22 Update of switch N4 Meyrin Ouest April 23 Update of switch  N6 Prévessin Site Ap...

  14. Predictors of CPAP compliance in different clinical settings: primary care versus sleep unit.

    Science.gov (United States)

    Nadal, Núria; de Batlle, Jordi; Barbé, Ferran; Marsal, Josep Ramon; Sánchez-de-la-Torre, Alicia; Tarraubella, Nuria; Lavega, Merce; Sánchez-de-la-Torre, Manuel

    2018-03-01

    Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.

  15. Compliance with Segment Disclosure Initiatives

    DEFF Research Database (Denmark)

    Arya, Anil; Frimor, Hans; Mittendorf, Brian

    2013-01-01

    Regulatory oversight of capital markets has intensified in recent years, with a particular emphasis on expanding financial transparency. A notable instance is efforts by the Financial Accounting Standards Board that push firms to identify and report performance of individual business units...... (segments). This paper seeks to address short-run and long-run consequences of stringent enforcement of and uniform compliance with these segment disclosure standards. To do so, we develop a parsimonious model wherein a regulatory agency promulgates disclosure standards and either permits voluntary...... by increasing transparency and leveling the playing field. However, our analysis also demonstrates that in the long run, if firms are unable to use discretion in reporting to maintain their competitive edge, they may seek more destructive alternatives. Accounting for such concerns, in the long run, voluntary...

  16. A Review of Factors for Tax Compliance

    Directory of Open Access Journals (Sweden)

    Nicoleta BARBUTA-MISU

    2011-03-01

    Full Text Available The aim of this paper is to identify the variables of tax compliance analysed by researchers from various countries and adapting them to the Romanian conditions to create a model to include factors that influence decision of tax compliance. Tax compliance has been studied in economics by analysing the individual decision of a representative person between paying taxes and evading taxes. In the research of tax compliance have been done many empirical studies that emphasized the impact of a wide variety of potential determinants of voluntary compliance with individual income/profit tax filing and reporting obligations. The most important determinants identified are: economic factors as the level of income, audit probabilities, tax audit, tax rate, tax benefits, penalties, fines and other non-economic factors as attitudes toward taxes, personal, social and national norms, perceived fairness etc.

  17. Monitoring compliance with requirements during site characterization

    International Nuclear Information System (INIS)

    Herrington, C.C.; Jennetta, A.R.; Dobson, D.C.

    1991-01-01

    The question of when a program of Regulatory Compliance should be applied and what it should be applied to, when the subject of compliance is a High Level Radioactive Waste Repository, defies resolution by merely relating to past practices of licensees of the US Nuclear Regulatory Commission (NRC). NRC regulations governing the disposal of High Level Waste include interactions with the potential applicant (US DOE) during the pre-license application phase of the program when the basis for regulatory compliance is not well defined. To offset this shortcoming, the DOE will establish an expanded basis for regulatory compliance, keeping the NRC apprised of the basis as it develops. As a result, the preapplication activities of DOE will assume the added benefit of qualification to a suitable Regulatory Compliance monitoring and maintenance plan

  18. 77 FR 68155 - Sunshine Act Meeting Notice

    Science.gov (United States)

    2012-11-15

    ...-Quality Control Compliance/3rd Party CPA XII. National Foreclosure Mitigation Counseling (NFMC) Compliance Update XIII. OHTS Watch List and Overview of Organizational Assessment Review Process XIV. Adjournment...

  19. The prevalence of, and factors related to, compliance with glove utilization among nurses in Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Naing, L; Nordin, R; Musa, R

    2001-09-01

    Increasing risk of HIV infections among health care workers has been a continuing concern. The study was designed to identify the compliance of glove utilization, and factors related to non-compliance. A sample of 150 staff nurses were recruited from the study population of 550 nurses in Hospital Universiti Sains Malaysia. Data were collected by using a structured self-administered questionnaires. The response rate was 98.4%. The study revealed a low compliance (13.5%) of glove utilization (for all 9 procedures), which varied among different procedures (27-97%). Younger nurses and those with shorter duration of working experience had better knowledge of Universal Precautions. Nurses in intensive care unit and operation theatre were better in both knowledge and compliance of glove utilization. The three commonest misconceptions were identified as "selective use of gloves for high risk groups and suspected cases", and "tendency to depend on HIV prevalence". Nurses reported practical problems including administrative and personal related such as "stock irregularity" (46%), "glove not available at the emergency sites" (44%), and "reduction of tactile sensation" (39%). It was concluded that poor knowledge and practical problems were possible responsible factors for the low compliance. A good training for nurses comprising principle and practice of Universal Precautions, updated knowledge of blood and body fluid borne infections and risk and its management, will probably improve the compliance.

  20. DWPF waste form compliance plan (Draft Revision)

    International Nuclear Information System (INIS)

    Plodinec, M.J.; Marra, S.L.

    1991-01-01

    The Department of Energy currently has over 100 million liters of high-level radioactive waste in storage at the Savannah River Site (SRS). In the late 1970's, the Department of Energy recognized that there were significant safety and cost advantages associated with immobilizing the high-level waste in a stable solid form. Several alternative waste forms were evaluated in terms of product quality and reliability of fabrication. This evaluation led to a decision to build the Defense Waste Processing Facility (DWPF) at SRS to convert the easily dispersed liquid waste to borosilicate glass. In accordance with the NEPA (National Environmental Policy Act) process, an Environmental Impact Statement was prepared for the facility, as well as an Environmental Assessment of the alternative waste forms, and issuance of a Record of Decision (in December, 1982) on the waste form. The Department of Energy, recognizing that start-up of the DWPF would considerably precede licensing of a repository, instituted a Waste Acceptance Process to ensure that these canistered waste forms would be acceptable for eventual disposal at a federal repository. This report is a revision of the DWPF compliance plan

  1. A road map for compliance training

    International Nuclear Information System (INIS)

    Miller, D.

    1995-01-01

    On April 6, 1990, the American Petroleum Institute (API) amended its bylaws to incorporate an environmental mission statement and 11 guiding environmental principles. The action renewed and reemphasized the industry's commitment to safe and environmentally sound operations. One of these principles deals specifically with safe plant operations: To operate their plants and facilities, and to handle their raw materials and products in a manner that protects the environment, and the safety and health of their employees and the public. This principle has particular relevance in the area of employee training and information transfer, where assurance of safe and environmentally sound operations start with a properly trained and informed workforce. Similarly, in 1988, the Chemical Manufacturers Association (CMA) adopted an initiative called Responsible Care reg-sign: A Public Commitment. The initiative commits member companies to improve performance in response to public concerns about the impact of chemicals on health, safety and environmental quality. The implementation of sound training programs will help achieve compliance with both API's and CMAs initiatives. Besides operations and maintenance skills training, however, Federally Mandated Training is an important issue facing the petroleum and chemical industry

  2. Diversity management in the workplace: beyond compliance

    Directory of Open Access Journals (Sweden)

    N.S. Gwele

    2009-09-01

    Full Text Available Diversity management is not a numbers game. Diversity management is a holistic and strategic intervention aimed at maximizing every individual’s potential to contribute towards the realization o f the organization’s goals through capitalizing on individual talents and differences within a diverse workforce environment. Managing interpersonal relationships within a diverse workforce environment presents a number of challenges related to changes in the social, legal and economic landscape, individual expectations and values as well as the inevitable change in organizational culture (Chartered Institute of Personnel and Development 2005: 1-7. Whether or not organizations are effective in managing diversity is a function of senior managements’ commitment, and the perceived centrality of diversity management by all those who populate the institution’s workspace. Above all it should be clear to all employees, irrespective of race, gender, or vocational/professional status, that each and every one of them has something of value to contribute towards the realization of the institution’s mission and goals. It is crucial to determine clear and manageable success indicators, focusing not only on compliance with legal obligations to include and/or increase the number of employees from the underrepresented and designated groups, but also on strategic intervention strategies to be used to promote and nurture individual talent and potential toward the realization of both individual aspirations and organizational goals re-quality patient outcomes.

  3. An update on conventional and molecular breeding approaches for ...

    African Journals Online (AJOL)

    Ezedom Theresa

    2014-03-05

    Mar 5, 2014 ... review summarizes the updated results of conventional and molecular breeding ... for the development of favorable fibre quality traits in cotton. ... length is the length of fibre with attached seed, and it can be measured with the ...

  4. 77 FR 31371 - Public Workshop: Privacy Compliance Workshop

    Science.gov (United States)

    2012-05-25

    ... presentations, including the privacy compliance fundamentals, privacy and data security, and the privacy... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Public Workshop: Privacy Compliance... Homeland Security Privacy Office will host a public workshop, ``Privacy Compliance Workshop.'' DATES: The...

  5. International Criminal Justice and the Politics of Compliance

    NARCIS (Netherlands)

    Lamont, Christopher

    2010-01-01

    International Criminal Justice and the Politics of Compliance provides a comprehensive study of compliance with legal obligations derived from the International Criminal Tribunal for the former Yugoslavia's (ICTY) Statute and integrates theoretical debates on compliance into international justice

  6. 78 FR 4848 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-01-23

    ...: Consumer Compliance Risk Management Guidance AGENCY: Federal Financial Institutions Examination Council... Media: Consumer Compliance Risk Management Guidance'' (guidance). Upon completion of the guidance, and... management practices adequately address the consumer compliance and legal risks, as well as related risks...

  7. Updating optical pseudoinverse associative memories.

    Science.gov (United States)

    Telfer, B; Casasent, D

    1989-07-01

    Selected algorithms for adding to and deleting from optical pseudoinverse associative memories are presented and compared. New realizations of pseudoinverse updating methods using vector inner product matrix bordering and reduced-dimensionality Karhunen-Loeve approximations (which have been used for updating optical filters) are described in the context of associative memories. Greville's theorem is reviewed and compared with the Widrow-Hoff algorithm. Kohonen's gradient projection method is expressed in a different form suitable for optical implementation. The data matrix memory is also discussed for comparison purposes. Memory size, speed and ease of updating, and key vector requirements are the comparison criteria used.

  8. Ontario regulatory update

    International Nuclear Information System (INIS)

    Thompson, P.

    1998-01-01

    This paper provides a summary of recent events which when combined add up to a gradual but unmistakable movement of the energy sector in Ontario towards a fully competitive market. Some of the events precipitating this movement towards competition include the passing of the Energy Competition Act of 1998 (Bill 35), electricity deregulation, regulatory reform of the natural gas sector, and changes to the consumer protection legislation. The role of the Ontario Energy Board was also updated to bring it in line with the demands of the competitive marketplace. Among the new roles that the Board will assume are to facilitate competition, to maintain fair and reasonable rates, and to facilitate rational expansion. Another objective is to provide opportunities for including energy efficiency in government policies. Implications of the changes in the OEB's mandate for market participants were also discussed, including (1) regulated gas sales and delivery mechanisms, (2) transactional services, (3) contract restructuring, (4) consumer protection, (5) supervision of competitive market participants, and (6) market surveillance

  9. Advanced Stirling Convertor Update

    Science.gov (United States)

    Wood, J. Gary; Carroll, Cliff; Matejczyk, Dan; Penswick, L. B.; Soendker, E.

    2006-01-01

    This paper reports on the 88 We Advanced Stirling Convertor (ASC) currently being developed under Phase II of a NASA NRA program for possible use in advanced high specific power radioisotope space power systems. An early developmental unit, the Frequency Test Bed (FTB) which was built and tested in Phase I demonstrated 36% efficiency. The ASC-1 currently being developed under Phase II, uses a high temperature heater head to allow for operation at 850 °C and is expected to have an efficiency approaching 40% (based on AC electrical out) at a temperature ratio of 3.1. The final lightweight ASC-2 convertor to be developed in Phase III is expected to have a mass of approximately 1 kg. The implementation of the ASC would allow for much higher specific power radioisotope power systems, requiring significantly less radioisotope fuel than current systems. The first run of the ASC-1 occurred in September 2005, and full temperature operation was achieved in early October 2005. Presented is an update on progress on the ASC program as well as the plans for future development. Also presented are efforts being performed to ensure the ASC has the required long life already demonstrated in free-piston Stirling cryocoolers.

  10. Tetraplegia Management Update.

    Science.gov (United States)

    Fridén, Jan; Gohritz, Andreas

    2015-12-01

    Tetraplegia is a profound impairment of mobility manifesting as a paralysis of all 4 extremities owing to cervical spinal cord injury. The purpose of this article is to provide an update and analyze current management, treatment options, and outcomes of surgical reconstruction of arm and hand function. Surgical restoration of elbow and wrist extension or handgrip has tremendous potential to improve autonomy, mobility, and critical abilities, for example, eating, personal care, and self-catheterization and productive work in at least 70% of tetraplegic patients. Tendon and nerve transfers, tenodeses, and joint stabilizations reliably enable improved arm and hand usability, reduce muscle imbalance and pain in spasticity, and prevent joint contractures. One-stage combined procedures have proven considerable advantages over traditional multistage approaches. Immediate activation of transferred muscles reduces the risk of adhesions, facilitates relearning, avoids adverse effects of immobilization, and enhances functional recovery. Transfer of axillary, musculocutaneous, and radial nerve fascicles from above the spinal cord injury are effective and promising options to enhance motor outcome and sensory protection, especially in groups with limited resources. Improved communication between medical disciplines, therapists, patients, and their relatives should help that more individuals can benefit from these advances and could empower many thousands tetraplegic individuals "to take life into their own hands" and live more independently. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Update in Internal Medicine

    Science.gov (United States)

    López-Jiménez, Francisco; Brito, Máximo; Aude, Y. Wady; Scheinberg, Phillip; Kaplan, Mariana; Dixon, Denise A.; Schneiderman, Neil; Trejo, Jorge F.; López-Salazar, Luis Humberto; Ramírez-Barba, Ector Jaime; Kalil, Roberto; Ortiz, Carmen; Goyos, José; Buenaño, Alvaro; Kottiech, Samer; Lamas, Gervasio A.

    2009-01-01

    More than 500,000 new medical articles are published every year and available time to keep updated is scarcer every day. Nowadays, the task of selecting useful, consistent, and relevant information for clinicians is a priority in many major medical journals. This review has the aim of gathering the results of the most important findings in clinical medicine in the last few years. It is focused on results from randomized clinical trials and well-designed observational research. Findings were included preferentially if they showed solid results, and we avoided as much as possible including only preliminary data, or results that included only non-clinical outcomes. Some of the most relevant findings reported here include the significant benefit of statins in patients with coronary artery disease even with mean cholesterol level. It also provides a substantial review of the most significant trials assessing the effectiveness of IIb/IIIa receptor blockers. In gastroenterology many advances have been made in the H. pylori eradication, and the finding that the cure of H. pylori infection may be followed by gastroesophageal reflux disease. Some new antivirals have shown encouraging results in patients with chronic hepatitis. In the infectious disease arena, the late breaking trials in anti-retroviral disease are discussed, as well as the new trends regarding antibiotic resistance. This review approaches also the role of leukotriene modifiers in the treatment of asthma and discusses the benefit of using methylprednisolone in patients with adult respiratory distress syndrome, among many other advances in internal medicine. PMID:11068074

  12. GNF Defense in Depth Update

    Energy Technology Data Exchange (ETDEWEB)

    Lingenfelter, Andrew A.; Schneider, Robert J.; Cantonwine, Paul E.; Moore, Brian; Rea, John; Crawford, Douglas C. [Global Nuclear Fuel, P.O. Box 780 M/C H25, Wilmington, NC 28402 (United States)

    2009-06-15

    Global Nuclear Fuel (GNF) has designed, fabricated, and placed into operation more than 9 million fuel rods in approximately 135 thousand assemblies. Customer satisfaction has always compelled GNF to reduce fuel rod failures (defined here as fuel rods that breach or leak in service), However, increasing success with and subsequent expectations for economic performance of nuclear reactor plants have raised broader Industry emphasis on fuel reliability. In 2005, GNF established its Defense-in-Depth (DID) Program for the purpose of focusing attention on the many aspects of fuel design, fabrication, performance, and utilization that affect fuel reliability as well as on the key methods that govern the utilization of GNF fuel. The Program is structured to address each of the identified in-service, fuel failure mechanisms. This paper provides a summary of GNF fuel performance, following previous updates. This paper will discuss recent GNF fuel reliability and channel performance, GNF2 introduction status, and methods. GNF's more recent fuel experience includes approximately 3.8 million GE11/13 (9x9) and GE12/14 (10x10) fuel rods, well over half of which are the GE12/14 design. (Those figures also include roughly 25,000 recently-introduced GNF2 fuel rods.) Reliability, expressed as annual, observed fuel failure rates (i.e., number of rods failed each year divided by the number of opportunities, or fuel rods in service), has improved for each year since 2005. The GNF fuel failure rate for years leading up to 2007 and 2008 has been on the order of 5 to 7 ppm (excluding the corrosion events of 2001-2003), and as of this writing (January 2009) the current in-service failure has decreased to around 1.5 ppm. Failures in GE14 fuel rod failures have been primarily due to debris-fretting (> 60%), with other failures being duty-related or yet undetermined. The only failure observed in GNF2 to date was a single, early-life debris failure in a bundle not equipped with GNF

  13. Evaluation of compliance with national legislation on emissions in Portugal

    Energy Technology Data Exchange (ETDEWEB)

    Joao F.P. Gomes [Instituto de Soldadura e Qualidade, Oeiras (Portugal). Centro de Tecnologias Ambientais

    2005-04-01

    More than 13 years after publication of the first air quality laws in Portugal and more than 10 years after the publication of the respective emission limits, it seems appropriate to analyze the degree of compliance by the Portuguese manufacturing industry. Using the data from emission measurements made regularly by the Instituto de Soldadura e Qualidade, the only officially accredited laboratory according to standard ISO 17025. The author analyzed a set of 400 sources in terms of compliance with the emission limits regarding total suspended particulates, sulfur dioxide, nitrogen oxides, and volatile organic compounds. He evaluated compliance through a nondimensional parameter and plotted it versus the emission flow rate to derive conclusions: the results indicate that emission limits are generally met regarding sulfur dioxide and nitrogen oxides but not for the other pollutants considered in this study. However, noncompliance occurs mainly for very low emission flow rates, which suggests some alterations in the emission limits, which are being revised at the moment. These alterations will include the exemption of measurements in minor sources. 7 refs., 8 figs., 7 tabs.

  14. Evaluation of compliance with national legislation on emissions in Portugal.

    Science.gov (United States)

    Gomes, João F P

    2005-04-01

    More than 13 years after publication of the first air quality laws in Portugal and more than 10 years after the publication of the respective emission limits, it seems appropriate to analyze the degree of compliance by the Portuguese manufacturing industry. Using the data from emission measurements made regularly by the Instituto de Soldadura e Qualidade, the only officially accredited laboratory according to standard ISO 17025, I analyzed a set of approximately 400 sources in terms of compliance with the emission limits regarding total suspended particulates, sulfur dioxide, nitrogen oxides, and volatile organic compounds. I evaluated compliance through a nondimensional parameter and plotted it versus the emission flow rate to derive conclusions: the results indicate that emission limits are generally met regarding sulfur dioxide and nitrogen oxides but not for the other pollutants considered in this study. However, noncompliance occurs mainly for very low emission flow rates, which suggests some alterations in the emission limits, which are being revised at the moment. These alterations will include the exemption of measurements in minor sources.

  15. Argonne Wakefield Accelerator Update '92

    International Nuclear Information System (INIS)

    Rosing, M.; Balka, L.; Chojnacki, E.; Gai, W.; Ho, C.; Konecny, R.; Power, J.; Schoessow, P.; Simpson, J.

    1992-01-01

    The Argonne Wakefield Accelerator (AWA) is an experiment designed to test various ideas related to wakefield technology. Construction is now underway for a 100 nC electron beam in December of 1992. This report updates this progress

  16. Internet Journal of Medical Update

    African Journals Online (AJOL)

    admin

    Internet Journal of Medical Update 2010 July;5(2):8-14. Internet Journal ... hospitalizations. This study of Nigerian patients with diabetes examined the adequacy of ..... Physicians need .... relationship between patient education and glycaemic ...

  17. Automated update, revision, and quality control of the maize genome annotations using MAKER-P improves the B73 RefGen_v3 gene models and identifies new genes

    Science.gov (United States)

    The large size and relative complexity of many plant genomes make creation, quality control, and dissemination of high-quality gene structure annotations challenging. In response, we have developed MAKER-P, a fast and easy-to-use genome annotation engine for plants. Here, we report the use of MAKER-...

  18. Resolving the problem of compliance with the ever increasing and changing regulations

    International Nuclear Information System (INIS)

    Leigh, H.

    1991-09-01

    The most common problem identified at several US Department of Energy (DOE) sites is regulatory compliance. Simply, the project viability depends on identifying regulatory requirements at the beginning of a specific project to avoid possible delays and cost overruns. The Radioisotope Power Systems Facility (RPSF) is using the Regulatory Compliance System (RCS) to deal with the problem that well over 1000 regulatory documents had to reviewed for possible compliance requirements applicable to the facility. This overwhelming number of possible documents is not atypical of all DOE facilities thus far reviewed using the RCS system. The RCS was developed to provide control and tracking of all the regulatory and institutional requirements on a given project. WASTREN, Inc., developed the RCS through various DOE contracts and continues to enhance and update the system for existing and new contracts. The RCS provides the information to allow the technical expert to assimilate and manage accurate resource information, compile the necessary checklists, and document that the project or facility fulfills all of the appropriate regulatory requirements. The RCS provides on-line information, including status throughout the project life, thereby allowing more intelligent and proactive decision making. Also, consistency and traceability are provided for regulatory compliance documentation. 1 ref., 1 fig

  19. Communication technology update and fundamentals

    CERN Document Server

    Grant, August E

    2010-01-01

    New communication technologies are being introduced at an astonishing rate. Making sense of these technologies is increasingly difficult. Communication Technology Update and Fundamentals is the single best source for the latest developments, trends, and issues in communication technology. Featuring the fundamental framework along with the history and background of communication technologies, Communication Technology Update and Fundamentals, 12th edition helps you stay ahead of these ever-changing and emerging technologies.As always, every chapter ha

  20. New uses of sulfur - update

    Energy Technology Data Exchange (ETDEWEB)

    Almond, K.P.

    1995-07-01

    An update to an extensive bibliography on alternate uses of sulfur was presented. Alberta Sulphur Research Ltd., previously compiled a bibliography in volume 24 of this quarterly bulletin. This update provides an additional 44 new publications. The information regarding current research focusses on topics regarding the use of sulfur in oil and gas applications, mining and metallurgy, concretes and other structural materials, waste management, rubber and textile products, asphalts and other paving and highway applications.

  1. Communication technology update and fundamentals

    CERN Document Server

    Grant, August E

    2008-01-01

    New communication technologies are being introduced at an astonishing rate. Making sense of these technologies is increasingly difficult. Communication Technology Update is the single best source for the latest developments, trends, and issues in communication technology. Now in its 11th edition, Communication Technology Update has become an indispensable information resource for business, government, and academia. As always, every chapter has been completely rewritten to reflect the latest developments and market statistics, and now covers mobile computing, dig

  2. Clinical Voices - an update

    DEFF Research Database (Denmark)

    Fusaroli, Riccardo; Weed, Ethan

    Anomalous aspects of speech and voice, including pitch, fluency, and voice quality, are reported to characterise many mental disorders. However, it has proven difficult to quantify and explain this oddness of speech by employing traditional statistical methods. In this talk we will show how...

  3. An update on falls

    NARCIS (Netherlands)

    Bloem, B.R.; Steijns, J.A.G.; Smits-Engelsman, B.C.M.

    2003-01-01

    Purpose of review: Falls among elderly persons create immense social problems because of their association with physical decline, serious psychosocial consequences, negative impact on the quality of life, and markedly reduced survival. In addition, falls pose high costs to the public health service.

  4. An update on falls.

    NARCIS (Netherlands)

    Bloem, B.R.; Steijns, J.A.G.; Smits-Engelsman, B.C.M.

    2003-01-01

    PURPOSE OF REVIEW: Falls among elderly persons create immense social problems because of their association with physical decline, serious psychosocial consequences, negative impact on the quality of life, and markedly reduced survival. In addition, falls pose high costs to the public health service.

  5. GENDER AND ETHNICITY DIFFERENCES IN TAX COMPLIANCE

    Directory of Open Access Journals (Sweden)

    Jeyapalan Kasipillai

    2006-01-01

    Full Text Available The purpose of this study is to investigate whether gender and ethnicity differences occur in relation to tax compliance attitude and behavior. Prior studies on tax compliance have focused little on gender as a predictor of compliance. In Malaysia, ethnic background of a taxpayer could be a major determinant of tax compliance. A personal interview approach is used to obtain information from taxpayers in urban towns. A t-test suggests that males and females were found to have similar compliant attitude. As for ethnicity, asimilar result was observed. Results of a regression analysis indicate that gender, academic qualification, and the person preparing tax return were statistically significant as determinants of non-compliant attitude. In terms of compliant behavior, a regression analysis revealed that "attitude towards non-compliance" and "receipt of cash income" were two significant explanatory variables of tax non-compliance behavior of understating income knowingly. The findings of this study are useful for policyimplications in identifying groups that require additional attention to increase voluntary tax compliance.

  6. [Drug compliance of patients on anticoagulant treatment].

    Science.gov (United States)

    Gadó, Klára; Kocsis, Eszter; Zelkó, Romána; Hankó, Balázs; Kovácsné Balogh, Judit; Forczig, Mónika; Domján, Gyula

    2015-08-09

    Despite several therapeutic possibilities the morbidity and mortality of thromboembolic disorders remain high. Improving drug compliance - i. e. keeping up the doctor's prescriptions - may be an effective tool to reach better results. To improve patients' compliance, the risk factors of non-compliance should be recognized. Among these patients' fear of adverse effects of drugs, their lack of knowledge about their illness and medication, forgetfulness, and other social, economic factors may be the most important. Furthermore, adherence may be worsened when the patient feels that the decision has been made over his/her head. Sustained medical adherence is important because anticoagulation may be a life-long treatment. The new oral anticoagulants make the matter of compliance to be current. These new type of drugs do not need regular laboratory monitoring and, therefore, compliance cannot be strictly followed. There are several studies concerning drug compliance to anticoagulant medications. Improvement of adherence is based on regular patient education after reviewing the factors of non-compliance, which needs teamwork with important roles of doctors, pharmacists, dietetics and nurses. Careful and accurate work of the participants of primary care might be complemented by the activity of anticoagulant clinics.

  7. NB market update

    International Nuclear Information System (INIS)

    Marshall, W. K.

    2004-01-01

    The 2004 New Brunswick proclamation introduced several changes to the industry. This paper presents an update of the current New Brunswick electricity market from the perspective of the recently created New Brunswick System Operator (NBSO). A comparison was made between the modified industry and the previous industry structure. Significant changes included: corporate restructuring and market implementation; the formation of the independent system operator; and an increase in Public Utilities Board regulatory authority. The main objectives of the NBSO were reviewed, including its intention to reliably plan and operate the integrated power system as well as facilitating and operating the electricity market. Details of directors and officers were provided along with a list of legislated functions which included entering agreements with transmitters; provision and procurement of ancillary services; maintenance of integrated system; coordination of external activities; participation with standards authorities; planning and development of transmission; and the facilitation of a competitive market. An outline of the NBSO, Transco and Public Utilities Board relationships were presented. Details of the market advisory committee were outlined, with information concerning contracts, operations and services agreements. Transmission and ancillary services were also discussed, as well as issues concerning interruptible load agreements. A chart of the New Brunswick electricity market structure was presented, along with a market overview including details of capacity, ancillary services and suppliers. Market rules and amendments were presented, as well as market participation guides. Details of generation resource adequacy requirements and the imposition of penalties were outlined. Scheduling and dispatch issues were overviewed, as well as settlement processes, inputs and their sources, including settlements for variances. Future development possibilities included an expansion of

  8. Nova Scotia electricity update

    International Nuclear Information System (INIS)

    Crandlemire, A.L.

    2004-01-01

    This paper provides an update of electricity issues concerning Nova Scotia such as supply, capacity, emission commitments, as well as co-generation and the Electricity Marketplace Governance Committee (EMGC). The goals of the strategy were reliability combined with competitive prices and greater environmental responsibility. The scope of these objectives included new capacity, transmission, renewables and co-generation. Other objectives included encouraging wholesale market competition; meeting reciprocity requirements; and a 50 MW renewable energy target. Recommendations of the EMGC included wholesale market competition; a broader market scope with a cost benefit analysis; Open Access Transmission Tariff (OATT); a scheduling and information system; network integration and a point to point service; and a separation of transmission and generation business units. Other recommendations included an open competitive process for new generation; a consideration of emissions and overall efficiency; a Renewable Energy Portfolio Standard (RPS) to start in 2006; the separation of RPS tags from electricity; and net metering of renewables. These recommendations were accepted in 2003, followed by the new Electricity Act in 2004, which made OATT mandatory, established RPS and opened to the wholesale market. Capacity at present was considered to be tight, with preparations for the new regulations under way. Reductions in air pollution were reported at 25 per cent, with renewable energy projects such as 2 windmills currently under way, as well as various other projects. Opportunities for provincial Atlantic cooperation were identified as being management of reserve requirements; trading of lowest cost electricity; new generation on a regional scale; stronger transmission ties; a system operator; a regional approach to RPS; regional management of air emissions; and regional opportunities for Carbon dioxide reductions. tabs., figs

  9. Directory of certificates of compliance for radioactive materials packages

    International Nuclear Information System (INIS)

    1991-10-01

    This directory contains a Report of NRC Approved Packages (Volume 1), Certificates of Compliance (Volume 2), and Report of NRC Approved Quality Assurance Programs for Radioactive Materials Packages (Volume 3). The purpose of this directory is to make available a convenient source of information on Quality Assurance Programs and Packagings which have been approved by the US Nuclear Regulatory Commission. Shipments of radioactive material utilizing these packagings must be in accordance with the provisions of 49 CFR section 173.471 and 10 CFR Part 71, as applicable. In satisfying the requirements of Section 71.12., it is the responsibility of the licensees to insure themselves that they have a copy of the current approval and conduct their transportation activities in accordance with an NRC approved quality assurance program

  10. Decentralized Consistent Updates in SDN

    KAUST Repository

    Nguyen, Thanh Dang

    2017-04-10

    We present ez-Segway, a decentralized mechanism to consistently and quickly update the network state while preventing forwarding anomalies (loops and blackholes) and avoiding link congestion. In our design, the centralized SDN controller only pre-computes information needed by the switches during the update execution. This information is distributed to the switches, which use partial knowledge and direct message passing to efficiently realize the update. This separation of concerns has the key benefit of improving update performance as the communication and computation bottlenecks at the controller are removed. Our evaluations via network emulations and large-scale simulations demonstrate the efficiency of ez-Segway, which compared to a centralized approach, improves network update times by up to 45% and 57% at the median and the 99th percentile, respectively. A deployment of a system prototype in a real OpenFlow switch and an implementation in P4 demonstrate the feasibility and low overhead of implementing simple network update functionality within switches.

  11. [Intervention to improve hand hygiene compliance in Catalonia, Spain].

    Science.gov (United States)

    Sobrequés, Jordi; Espuñes, Jordi; Bañeres, Joaquim

    2014-07-01

    Hand hygiene (HM) is the single most important measure and effective in reducing the risk of Healthcare acquired infections (IRAS). Although HM is an effective, simple and cheap measure, it is usual to find results of low compliance among health professionals. The main objective of this strategy has been to give new force to the promotion of HM in hospitals and educate professionals about the importance of this single action. The strategy was planned as a multicenter intervention study to promote HM in health centers of Catalonia in 2009-2010. The intervention is based on 4 main areas: a survey of barriers and facilitators, distribution of graphic material, training at different levels and measure of quality indicators. With this strategy a total of 57% of the number of acute beds in the concerted public and private network of hospitals were reached. The survey revealed that training was perceived as the main facilitator of the HM action. 15,376 professionals registered to the on-line training. The overall compliance with HM indications (based on "five moments for HM") was 56.45% in the acute areas. The campaigns and programs to promote HM carried out in the last four years in Catalonia has helped to achieve an increasing number of hospitals associated to the strategy of the Alliance for Patient Safety in Catalonia. The on-line curse acceptance was very high and seems a powerful tool to improve hand hygiene knowledge and compliance among health professionals. The compliance of HM seems to increase in the hospitals of Catalonia evaluated. Copyright © 2014. Published by Elsevier Espana.

  12. Motivation and compliance with intraoral elastics.

    Science.gov (United States)

    Veeroo, Helen J; Cunningham, Susan J; Newton, Jonathon Timothy; Travess, Helen C

    2014-07-01

    Intraoral elastics are commonly used in orthodontics and require regular changing to be effective. Unfortunately, poor compliance with elastics is often encountered, especially in adolescents. Intention for an action and its implementation can be improved using "if-then" plans that spell out when, where, and how a set goal, such as elastic wear, can be put into action. Our aim was to determine the effect of if-then plans on compliance with elastics. To identify common barriers to compliance with recommendations concerning elastic wear, semistructured interviews were carried out with 14 adolescent orthodontic patients wearing intraoral elastics full time. Emerging themes were used to develop if-then plans to improve compliance with elastic wear. A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear. Twelve participants were randomized equally into study and control groups; the study group received information about if-then planning. The participants were asked to collect used elastics, and counts of these were used to assess compliance. A wide range of motivational and volitional factors were described by the interviewed participants, including the perceived benefits of elastics, cues to remember, pain, eating, social situations, sports, loss of elastics, and breakages. Compliance with elastic wear was highly variable among patients. The study group returned more used elastics, suggesting increased compliance, but the difference was not significant. The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  13. Dietary compliance in Iranian children and adolescents with celiac disease

    Directory of Open Access Journals (Sweden)

    Taghdir M

    2016-08-01

    Full Text Available Maryam Taghdir,1 Naser Honar,2 Seyed Mohammad Mazloomi,3 Mojtaba Sepandi,4 Mahkameh Ashourpour,1 Musa Salehi5 1Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Pediatric Gastroenterology and Hepatology, Shiraz University of Medical Sciences, Shiraz, Iran; 3Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 4Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Sciences, Tehran, Iran; 5Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Introduction: Celiac disease (CD is caused due to intake of gluten, a protein component in wheat, barley, and rye. The only treatment currently available for CD is strict lifetime adherence to a gluten-free diet (GFD which is a diet that excludes wheat, barley, and rye. There is limited information on barriers to following a GFD. The present study aimed to investigate the compliance with a GFD, barriers to compliance, and the impact of compliance on the quality of life (QOL in Iranian children and adolescents suffering from CD.Methods: In this cross-sectional study, a total of 65 known cases of CD (both males and females, diagnosed in Namazi Hospital, a large referral center in south of Iran, selected by census were studied in 2014. Dietary compliance was assessed using a questionnaire. A disease-specific QOL questionnaire for children with CD (the celiac disease DUX [CDDUX] was used. Comparisons between categorical variables were performed using chi-square test.Results: Sixty-five patients, 38 females (58.5% and 27 (41.5% males, were surveyed. Mean (± standard deviation [SD] age of the respondents was 11.3 (±3.8 years. Dietary compliance was reported by

  14. Compliance with Corporate Governance Principles: Australian Evidence

    Directory of Open Access Journals (Sweden)

    Maryam Safari

    2015-12-01

    Full Text Available This study investigates the association between the level of compliance of Australian listed companies with Australian corporate governance principles, in aggregate, and the level of discretionary accruals using the modified Jones model. It is hypothesised that higher levels of compliance would be associated with lower levels of discretionary accruals. Data from a random sample of 214 Australian listed companies for the years 2009 and 2010 were used to test the hypothesis. The results demonstrate a significant negative relationship indicating that companies with higher levels of compliance engage in lower levels of earnings management via discretionary accruals.

  15. Information security policy development for compliance

    CERN Document Server

    Williams, Barry L

    2013-01-01

    Although compliance standards can be helpful guides to writing comprehensive security policies, many of the standards state the same requirements in slightly different ways. Information Security Policy Development for Compliance: ISO/IEC 27001, NIST SP 800-53, HIPAA Standard, PCI DSS V2.0, and AUP V5.0 provides a simplified way to write policies that meet the major regulatory requirements, without having to manually look up each and every control. Explaining how to write policy statements that address multiple compliance standards and regulatory requirements, the book will he

  16. Update on value-based medicine.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C

    2013-05-01

    To update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act assures that some variant of Value-Based Medicine cost-utility analysis will play a key role in the healthcare system. It identifies the highest quality care, thereby maximizing the most efficacious use of healthcare resources and empowering patients and physicians.Standardization is critical for the creation and acceptance of a Value-Based Medicine, cost-utility analysis, information system, since 27 million different input variants can go into a cost-utility analysis. Key among such standards is the use of patient preferences (utilities), as patients best understand the quality of life associated with their health states. The inclusion of societal costs, versus direct medical costs alone, demonstrates that medical interventions are more cost effective and, in many instances, provide a net financial return-on-investment to society referent to the direct medical costs expended. Value-Based Medicine provides a standardized methodology, integrating critical, patient, quality-of-life preferences, and societal costs, to allow the highest quality, most cost-effective care. Central to Value-Based Medicine is the concept that all patients deserve the interventions that provide the greatest patient value (improvement in quality of life and/or length of life).

  17. Subjective and Objective CPAP Compliance in Patients with Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Ji-Ae Choi

    2011-08-01

    Full Text Available Background and Objective This study aimed to investigate objective and subjective continuous positive airway pressure (CPAP compliance in patients with obstructive sleep apnea syndrome (OSAS. Moreover, we evaluated the factors and benefits associated with good CPAP compliance. Methods Subjects were 153 OSAS patients who underwent polysomnography for CPAP titration. Subjective compliance was defined as reported CPAP use of at least 4 hours a day for five or more days per week, and objective compliance was defined as CPAP use of at least 4 hours a day for more than 70% of the time recorded in the CPAP machine. Results The subjective and objective compliance rates were 34.0% and 20.7%, respectively. Subjectively compliant patients had lower minimum O2 saturation and higher % of time with O2 saturation lower than 90% than did patients declining CPAP treatment. Objectively compliant patients had lower insomnia and depression score and lower minimum O2 saturation than did patients declining CPAP treatment. Daytime sleepiness and subjective sleep quality improved to the same extent in both objectively and subjectively compliant patients. Conclusions Lower insomnia score and more severe OSA correlate with good CPAP compliance. CPAP effect was comparable between subjectively and objectively compliant patients.

  18. Prospective analysis of the quality of Spanish health information web sites after 3 years.

    Science.gov (United States)

    Conesa-Fuentes, Maria C; Hernandez-Morante, Juan J

    2016-12-01

    Although the Internet has become an essential source of health information, our study conducted 3 years ago provided evidence of the low quality of Spanish health web sites. The objective of the present study was to evaluate the quality of Spanish health information web sites now, and to compare these results with those obtained 3 years ago. For the original study, the most visited health information web sites were selected through the PageRank® (Google®) system. The present study evaluated the quality of the same web sites from February to May 2013, using the method developed by Bermúdez-Tamayo et al. and HONCode® criteria. The mean quality of the selected web sites was low and has deteriorated since the previous evaluation, especially in regional health services and institutions' web sites. The quality of private web sites remained broadly similar. Compliance with privacy and update criteria also improved in the intervening period. The results indicate that, even in the case of health web sites, design or appearance is more relevant to developers than quality of information. It is recommended that responsible institutions should increase their efforts to eliminate low-quality health information that may further contribute to health problems.

  19. Local Government Internal Audit Compliance

    Directory of Open Access Journals (Sweden)

    Greg Jones

    2015-09-01

    Full Text Available Local government councils (LGC rely on a number of funding sources including state and federal governments as well as their community constituents to enable them to provide a range of public services. Given the constraints on these funding sources councils need to have in place a range of strategies and policies capable of providing good governance and must appropriately discharge their financial accountabilities. To assist LGC with meeting their governance and accountability obligations they often seek guidance from their key stakeholders. For example, in the Australian State of New South Wales (NSW, the Office of Local Government has developed a set of guidelines, the Internal Audit Guidelines. In 2010 the NSW Office of Local Government issued revised guidelines emphasising that an internal audit committee is an essential component of good governance. In addition, the guidelines explained that to improve the governance and accountability of the councils, these committees should be composed of a majority of independent members. To maintain committee independence the guidelines indicated that the Mayor should not be a member of the committee. However these are only guidelines, not legislated requirements and as such compliance with the guidelines, before they were revised, has been demonstrated to be quite low (Jones & Bowrey 2013. This study, based on a review of NSW Local Government Councils’ 2012/2013 reports, including Annual Reportsrelation to internal audit committees, to determine if the guidelines are effective in improving local government council governance.

  20. Compliance with public dose limits

    International Nuclear Information System (INIS)

    Mason, G.C.

    1991-01-01

    Radiation, in various forms, is ubiquitous in the environment. Natural background radiation leads to an average radiation exposure for the general population of about 2 mSv per year. The mining and milling of radioactive ores - uranium and mineral sands - may cause a small increase in radiation exposure for some members of the public. Because any such increment in exposure is small compared with a natural exposure that is variable and difficult to quantify accurately, it is not easy to determine what proportion of the total dose received by a member of the public can be attributed to mining and milling activities. Consequently, because public dose limits apply and to those doses caused by human activity, such as mining and milling, the task of demonstrating compliance can be hampered by uncertainty. Some strategies for handling this situation are discussed. While the discussion concentrates on public dose limits, much of it may also be applicable, or adaptable, to occupational exposure. 4 refs., 2 figs

  1. Design and implementation of strategies for the assurance of quality for sterility testing in the Quality Control Section of the Chilean Nuclear Energy Commission

    International Nuclear Information System (INIS)

    Olave Carreno, Evelyn Karina

    2015-01-01

    The Department of Production and Service of the Chilean Nuclear Energy Commission (CCHEN), is an organization dedicated to the production and quality control of radioisotopes and radiopharmaceuticals. To be considered pharmaceutical specialties, the department has implemented a quality assurance system to guarantee compliance with the required standards during manufacturing processes, quality control and distribution. Such products are administered, mostly by via parental; that is why it is extremely important that as an injectable solution is sterile non-pyrogenic. Therefore, the Head of Quality Control Section emphasized the importance of validating sterility testing for these products. In the first instance we proceeded to update the related documentation, as this is one of the essential pillars of a good system of quality assurance, then continuing with the verification of compliance with the physical conditions of the place where the infertility tests are performed (classification of areas from a microbiological point of view). During this process, the proper training of personnel involved in performing environmental testing and sterility testing was performed. Finally, we proceeded to validate the sterility test by the method of direct inoculation three radiopharmaceuticals; also implemented sterility testing by membrane filtration method described in the USP. It was possible to validate the methods of direct inoculation and membrane filtration based on the validation protocol guidelines generated and previously approved by the Chief; demonstrating that in both cases the detection of reference strains of inocula is achieved under 100 cfu (Staphylococcus aureus, Bacillus spizizenii, Pseudomonas aeruginosa, Clostridium sporogenes, Candida albicans, Aspergillus brasiliensis), without interference of two of the products tested and interference of a product by direct inoculation method which was resolved. Based on these results, the documented evidence that

  2. 7 CFR 773.9 - Environmental compliance.

    Science.gov (United States)

    2010-01-01

    ... cooperative which deals with the production, processing or marketing of apples; and (6) Payment of loan... AGRICULTURE SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.9 Environmental compliance. (a) Except as...

  3. Iowa Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-09-04

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  4. Architecture-based regulatory compliance argumentation

    DEFF Research Database (Denmark)

    Mihaylov, Boyan; Onea, Lucian; Hansen, Klaus Marius

    2016-01-01

    Standards and regulations are difficult to understand and map to software, which makes compliance with them challenging to argue for software products and development process. This is problematic since lack of compliance may lead to issues with security, safety, and even to economic sanctions....... An increasing number of applications (for example in healthcare) are expected to have to live up to regulatory requirements in the future, which will lead to more software development projects having to deal with such requirements. We present an approach that models regulations such that compliance arguments...... the approach on the migration of the telemedicine platform Net4Care to the cloud, where certain regulations (for example privacy) should be concerned. The approach has the potential to support simpler compliance argumentation with the eventual promise of safer and more secure applications....

  5. Enforcement and Compliance History Online (ECHO) Facilities

    Data.gov (United States)

    U.S. Environmental Protection Agency — ECHO provides integrated compliance and enforcement information for about 800,000 regulated facilities nationwide. Its features range from simple to advanced,...

  6. Nevada Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-08-30

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  7. Utah Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-08-30

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  8. Consolidated Audit And Compliance System (CACS)

    Data.gov (United States)

    US Agency for International Development — Consolidated Audit and Compliance System: is an audit findings management and reporting system. CACS is an implementation of the Agency Secure Image and Storage...

  9. Relationship of Personal- Social and Therapeutic Factors with Medication Compliance in TB Patients in Ahwaz

    Directory of Open Access Journals (Sweden)

    S Jahani

    2012-01-01

    Full Text Available Introduction: Despite the implementation of DOTS strategy, TB remains one of the ten leading causes of death in developing countries. Compliance with treatment is affected by social, cultural, and economic factors, and patients’ knowledge and attitude as well. The aim of this study was to determine the relationship between compliance with treatment and personal, social and therapeutic factors in TB patients in Ahwaz. Methods: This cross-sectional descriptive study was conducted on 167 TB patients. Subjects were selected based on target. The data were collected using a questionnaire, and by observation, sputum analysis, and Kvzart Ponce urine test. The validity of the questionnaire was tested by the method of content validity, and its internal consistency and reliability was tested by Cronbach's alpha coefficient. Data analyzed by SpSS. Results: Among all subjects, 52.7% of patients showed complete compliance and 35.2% and 12% of them showed partial and poor compliance, respectively. There was a significant relationship between treatment compliance and gender(p=0.009, quality of monthly income(p=0.007, and addiction(p=0.001. The quality of treatment compliance was not significantly related to age, marital status, educational level, ethnicity, and medical complications. Conclusion: The findings showed that Incomplete treatment of TB is much worse than not treating it, because the lack of precision in the administration and consumption of anti-tuberculosis drugs, leads to the emergence of resistant TB. Paying attention to the factors decreasing treatment compliance and trying to eliminate them may lead to better treatment and lower incidence and prevalence of tuberculosis in the community.

  10. The evolution of mobile apps for asthma: an updated systematic assessment of content and tools.

    Science.gov (United States)

    Huckvale, Kit; Morrison, Cecily; Ouyang, Jing; Ghaghda, Aseem; Car, Josip

    2015-03-23

    Interest in mobile apps that support long-term conditions such as asthma is matched by recognition of the importance of the quality and safety of apps intended for patient use. We assessed how changes over a 2-year period affected the clinical suitability of apps providing self-management information and tools for people with asthma by updating a review first performed in 2011. Systematic content assessment of all apps for iOS and Android examining the comprehensiveness of asthma information, consistency with the evidence base for asthma self-management and adherence to best practice principles for trustworthy content, comparing the quality of apps available in 2011 to those released since. Between 2011 and 2013, numbers of asthma apps more than doubled from 93 to 191, despite withdrawal of 25% (n = 23/93) of existing apps. Newer apps were no more likely than those available in 2011 to include comprehensive information, such as the use of action plans, or offer guidance consistent with evidence; 13% (n = 19/147) of all apps, and 39% (n = 9/23) of those intended to manage acute asthma, recommended self-care procedures unsupported by evidence. Despite increases in the numbers of apps targeting specific skills, such as acute asthma management (n = 12 to 23) and inhaler technique (from n = 2 to 12), the proportion consistent with guidelines (17%, n = 4/23) and inhaler instructions (25%, n = 3/12), respectively, was low, and most apps provided only either basic information about asthma (50%, n = 75/147) or simple diary functions (24%, n = 36/147). In addition to persisting questions about clinical quality and safety, dynamic aspects of app turnover and feature evolution affect the suitability of asthma apps for use in routine care. The findings underline the need for coordinated quality assurance processes that can adapt to changing clinical and information governance-related risks, ensure compliance with the evidence base and reflect

  11. 75 FR 62810 - Twenty-Fourth Update of the Federal Agency Hazardous Waste Compliance Docket

    Science.gov (United States)

    2010-10-13

    ... Restoration and Reuse Office (Mail Code 5106P), U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue... Coordinator, Federal Facilities Restoration and Reuse Office (Mail Code 5106P), U.S. Environmental Protection... facilities, as reported under RCRA Section 3010; and (4) Federal facilities that have mixed mine or mill site...

  12. 77 FR 66609 - Twenty-Fifth Update of the Federal Agency Hazardous Waste Compliance Docket

    Science.gov (United States)

    2012-11-06

    .... Middle Island Light Station..... Middle Island...... Alpena Township.... MI 49707 Homeland Security... 48740 Homeland Security.. Other 17 Scenic Road. Thunder Bay Island Light Station Michigan Islands Alpena...

  13. 78 FR 16668 - Twenty-Fifth Update of the Federal Agency Hazardous Waste Compliance Docket

    Science.gov (United States)

    2013-03-18

    ....... Alpena Township...... MI 49707 Homeland Other 17 Security. Old Station Ludington......... 101 S.... Thunder Bay Island Light Michigan Islands Alpena Township...... MI 49707 Homeland Other 19A Station. Nat'l...

  14. Streamlining Compliance Validation Through Automation Processes

    Science.gov (United States)

    2014-03-01

    INTENTIONALLY LEFT BLANK xv LIST OF ACRONYMS AND ABBREVIATIONS ACAS Assured Compliance Assessment Suite AMP Apache- MySQL -PHP ANSI American...enemy. Of course , a common standard for DoD security personnel to write and share compliance validation content would prevent duplicate work and aid in...process and consume much of the SCAP content available. Finally, it is free and easy to install as part of the Apache/ MySQL /PHP (AMP) [37

  15. Enforcement and Compliance History Online | US EPA

    Science.gov (United States)

    ECHO, Enforcement and Compliance History Online, provides compliance and enforcement information for approximately 800,000 EPA-regulated facilities nationwide. ECHO includes permit, inspection, violation, enforcement action, and penalty information about facilities regulated under the Clean Air Act (CAA) Stationary Source Program, Clean Water Act (CWA) National Pollutant Elimination Discharge System (NPDES), and/or Resource Conservation and Recovery Act (RCRA). Information also is provided on surrounding demographics when available.

  16. Design Compliance Matrices to ANSI and OSHA

    International Nuclear Information System (INIS)

    BENDIXSEN, R.B.

    2000-01-01

    U.S. Department of Energy Letter 98-SFD-028 requested Fluor Daniel Hanford, Inc. to provide clarifications as to compliance with ANSI 57.1, 57.2, 57.9, and 29 CFR 1910.179 (OSHA), in the form of an item-by-item compliance matrix, for the CSB. This Supporting Document contains Fluor Daniel, Inc.'s response for use by Fluor Daniel Hanford, Inc. regarding the clarifications requested by the U.S. Department of Energy

  17. SMEs’ corporate income tax compliance in Tanzania

    OpenAIRE

    Mahangila, Deogratius Ng'winula

    2014-01-01

    Many governments are struggling with inadequate tax revenue and increasing tax gaps. Consequently, changing behaviour of non-compliant taxpayers as small and medium enterprises (SMEs) because of their tax revenue potential and non-compliance behaviour is essential. This thesis examined the impact of corporate income tax penalty incidence, retributive justice, procedural justice, the interaction between retributive and procedural justice on corporate income tax compliance behaviour. Also, the ...

  18. Compliance with Corporate Governance Principles: Australian Evidence

    OpenAIRE

    Maryam Safari; Soheila Mirshekary; Victoria Wise

    2015-01-01

    This study investigates the association between the level of compliance of Australian listed companies with Australian corporate governance principles, in aggregate, and the level of discretionary accruals using the modified Jones model. It is hypothesised that higher levels of compliance would be associated with lower levels of discretionary accruals. Data from a random sample of 214 Australian listed companies for the years 2009 and 2010 were used to test the hypothesis. The results demonst...

  19. Compliance with occlusion therapy for childhood amblyopia.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2013-09-17

    Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

  20. Predicting Regulatory Compliance in Beer Advertising on Facebook.

    Science.gov (United States)

    Noel, Jonathan K; Babor, Thomas F

    2017-11-01

    The prevalence of alcohol advertising has been growing on social media platforms. The purpose of this study was to evaluate alcohol advertising on Facebook for regulatory compliance and thematic content. A total of 50 Budweiser and Bud Light ads posted on Facebook within 1 month of the 2015 NFL Super Bowl were evaluated for compliance with a self-regulated alcohol advertising code and for thematic content. An exploratory sensitivity/specificity analysis was conducted to determine if thematic content could predict code violations. The code violation rate was 82%, with violations prevalent in guidelines prohibiting the association of alcohol with success (Guideline 5) and health benefits (Guideline 3). Overall, 21 thematic content areas were identified. Displaying the product (62%) and adventure/sensation seeking (52%) were the most prevalent. There was perfect specificity (100%) for 10 content areas for detecting any code violation (animals, negative emotions, positive emotions, games/contests/promotions, female characters, minorities, party, sexuality, night-time, sunrise) and high specificity (>80%) for 10 content areas for detecting violations of guidelines intended to protect minors (animals, negative emotions, famous people, friendship, games/contests/promotions, minorities, responsibility messages, sexuality, sunrise, video games). The high prevalence of code violations indicates a failure of self-regulation to prevent potentially harmful content from appearing in alcohol advertising, including explicit code violations (e.g. sexuality). Routine violations indicate an unwillingness to restrict advertising content for public health purposes, and statutory restrictions may be necessary to sufficiently deter alcohol producers from repeatedly violating marketing codes. Violations of a self-regulated alcohol advertising code are prevalent in a sample of beer ads published on Facebook near the US National Football League's Super Bowl. Overall, 16 thematic content

  1. Overview of environmental surveillance and compliance at Los Alamos during 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    After introductory remarks about the National Lab, the report discusses background radiation, human-produced radiation, radionuclide migration, doses, and health physics risk; the environmental programs at LANL including environmental protection, restoration, waste management, quality assurance, environmental oversight, environmental safety and training; environmental monitoring of external penetrating radiation, surface waters, sediments, soils, foodstuffs, and associated biota; and environmental compliance with existing regulations.

  2. 42 CFR 423.171 - Procedures for approval of accreditation as a basis for deeming compliance.

    Science.gov (United States)

    2010-10-01

    ... BENEFIT Cost Control and Quality Improvement Requirements § 423.171 Procedures for approval of... 42 Public Health 3 2010-10-01 2010-10-01 false Procedures for approval of accreditation as a basis for deeming compliance. 423.171 Section 423.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

  3. Theory of Compliance: Indicator Checklist Statistical Model and Instrument Based Program Monitoring Information System.

    Science.gov (United States)

    Fiene, Richard J.; Woods, Lawrence

    Two unanswered questions about child care are: (1) Does compliance with state child care regulations have a positive impact on children? and (2) Have predictors of program quality been identified? This paper explores a research study and related model that have had some success in answering these questions. Section I, a general introduction,…

  4. Overview of environmental surveillance and compliance at Los Alamos during 1996

    International Nuclear Information System (INIS)

    1997-09-01

    After introductory remarks about the National Lab, the report discusses background radiation, human-produced radiation, radionuclide migration, doses, and health physics risk; the environmental programs at LANL including environmental protection, restoration, waste management, quality assurance, environmental oversight, environmental safety and training; environmental monitoring of external penetrating radiation, surface waters, sediments, soils, foodstuffs, and associated biota; and environmental compliance with existing regulations

  5. 40 CFR 63.1215 - What are the health-based compliance alternatives for total chlorine?

    Science.gov (United States)

    2010-07-01

    ... congregate for work, school, or recreation. (iii) Your facility is eligible for the health-based compliance... for work, school, or recreation; (C) Use site-specific, quality-assured data wherever possible; (D... diameter, stack gas temperature, and stack gas exit velocity; (D) Plot plan showing all stack emission...

  6. Software product quality control

    CERN Document Server

    Wagner, Stefan

    2013-01-01

    Quality is not a fixed or universal property of software; it depends on the context and goals of its stakeholders. Hence, when you want to develop a high-quality software system, the first step must be a clear and precise specification of quality. Yet even if you get it right and complete, you can be sure that it will become invalid over time. So the only solution is continuous quality control: the steady and explicit evaluation of a product's properties with respect to its updated quality goals.This book guides you in setting up and running continuous quality control in your environment. Star

  7. Compliance with RSV prophylaxis: Global physicians’ perspectives

    Directory of Open Access Journals (Sweden)

    Kari S Anderson

    2009-07-01

    Full Text Available Kari S Anderson, Victoria M Mullally, Linda M Fredrick, Andrew L CampbellAbbott Laboratories, Abbott Park, IL, USAAbstract: Respiratory syncytial virus (RSV is a significant cause of morbidity in high-risk infants. Palivizumab is proven to prevent serious RSV disease, but compliance with prophylaxis (monthly doses during the RSV season is essential to ensure protection. We invited 453 pediatricians to participate in a survey to identify their perspectives of barriers to compliance and interventions to improve compliance with palivizumab prophylaxis schedules. One hundred physicians from five continents completed the survey, identifying caregiver inconvenience, distance to clinic, cost of prophylaxis, and lack of understanding of the severity of RSV as the most common reasons for noncompliance. They recommended provision of educational materials about RSV, reminders from hospital or clinic, and administration of prophylaxis at home to increase compliance. Globally, physicians recognize several obstacles to prophylaxis compliance. This survey suggests that focused proactive interventions such as empowering caregivers with educational materials and reducing caregiver inconvenience may be instrumental to increase compliance.Keywords: medication adherence, respiratory syncytial virus infections, infant, premature, immunization, passive

  8. Using the acid rain advisor to evaluate compliance strategies

    International Nuclear Information System (INIS)

    Stallard, G.S.; Anderson, A.A.

    1991-01-01

    Unlike prior Clean Air Act (CAA) legislation, the most recent amendments will require utilities to reduce SO 2 and NO x emissions for existing operating power station and provides for compliance strategies in which emissions for existing operating power stations and provides for compliance strategies in which emission reductions can be transferred from one unit to another. The Electric Power Research Institute (EPRI), in conjunction with the Department of Energy (DOE), is funding the development of the Coal Quality Expert (CQE), a comprehensive analytical/planning tool to consider the myriad of potential coal purchase decisions now facing the utility, including fuel switching, blending, coal beneficiation, and the installation of retrofit emission controls. The CQE will be built on the foundation of proven, validated computer models to the maximum extent possible, including EPRI's Coal Quality Impact Model (CQIM), a state-of-the-art computer model designed to evaluate cost/performance impacts of fuel switching at existing power plants. In addition, as the CQE development permits, interim computer products will be offered. The first of these products is the Acid Rain Advisor (ARA). The ARA complements the CQIM by providing the ability to rapidly evaluate the system-wide cost and reduction benefits which result from selecting various reduction techniques on various units within the system. Thus, with the ARA, the utility can efficiently combine cost/performance information, view overall system results, and rapidly consider various 'What if' alternatives to ensure that individual unit reduction strategies are consistent with the goals of the utility as a whole. This paper demonstrates the capabilities of the ARA, and by use of a 'sample analysis,' illustrates how a utility might develop and evaluate alternative CAA compliance strategies

  9. CT technology update

    International Nuclear Information System (INIS)

    Edyvean, S.

    2004-01-01

    Full text: The capabilities of CT scanning as a diagnostic imaging medium increased dramatically with the introduction of four slice scanners in the second half of 1998. The ability to acquire four sets of scan projection data per revolution of the scanner gantry can be exploited by imaging a scan volume faster, or with greater z-axis resolution than a single slice scanner, or scanning larger volumes in the same total time. This has improved the quality of a number of clinical applications, as well as enabling new techniques that were not previously possible. This workshop will review the advances in CT scanning that have lead to modern multi-slice scanning. The operation of scanners will be explored looking at the hardware required and the changes in reconstruction techniques necessary with the higher number of imaged slices. The advantages and disadvantages of multi-slice scanners over their single-slice equivalents will be investigated, and image quality and dose issues will be discussed. An overview of the clinical applications that benefit from multi-slice technology will be given. The talk will end with a glimpse into the future where we have 64 and 256 slice, as well as flat panel, systems currently being trialled. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  10. Threshold guidance update

    International Nuclear Information System (INIS)

    Wickham, L.E.

    1986-01-01

    The Department of Energy (DOE) is developing the concept of threshold quantities for use in determining which waste materials must be handled as radioactive waste and which may be disposed of as nonradioactive waste at its sites. Waste above this concentration level would be managed as radioactive or mixed waste (if hazardous chemicals are present); waste below this level would be handled as sanitary waste. Last years' activities (1984) included the development of a threshold guidance dose, the development of threshold concentrations corresponding to the guidance dose, the development of supporting documentation, review by a technical peer review committee, and review by the DOE community. As a result of the comments, areas have been identified for more extensive analysis, including an alternative basis for selection of the guidance dose and the development of quality assurance guidelines. Development of quality assurance guidelines will provide a reasonable basis for determining that a given waste stream qualifies as a threshold waste stream and can then be the basis for a more extensive cost-benefit analysis. The threshold guidance and supporting documentation will be revised, based on the comments received. The revised documents will be provided to DOE by early November. DOE-HQ has indicated that the revised documents will be available for review by DOE field offices and their contractors

  11. Update on subclinical hyperthyroidism.

    Science.gov (United States)

    Donangelo, Ines; Braunstein, Glenn D

    2011-04-15

    Subclinical hyperthyroidism is defined by low or undetectable serum thyroid-stimulating hormone levels, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (as in Graves disease or toxic nodular goiter), administration of thyroid hormone for treatment of malignant thyroid disease, or unintentional excessive thyroid hormone therapy. The rate of progression to overt hyperthyroidism is higher in persons who have suppressed thyroid-stimulating hormone levels compared with those who have low but detectable levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation in older adults, and with decreased bone mineral density in postmenopausal women; however, the effectiveness of treatment in preventing these conditions is unknown. There is lesser-quality evidence suggesting an association between subclinical hyperthyroidism and other cardiovascular effects, including increased heart rate and left ventricular mass, and increased bone turnover markers. Possible associations between subclinical hyperthyroidism and quality of life parameters, cognition, and increased mortality rates are controversial. Prospective randomized controlled trials are needed to address the effects of early treatment on potential morbidities to help determine whether screening should be recommended in the asymptomatic general population.

  12. Endocrinology Update: Hypopituitarism.

    Science.gov (United States)

    Heidelbaugh, Joel J

    2016-12-01

    Hypopituitarism is defined as a deficiency of one or more pituitary hormones due to a decline in function of the pituitary gland and/or hypothalamus, which can result in higher risks of morbidity and mortality and decreased quality of life. Although hypopituitarism is a rare condition, it commonly develops after traumatic brain injury and in the setting of functioning and nonfunctioning pituitary adenomas. The diagnosis is based on detailed investigation of symptoms of target endocrine gland function relative to the corresponding pituitary hormone deficiency. The clinical manifestations of hypopituitarism result from the degree of the specific hormone deficiency. A thorough and longitudinal history and physical examination, including visual field testing, are paramount. Management consists of prompt pharmacotherapy, surgery, and/or radiotherapy to restore normal endocrine function and quality of life. In most patients with anterior and posterior pituitary hormone deficiency, corresponding hormone replacement is the mainstay of therapy. The prognosis for patients with hypopituitarism depends on the manner of and age at presentation, degree and severity of hormonal impairment, and response to medical and surgical therapies. Patients with hypopituitarism require lifelong monitoring of serum hormone levels and symptoms of hormone deficiency or excess. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  13. How update schemes influence crowd simulations

    International Nuclear Information System (INIS)

    Seitz, Michael J; Köster, Gerta

    2014-01-01

    Time discretization is a key modeling aspect of dynamic computer simulations. In current pedestrian motion models based on discrete events, e.g. cellular automata and the Optimal Steps Model, fixed-order sequential updates and shuffle updates are prevalent. We propose to use event-driven updates that process events in the order they occur, and thus better match natural movement. In addition, we present a parallel update with collision detection and resolution for situations where computational speed is crucial. Two simulation studies serve to demonstrate the practical impact of the choice of update scheme. Not only do density-speed relations differ, but there is a statistically significant effect on evacuation times. Fixed-order sequential and random shuffle updates with a short update period come close to event-driven updates. The parallel update scheme overestimates evacuation times. All schemes can be employed for arbitrary simulation models with discrete events, such as car traffic or animal behavior. (paper)

  14. Updated safety analysis of ITER

    International Nuclear Information System (INIS)

    Taylor, Neill; Baker, Dennis; Ciattaglia, Sergio; Cortes, Pierre; Elbez-Uzan, Joelle; Iseli, Markus; Reyes, Susana; Rodriguez-Rodrigo, Lina; Rosanvallon, Sandrine; Topilski, Leonid

    2011-01-01

    An updated version of the ITER Preliminary Safety Report has been produced and submitted to the licensing authorities. It is revised and expanded in response to requests from the authorities after their review of an earlier version in 2008, to reflect enhancements in ITER safety provisions through design changes, to incorporate new and improved safety analyses and to take into account other ITER design evolution. The updated analyses show that changes to the Tokamak cooling water system design have enhanced confinement and reduced potential radiological releases as well as removing decay heat with very high reliability. New and updated accident scenario analyses, together with fire and explosion risk analyses, have shown that design provisions are sufficient to minimize the likelihood of accidents and reduce potential consequences to a very low level. Taken together, the improvements provided a stronger demonstration of the very good safety performance of the ITER design.

  15. Updated safety analysis of ITER

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Neill, E-mail: neill.taylor@iter.org [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Baker, Dennis; Ciattaglia, Sergio; Cortes, Pierre; Elbez-Uzan, Joelle; Iseli, Markus; Reyes, Susana; Rodriguez-Rodrigo, Lina; Rosanvallon, Sandrine; Topilski, Leonid [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

    2011-10-15

    An updated version of the ITER Preliminary Safety Report has been produced and submitted to the licensing authorities. It is revised and expanded in response to requests from the authorities after their review of an earlier version in 2008, to reflect enhancements in ITER safety provisions through design changes, to incorporate new and improved safety analyses and to take into account other ITER design evolution. The updated analyses show that changes to the Tokamak cooling water system design have enhanced confinement and reduced potential radiological releases as well as removing decay heat with very high reliability. New and updated accident scenario analyses, together with fire and explosion risk analyses, have shown that design provisions are sufficient to minimize the likelihood of accidents and reduce potential consequences to a very low level. Taken together, the improvements provided a stronger demonstration of the very good safety performance of the ITER design.

  16. Current standards for infection control: audit assures compliance.

    Science.gov (United States)

    Flanagan, Pauline

    Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

  17. Quality assurance in France - The system applied by Electrite de France

    International Nuclear Information System (INIS)

    Vaujour, J.A.

    1975-01-01

    For the design and construction of nuclear power stations, Electricite de France (EDF) has adopted a method which is based on its experience - taking account of its position as virtually the sole client of an industry in the course of development - and which enables it to fulfil its statutory obligations. Together with the power station constructors, EDF defines the technical objectives to be attained and the technical rules to be complied with, both of which are set forth in the contracts; it examines the designs and technical specifications submitted by the constructors and, if necessary, has them modified so that they conform to the contractual provisions; it maintains a check on the construction work to ensure compliance with the contracts as it has accepted them, examining any requests by the constructors for the waiving of certain provisions, and co-ordinates the activities of the different contractors involved in a single project. EDF requires that the constructors have a 'quality control organization' conforming to specifications which are regularly up-dated and which ensure compliance with the principles set forth in the contracts. In particular, each contracting body must have a system of 'internal controls' for ensuring the required quality in all operations and also a system of 'external controls' for enabling the management to verify the proper function of the system of 'internal controls'

  18. A Theory of Compliance with Minimum Wage Law

    OpenAIRE

    Asongu Simplice; Jellal Mohamed

    2014-01-01

    Purpose – In this paper, we introduce firm heterogeneity in the context of a model of non-compliance with minimum wage legislation. Design/methodology/approach – Theoretical modeling under government compliance policy and wages & employment under non compliance. Findings – The introduction of heterogeneity in the ease with which firms can be monitored for non compliance allows us to show that non-compliance will persist in sectors which are relatively difficult to monitor, despite the governm...

  19. Update on markets for forestry offsets

    International Nuclear Information System (INIS)

    Neeff, T.; Eichler, L.; Deecke, I.; Fehse, J.

    2007-01-01

    This guide is an update of the book 'Guidebook to Markets and Commercialization of CDM forestry projects'. The document provides information on the development of CMD methodologies, projects registered and markets since the publication of the first version. In addition it introduces the emerging non-Kyoto markets, it presents a classification of the existing developments, it describes each market including the buyer's preferences and it discusses the use of standards and quality criteria and transaction costs. We focus on markets for offsets from developing countries, rather than domestic offsets in developed countries. Section 1 is an introduction to the topic and an overview of the most recent developments. Sections 2 and 3 look at recent experiences and market developments for CDM reforestation projects. These sections are meant to be an update of the above mentioned guidebook and thus refrain from an exhaustive description. Section 4 assesses non-Kyoto markets for carbon offsets from forestry projects. It includes a description of the various market schemes and types of buyers. The section attempts to provide the project developer with useful information for developing a project following buyer' requirements. Finally, section 5 puts the assessment of opportunities for forestry in the broader context of the larger carbon markets. The report then concludes with a comparison of advantages and disadvantages of the CDM and non-Kyoto schemes from the project developer's point of view

  20. The primordial helium abundance from updated emissivities

    International Nuclear Information System (INIS)

    Aver, Erik; Olive, Keith A.; Skillman, Evan D.; Porter, R.L.

    2013-01-01

    Observations of metal-poor extragalactic H II regions allow the determination of the primordial helium abundance, Y p . The He I emissivities are the foundation of the model of the H II region's emission. Porter, Ferland, Storey, and Detisch (2012) have recently published updated He I emissivities based on improved photoionization cross-sections. We incorporate these new atomic data and update our recent Markov Chain Monte Carlo analysis of the dataset published by Izotov, Thuan, and Stasi'nska (2007). As before, cuts are made to promote quality and reliability, and only solutions which fit the data within 95% confidence level are used to determine the primordial He abundance. The previously qualifying dataset is almost entirely retained and with strong concordance between the physical parameters. Overall, an upward bias from the new emissivities leads to a decrease in Y p . In addition, we find a general trend to larger uncertainties in individual objects (due to changes in the emissivities) and an increased variance (due to additional objects included). From a regression to zero metallicity, we determine Y p = 0.2465 ± 0.0097, in good agreement with the BBN result, Y p = 0.2485 ± 0.0002, based on the Planck determination of the baryon density. In the future, a better understanding of why a large fraction of spectra are not well fit by the model will be crucial to achieving an increase in the precision of the primordial helium abundance determination

  1. Update on Cernavoda

    International Nuclear Information System (INIS)

    Boucher, R.

    1994-01-01

    The Cernavoda project in Romania is for five 700 MWe CANDU units. Construction began in 1980, but because of problems occurring, many of them associated with political, social, and economic changes in Romania, in 1991 the management of construction of Unit 1 was transferred from RENEL (Regia Nationala de Electricitate) to a consortium formed by AECL and Ansaldo. This had been one of the chief recommendations of a pr-operational safety review conducted by the I.A.E.A. By May 1994, Unit 1 was 93.4% complete, but progress was hampered by the need to rework a number of components, mainly piping. A continuous quality assurance program was in place. Ninety-two Romanian operators were trained by New Brunswick Power at Point Lepreau. As of the date of the conference, the target date for grid connection was March 1995, nine months ahead of the contractual target

  2. New updating into hemoglobinopathies.

    Science.gov (United States)

    Fucharoen, S; Winichagoon, P

    2012-12-01

    Thalassemia and abnormal hemoglobin are the most common genetic disorders and are considered health problems in many developing countries. In the last few years, there has been much progress in laboratory diagnosis, treatment and control of thalassemia. The variation in the clinical severity in both α- and β-thalassemia reflects a genotype-phenotype interaction. This is important for future therapeutic intervention and should be well characterized in each population. The quality of life of the patients is much improved with regular blood transfusion and novel iron chelators. The cure for thalassemia is possible by stem cell transplantation and future gene therapy. It is expected that under multinational collaboration the prevention of thalassemia will happen worldwide. © 2012 Blackwell Publishing Ltd.

  3. Methanol fuel update

    International Nuclear Information System (INIS)

    Colledge, R.; Spacek, J.

    1992-01-01

    An overview is presented of methanol fuel developments, with particular reference to infrastructure, supply and marketing. Methanol offers reduced emissions, easy handling, is cost effective, can be produced from natural gas, coal, wood, or municipal waste, is a high performance fuel, is safer than gasoline, and contributes to energy security. Methanol supply, environmental benefits, safety/health issues, economics, passenger car economics, status of passenger car technology, buses, methanol and the prosperity initiative, challenges to implementation, and the role of government and original equipment manufacturers are discussed. Governments must assist in the provision of methanol refuelling infrastructure, and in providing an encouraging regulatory atmosphere. Discriminatory and inequitable taxing methods must be addressed, and an air quality agenda must be defined to allow the alternative fuel industry to respond in a timely manner

  4. Validation of gamma irradiator controls for quality and regulatory compliance

    International Nuclear Information System (INIS)

    Harding, R.B.; Pinteric, F.J.A.

    1995-01-01

    Since 1978 the U.S. Food and Drug Administration (FDA) has had both the legal authority and the current good manufacturing practice (CGMP) regulations in progress to require irradiator owners who process medical devices to produce evidence of Irradiation Process Validation. One of the key components of Irradiation Process Validation is the validation of the irradiator controls. However it is only recently that FDA audits have focussed on this component of the process validation. (author)

  5. Federal Education Update, December 2004. Commission Update 04-17.

    Science.gov (United States)

    California Postsecondary Education Commission, 2004

    2004-01-01

    This update presents some of the major issues affecting education occurring at the national level. These include: Higher Education Act Extended for One Year; New Law Increases Loan Forgiveness for Teachers; Domestic Appropriations Measures Completed; Change in Federal Student Aid Rules; Bush Advisor Nominated To Be Education Secretary In Second…

  6. PRODUCING IN COMPLIANCE WITH ENVIRONMENTAL ...

    African Journals Online (AJOL)

    on study of Bedele brewery with the intent to examine whether it is ... Environmental Standards for Industrial Pollution Control by the Federal ... Fikresilasie, Impact of Brewery Effluent on River Water Quality: The Case of ... Total ammonia (as N) .... impact of this factory, we work based on - Food, Medicine and Health Care.

  7. Directory of certificates of compliance for radioactive materials packages

    International Nuclear Information System (INIS)

    1997-10-01

    The purpose of this directory is to make available a convenient source of information on packagings approved by the U.S. Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 for approved Quality Assurance programs. The reports include a listing of all users of each package design and approved Quality Assurance programs prior to the publication date of the directory. Comments to make future revisions of this directory more useful are invited and should be directed to the Spent Fuel Project Office, U.S. Nuclear Regulatory Commission

  8. Directory of certificates of compliance for radioactive materials packages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The purpose of this directory is to make available a convenient source of information on packagings approved by the U.S. Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 for approved Quality Assurance programs. The reports include a listing of all users of each package design and approved Quality Assurance programs prior to the publication date of the directory. Comments to make future revisions of this directory more useful are invited and should be directed to the Spent Fuel Project Office, U.S. Nuclear Regulatory Commission.

  9. Nuclear quality assurance operating philosophy: A quality-oriented approach

    International Nuclear Information System (INIS)

    Corcoran, W.R.; Geiger, J.E.; Heibel, R.E.; Cotton, J.B.; Sabol, A.R.

    1992-01-01

    Quality assurance programs have been part of the nuclear utility management process since the publication of the draft of 10CFR50 Appendix B in the late 1960s. The unwritten operational philosophy of nuclear quality assurance organizations focused on compliance with federal regulations. Adverse experiences, including operational events and extended shutdowns, prompted the gradual adoption of isolated practices extending beyond compliance orientation. These practices have an orientation that accommodates a definition of quality, a perspective of the role of nuclear quality assurance organizations in the overall concept of defense-in-depth, a definition of the segments of the nuclear quality assurance mission, and recent advances in the understanding of self-assessment. Observation of these practices at various nuclear utilities resulted in a syntheses of practices and approaches into a coherent quality-oriented nuclear quality assurance operating philosophy that is not totally adopted at any one utility

  10. JPSS CGS Tools For Rapid Algorithm Updates

    Science.gov (United States)

    Smith, D. C.; Grant, K. D.

    2011-12-01

    The National Oceanic and Atmospheric Administration (NOAA) and National Aeronautics and Space Administration (NASA) are jointly acquiring the next-generation civilian weather and environmental satellite system: the Joint Polar Satellite System (JPSS). JPSS will contribute the afternoon orbit component and ground processing system of the restructured National Polar-orbiting Operational Environmental Satellite System (NPOESS). As such, JPSS replaces the current Polar-orbiting Operational Environmental Satellites (POES) managed by NOAA and the ground processing component of both POES and the Defense Meteorological Satellite Program (DMSP) replacement known as the Defense Weather Satellite System (DWSS), managed by the Department of Defense (DoD). The JPSS satellites will carry a suite of sensors designed to collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The ground processing system for JPSS is known as the JPSS Common Ground System (JPSS CGS), and consists of a Command, Control, and Communications Segment (C3S) and the Interface Data Processing Segment (IDPS). Both are developed by Raytheon Intelligence and Information Systems (IIS). The Interface Data Processing Segment will process NPOESS Preparatory Project, Joint Polar Satellite System and Defense Weather Satellite System satellite data to provide environmental data products to NOAA and DoD processing centers operated by the United States government. Under NPOESS, Northrop Grumman Aerospace Systems Algorithms and Data Products (A&DP) organization was responsible for the algorithms that produce the EDRs, including their quality aspects. For JPSS, that responsibility has transferred to NOAA's Center for Satellite Applications & Research (STAR). As the Calibration and Validation (Cal/Val) activities move forward following both the NPP launch and subsequent JPSS and DWSS launches, rapid algorithm updates may be required. Raytheon and

  11. Adolescents' Compliance-Resistance: Effects of Parents' Compliance Strategy and Gender.

    Science.gov (United States)

    White, Kim D.; And Others

    1989-01-01

    Examined choice of compliance-resisting behaviors among adolescents. Findings from 118 high school students revealed significant differences in resistance strategy the adolescent selected on basis of parent gender, adolescent gender, and compliance-gaining strategy (manipulation, nonnegotiation, emotional appeal, personal rejection, empathic…

  12. Compliance pluralisme and processes : Understanding compliance behavior in restaurants in China

    NARCIS (Netherlands)

    Wu, Y.

    2017-01-01

    This research aimed to offer a case study of dynamic compliance processes in selected Chinese restaurants with the main methods of participant observation and in-depth interviews. It applied an integrated and dynamic research approach, called descriptive analysis of compliance behavior, which

  13. Patient compliance with exercise: different theoretical approaches to short-term and long-term compliance.

    NARCIS (Netherlands)

    Sluijs, E.M.; Knibbe, J.J.

    1991-01-01

    Compliance with exercise regimens is difficult to obtain as is compliance with other medical regimens. In analyzing noncompliance, two problems exist: (I) current theories only partly explain patients’ noncompliance; (2) health care providers seldom act according to the recommendations derived from

  14. Compliance checking of data-aware and resource-aware compliance requirements

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Gromov, V.; Fahland, D.; Aalst, van der W.M.P.; Meersman, R.; Panetto, H.; Dillon, T.; Missikoff, M.; Liu, L.; Pastor, O.; Cuzzocrea, A.; Sllis, T.

    2014-01-01

    Compliance checking is gaining importance as today’s organizations need to show that their business practices are in accordance with predefined (legal) requirements. Current compliance checking techniques are mostly focused on checking the control-flow perspective of business processes. This paper

  15. Improving Metadata Compliance for Earth Science Data Records

    Science.gov (United States)

    Armstrong, E. M.; Chang, O.; Foster, D.

    2014-12-01

    One of the recurring challenges of creating earth science data records is to ensure a consistent level of metadata compliance at the granule level where important details of contents, provenance, producer, and data references are necessary to obtain a sufficient level of understanding. These details are important not just for individual data consumers but also for autonomous software systems. Two of the most popular metadata standards at the granule level are the Climate and Forecast (CF) Metadata Conventions and the Attribute Conventions for Dataset Discovery (ACDD). Many data producers have implemented one or both of these models including the Group for High Resolution Sea Surface Temperature (GHRSST) for their global SST products and the Ocean Biology Processing Group for NASA ocean color and SST products. While both the CF and ACDD models contain various level of metadata richness, the actual "required" attributes are quite small in number. Metadata at the granule level becomes much more useful when recommended or optional attributes are implemented that document spatial and temporal ranges, lineage and provenance, sources, keywords, and references etc. In this presentation we report on a new open source tool to check the compliance of netCDF and HDF5 granules to the CF and ACCD metadata models. The tool, written in Python, was originally implemented to support metadata compliance for netCDF records as part of the NOAA's Integrated Ocean Observing System. It outputs standardized scoring for metadata compliance for both CF and ACDD, produces an objective summary weight, and can be implemented for remote records via OPeNDAP calls. Originally a command-line tool, we have extended it to provide a user-friendly web interface. Reports on metadata testing are grouped in hierarchies that make it easier to track flaws and inconsistencies in the record. We have also extended it to support explicit metadata structures and semantic syntax for the GHRSST project that can be

  16. Break the fast? Update on patient preparation for cholesterol testing.

    Science.gov (United States)

    Naugler, Christopher; Sidhu, Davinder

    2014-10-01

    To provide an update on the clinical usefulness of nonfasting versus fasting lipid testing to improve patient compliance, patient safety, and clinical assessment in cholesterol testing. Recommendations are identified as supported by good, fair, and poor (conflicting or insufficient) evidence, according to the classifications adopted by the Canadian Task Force on Preventive Health Care. Screening for dyslipidemia as a risk factor for coronary artery disease and management of lipid-lowering medications are key parts of primary care. Recent evidence has questioned the fasting requirement for lipid testing. In population-based studies, total cholesterol, high-density lipoprotein cholesterol, and non-low-density lipoprotein cholesterol all varied by an average of 2% with fasting status. For routine screening, nonfasting cholesterol measurement is now a reasonable alternative to a fasting cholesterol measurement. For patients with diabetes, the fasting requirement might be an important safety issue because of problems with hypoglycemia. For the monitoring of triglyceride and low-density lipoprotein cholesterol levels in patients taking lipid-lowering medications, fasting becomes more important. Fasting for routine lipid level determinations is largely unnecessary and unlikely to affect patient clinical risk stratification, while nonfasting measurement might improve patient compliance and safety. Copyright© the College of Family Physicians of Canada.

  17. [Update of hidradenitis suppurativa in Primary Care].

    Science.gov (United States)

    García-Martínez, F J; Pascual, J C; López-Martín, I; Pereyra-Rodríguez, J J; Martorell Calatayud, A; Salgado-Boquete, L; Labandeira-García, J

    Hidradenitis suppurativa is a prevalent disease that is noted for its clinical variability and by its severe impact on quality of life. A meticulous scientific literature review is presented in this article in order to give an update on what is known on this condition. Primary Care physicians obviously play an important role in the early diagnosis and management of hidradenitis suppurativa. This review aims to provide a current and practical overview about this disease in order to optimise the healthcare for these patients by making the best use of available resources. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Dental Anomalies: An Update

    Directory of Open Access Journals (Sweden)

    Fatemeh Jahanimoghadam

    2016-01-01

    Full Text Available Dental anomalies are usual congenital malformation that can happen either as isolated findings or as a part of a syndrome. Developmental anomalies influencing the morphology exists in both deciduous and permanent dentition and shows different forms such as gemination, fusion, concrescence, dilaceration, dens evaginatus (DE, enamel pearls, taurodontism or peg-shaped laterals. All These anomalies have clinical significance concerning aesthetics, malocclusion and more necessary preparing of the development of dental decays and oral diseases. Through a search in PubMed, Google, Scopus and Medline, a total of eighty original research papers during 1928-2016 were found with the keywords such as dental anomaly, syndrome, tooth and hypodontia. One hundred review titles were identified, eighty reviews were retrieved that were finally included as being relevant and of sufficient quality. In this review, dental anomalies including gemination, fusion, concrescence, dilaceration, dens invaginatus, DE, taurodontism, enamel pearls, fluorosis, peg-shaped laterals, dentinal dysplasia, regional odontodysplasia and hypodontia are discussed. Diagnosing dental abnormality needs a thorough evaluation of the patient, involving a medical, dental, familial and clinical history. Clinical examination and radiographic evaluation and in some of the cases, specific laboratory tests are also needed. Developmental dental anomalies require careful examination and treatment planning. Where one anomaly is present, clinicians should suspect that other anomalies may also be present. Moreover, careful clinical and radiographical examination is required. Furthermore, more complex cases need multidisciplinary planning and treatment.

  19. Quality-improvement analytics for intravenous infusion pumps.

    Science.gov (United States)

    Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

    2013-04-15

    The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

  20. Belief update as social choice

    NARCIS (Netherlands)

    van Benthem, J.; Girard, P.; Roy, O.; Marion, M.

    2011-01-01

    Dynamic epistemic-doxastic logics describe the new knowledge or new beliefs indexBelief of agents after some informational event has happened. Technically, this requires an update rule that turns a doxastic-epistemic modelM(recording the current information state of the agents) and a dynamic ‘event