WorldWideScience

Sample records for general safety guidelines

  1. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

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

  2. Biological effects of ultrasound: development of safety guidelines. Part II: general review.

    Science.gov (United States)

    Nyborg, W L

    2001-03-01

    In the 1920s, the availability of piezoelectric materials and electronic devices made it possible to produce ultrasound (US) in water at high amplitudes, so that it could be detected after propagation through large distances. Laboratory experiments with this new mechanical form of radiation showed that it was capable of producing an astonishing variety of physical, chemical and biologic effects. In this review, the early findings on bioeffects are discussed, especially those from experiments done in the first few decades, as well as the concepts employed in explaining them. Some recent findings are discussed also, noting how the old and the new are related. In the first few decades, bioeffects research was motivated partly by curiosity, and partly by the wish to increase the effectiveness and ensure the safety of therapeutic US. Beginning in the 1970s, the motivation has come also from the need for safety guidelines relevant to diagnostic US. Instrumentation was developed for measuring acoustic pressure in the fields of pulsed and focused US employed, and standards were established for specifying the fields of commercial equipment. Critical levels of US quantities were determined from laboratory experiments, together with biophysical analysis, for bioeffects produced by thermal and nonthermal mechanisms. These are the basis for safety advice and guidelines recommended or being considered by national, international, professional and governmental organizations.

  3. Cryogenic Safety Rules and Guidelines at CERN

    CERN Document Server

    CERN. Geneva

    2016-01-01

    CERN defines and implements a Safety Policy that sets out the general principles governing safety at CERN. As an intergovernmental organisation, CERN further establishes its own Safety Rules as necessary for its proper functioning. In this process, it takes into account the laws and regulation of the Host States (France and Switzerland), EU regulations and directives, as well as international regulations, standards and directives. For the safety of cryogenic equipment, this is primarily covered by the Safety Regulation for Mechanical Equipment and the General Safety Instruction for Cryogenic Equipment. In addition, CERN has also developed Safety Guidelines to support the implementation of these safety rules, covering cryogenic equipment and oxygen deficiency hazard assessment and mitigation. An overview of the cryogenic safety rules and these safety guidelines will be presented.

  4. Primary battery design and safety guidelines handbook

    Science.gov (United States)

    Bragg, Bobby J.; Casey, John E.; Trout, J. Barry

    1994-12-01

    This handbook provides engineers and safety personnel with guidelines for the safe design or selection and use of primary batteries in spaceflight programs. Types of primary batteries described are silver oxide zinc alkaline, carbon-zinc, zinc-air alkaline, manganese dioxide-zionc alkaline, mercuric oxide-zinc alkaline, and lithium anode cells. Along with typical applications, the discussions of the individual battery types include electrochemistry, construction, capacities and configurations, and appropriate safety measures. A chapter on general battery safety covers hazard sources and controls applicable to all battery types. Guidelines are given for qualification and acceptance testing that should precede space applications. Permissible failure levels for NASA applications are discussed.

  5. 10 CFR 1023.9 - General guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false General guidelines. 1023.9 Section 1023.9 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) CONTRACT APPEALS Overview: Organization, Functions and Authorities § 1023.9 General guidelines. (a) The principles of this Overview shall apply to all Board...

  6. EM Health and Safety Plan Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

  7. General safety considerations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-09-01

    This document presents the full filling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 4 of the document contains some details about the priority to safety, financial and human resources, human factors, quality assurance, safety assessment and verification, radiation protection and emergency preparedness.

  8. General safety considerations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    This document presents the full filling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 4 of the document contains some details about the priority to safety, financial and human resources, human factors, quality assurance, safety assessment and verification, radiation protection and emergency preparedness.

  9. Guidelines for computer security in general practice

    Directory of Open Access Journals (Sweden)

    Peter Schattner

    2007-06-01

    Conclusions This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making these guidelines relevant to local contexts should help maximise their uptake.

  10. Adherence to asthma guidelines in general practices.

    Science.gov (United States)

    Roghmann, M C; Sexton, M

    1999-06-01

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

  11. Discussions about safety criteria and guidelines for radioactive waste management.

    Science.gov (United States)

    Yamamoto, Masafumi

    2011-07-01

    In Japan, the clearance levels for uranium-bearing waste have been established by the Nuclear Safety Commission (NSC). The criteria for uranium-bearing waste disposal are also necessary; however, the NSC has not concluded the discussion on this subject. Meanwhile, the General Administrative Group of the Radiation Council has concluded the revision of its former recommendation 'Regulatory exemption dose for radioactive solid waste disposal', the dose criteria after the institutional control period for a repository. The Standardization Committee on Radiation Protection in the Japan Health Physics Society (The Committee) also has developed the relevant safety criteria and guidelines for existing exposure situations, which are potentially applicable to uranium-bearing waste disposal. A new working group established by The Committee was initially aimed at developing criteria and guidelines specifically for uranium-bearing waste disposal; however, the aim has been shifted to broader criteria applicable to any radioactive wastes.

  12. Nuclear criticality safety training: guidelines for DOE contractors

    Energy Technology Data Exchange (ETDEWEB)

    Crowell, M.R.

    1983-09-01

    The DOE Order 5480.1A, Chapter V, Safety of Nuclear Facilities, establishes safety procedures and requirements for DOE nuclear facilities. This guide has been developed as an aid to implementing the Chapter V requirements pertaining to nuclear criticality safety training. The guide outlines relevant conceptual knowledge and demonstrated good practices in job performance. It addresses training program operations requirements in the areas of employee evaluations, employee training records, training program evaluations, and training program records. It also suggests appropriate feedback mechanisms for criticality safety training program improvement. The emphasis is on academic rather than hands-on training. This allows a decoupling of these guidelines from specific facilities. It would be unrealistic to dictate a universal program of training because of the wide variation of operations, levels of experience, and work environments among DOE contractors and facilities. Hence, these guidelines do not address the actual implementation of a nuclear criticality safety training program, but rather they outline the general characteristics that should be included.

  13. 77 FR 37093 - Amendments to Highway Safety Program Guidelines

    Science.gov (United States)

    2012-06-20

    ..., Guideline No. 6 Codes and Laws, Guideline No. 16 Management of Highway Incidents (formerly Debris Hazard... activities statewide. Highway Safety Program Guideline No. 16 Management of Highway Incidents (Formerly... program should provide at a minimum that: A. Traffic Incident Management programs are effective and...

  14. Human Hallucinogen Research: Guidelines for Safety

    Science.gov (United States)

    Johnson, Matthew W.; Richards, William A.; Griffiths, Roland R.

    2010-01-01

    There has recently been a renewal of human research with classical hallucinogens (psychedelics). This paper first briefly discusses the unique history of human hallucinogen research, and then reviews the risks of hallucinogen administration and safeguards for minimizing these risks. Although hallucinogens are relatively safe physiologically and are not considered drugs of dependence, their administration involves unique psychological risks. The most likely risk is overwhelming distress during drug action (“bad trip”), which could lead to potentially dangerous behavior such as leaving the study site. Less common are prolonged psychoses triggered by hallucinogens. Safeguards against these risks include the exclusion of volunteers with personal or family history of psychotic disorders or other severe psychiatric disorders, establishing trust and rapport between session monitors and volunteer before the session, careful volunteer preparation, a safe physical session environment, and interpersonal support from at least two study monitors during the session. Investigators should probe for the relatively rare hallucinogen persisting perception disorder in follow up contact. Persisting adverse reactions are rare when research is conducted along these guidelines. Incautious research may jeopardize participant safety and future research. However, carefully conducted research may inform the treatment of psychiatric disorders, and may lead to advances in basic science. PMID:18593734

  15. An appraisal of meta-analysis guidelines: how do they relate to safety outcomes?

    Science.gov (United States)

    Bennetts, Meg; Whalen, Ed; Ahadieh, Sima; Cappelleri, Joseph C

    2016-09-09

    Although well developed to assess efficacy questions, meta-analyses and, more generally, systematic reviews, have received less attention in application to safety-related questions. As a result, many open questions remain on how best to apply meta-analyses in the safety setting. This appraisal attempts to: (i) summarize the current guidelines for assessing individual studies, systematic reviews, and network meta-analyses; (ii) describe several publications on safety meta-analytic approaches; and (iii) present some of the questions and issues that arise with safety data. A number of gaps in the current quality guidelines are identified along with issues to consider when performing a safety meta-analysis. While some work is ongoing to provide guidance to improve the quality of safety meta-analyses, this review emphasizes the critical need for better reporting and increased transparency regarding safety data in the systematic review guidelines. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Advanced human-system interface design review guideline. General evaluation model, technical development, and guideline description

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.

    1994-07-01

    Advanced control rooms will use advanced human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator`s overall role in the system, the method of information presentation, and the ways in which operators interact with the system. The U.S. Nuclear Regulatory Commission (NRC) reviews the HSI aspects of control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported to protect public health and safety. The principal guidance available to the NRC, however, was developed more than ten years ago, well before these technological changes. Accordingly, the human factors guidance needs to be updated to serve as the basis for NRC review of these advanced designs. The purpose of this project was to develop a general approach to advanced HSI review and the human factors guidelines to support NRC safety reviews of advanced systems. This two-volume report provides the results of the project. Volume I describes the development of the Advanced HSI Design Review Guideline (DRG) including (1) its theoretical and technical foundation, (2) a general model for the review of advanced HSIs, (3) guideline development in both hard-copy and computer-based versions, and (4) the tests and evaluations performed to develop and validate the DRG. Volume I also includes a discussion of the gaps in available guidance and a methodology for addressing them. Volume 2 provides the guidelines to be used for advanced HSI review and the procedures for their use.

  17. TIS General Safety Group Annual Report 2000

    CERN Document Server

    Weingarten, W

    2001-01-01

    This report summarises the main activities of the General Safety (GS) Group of the Technical Inspection and Safety Division (TIS) during the year 2000, and the results obtained. The different topics in which the Group is active are covered: general safety inspections and ergonomy, electrical, chemistry and gas safety, chemical pollution containment and control, industrial hygiene, the safety of civil engineering works and outside contractors, fire prevention and the safety aspects of the LHC experiments.

  18. Methodology for calculating guideline concentrations for safety shot sites

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    Residual plutonium (Pu), with trace quantities of depleted uranium (DU) or weapons grade uranium (WU), exists in surficial soils at the Nevada Test Site (NTS), Nellis Air Force Range (NAFR), and the Tonopah Test Range (TTR) as the result of the above-ground testing of nuclear weapons and special experiments involving the detonation of plutonium-bearing devices. The special experiments (referred to as safety shots) involving plutonium-bearing devices were conducted to study the behavior of Pu as it was being explosively compressed; ensure that the accidental detonation of the chemical explosive in a production weapon would not result in criticality; evaluate the ability of personnel to manage large-scale Pu dispersal accidents; and develop criteria for transportation and storage of nuclear weapons. These sites do not pose a health threat to either workers or the general public because they are under active institutional control. The DOE is committed to remediating the safety shot sites so that radiation exposure to the public, both now and in the future, will be maintained within the established limits and be as low as reasonably achievable. Remediation requires calculation of a guideline concentration for the Pu, U, and their decay products that are present in the surface soil. This document presents the methodology for calculating guideline concentrations of weapons grade plutonium, weapons grade uranium, and depleted uranium in surface soils at the safety shot sites. Emphasis is placed on obtaining site-specific data for use in calculating dose to potential residents from the residual soil contamination.

  19. Guideline for the preparation of a contractor safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Stinnett, L

    1982-04-01

    This document is only a guideline for contractors to use in formalizing a safety program or preparing a safety plan. It contains a format of a suggested safety plan as well as pertinent safety elements which should be considered for inclusion. However, consideration of only those items listed may not be sufficient. Each contractor should include in the safety plan particular reference to those elements peculiar to the inherent hazards of the contractor's specific type of construction services, whether the hazard is shown in the list of safety elements or not. Each safety plan should be reviewed annually by the contractor's management. Reissue of the safety plan is mandatory if safety requirements have changed, or if the contractor's address or management (approval signature) has changed.

  20. Adherence to COPD guidelines in general practice

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Sørensen, Tina Brandt; Højmark, Torben Brunse

    2013-01-01

    BACKGROUND: The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). AIMS: To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD...... guidelines. METHODS: A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted...... were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. RESULTS: Data for 102 participating GP practices were analysed...

  1. Clinical guidelines: their implementation in general practice.

    OpenAIRE

    M Conroy; Shannon, W

    1995-01-01

    In recent years the development of clinical guidelines has received increasing attention from medical educators and those involved in standard setting, and has been initiated at both central and local levels. This review article outlines the current state of knowledge with regard to clinical guideline implementation in medical practice. It deals with the main aspects of the current guideline debate, such as, clinical freedom and doctor autonomy, the importance of ownership in guideline implem...

  2. Guidelines for engineering design for process safety

    National Research Council Canada - National Science Library

    2012-01-01

    .... Key areas to be enhanced in the new edition include inherently safer design, specifically concepts for design of inherently safer unit operations and Safety Instrumented Systems and Layer of Protection Analysis...

  3. Guidelines for engineering design for process safety

    National Research Council Canada - National Science Library

    2012-01-01

    "This updated version of one of the most popular and widely used CCPS books provides plant design engineers, facility operators, and safety professionals with key information on selected topics of interest...

  4. [WHO Surgical Safety Checklist and guideline for safe surgery 2009].

    Science.gov (United States)

    Nishiwaki, Kimitoshi; Ichikawa, Takao

    2014-03-01

    The World Health Organization (WHO) launched the Safe Surgery Saves Lives campaign in 2007 to improve safety of surgical care in the world. As a part of the campaign, the first edition of the Surgical Safety Checklist was created through an international consultative process in 2008 and the second edition was published in the WHO Guidelines for Safe Surgery 2009. The guidelines consist of ten essential objectives for safe surgery, and nine of the ten objectives are facilitated by introducing the surgical checklist in the operating room, which is designed to improve teamwork of the operating room member and to give them chances to use the safety processes consistently. It consists of nineteen check points scheduled to be used in three phases: before anesthesia induction, before any skin incision, and at the end of surgery. In this article we gave an outline of WHO Surgical Safety Checklist and WHO Guidelines for Safe Surgery 2009, and reviewed the evidence of the guidelines and checklist. Finally we presented the evidence indicating the efficacy of the WHO Surgical Safety Checklist, which included the pilot study attached in the guidelines showing that its use markedly decreased complications in patients undergoing noncardiac surgery in eight diverse international hospitals.

  5. Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics.

    NARCIS (Netherlands)

    Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.

    2016-01-01

    Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and

  6. Safety inspection guidelines for photovoltaic residences: a subcontract report

    Energy Technology Data Exchange (ETDEWEB)

    Forman, S.E.; Klein, D.N.

    1982-11-01

    A set of interim inspection guidelines is provided to assess the safety of a residential PV system until more formal documentation is available from code-generating groups. Included are definitions, source electrical characteristics, grounding, isolation, lightning protection, overcurrent protection, disconnect means, wiring methods, and structural guidelines. Suggested forms are included for system component identification, as well as a discussion of equivalent system grounding protection. (LEW)

  7. 43 CFR 4.100 - General rules and guidelines.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false General rules and guidelines. 4.100... rules and guidelines. (a) Effective date and applicability—(1) Effective date and general applicability..., in which event the period shall run to the end of the next business day. (e) General...

  8. The wound/burn guidelines - 1: Wounds in general.

    Science.gov (United States)

    Inoue, Yuji; Hasegawa, Minoru; Maekawa, Takeo; Le Pavoux, Andres; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Ito, Takaaki; Isei, Taiki; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kodera, Masanari; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kukino, Ryuichi; Kono, Takeshi; Sakai, Keisuke; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hashimoto, Akira; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Tachibana, Takao; Ihn, Hironobu

    2016-04-01

    The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders. © 2016 Japanese Dermatological Association.

  9. Perceived barriers to guideline adherence: A survey among general practitioners

    Directory of Open Access Journals (Sweden)

    Besters Casper F

    2011-09-01

    Full Text Available Abstract Background Despite considerable efforts to promote and support guideline use, adherence is often suboptimal. Barriers to adherence vary not only across guidelines but also across recommendations within guidelines. The aim of this study was to assess the perceived barriers to guideline adherence among GPs by focusing on key recommendations within guidelines. Methods We conducted a cross-sectional electronic survey among 703 GPs in the Netherlands. Sixteen key recommendations were derived from four national guidelines. Six statements were included to address the attitudes towards guidelines in general. In addition, GPs were asked to rate their perceived adherence (one statement and the perceived barriers (fourteen statements for each of the key recommendations, based on an existing framework. Results 264 GPs (38% completed the questionnaire. Although 35% of the GPs reported difficulties in changing routines and habits to follow guidelines, 89% believed that following guidelines leads to improved patient care. Perceived adherence varied between 52 and 95% across recommendations (mean: 77%. The most perceived barriers were related to external factors, in particular patient ability and behaviour (mean: 30% and patient preferences (mean: 23%. Lack of applicability of recommendations in general (mean: 22% and more specifically to individual patients (mean: 25% were also frequently perceived as barriers. The scores on perceived barriers differed largely between recommendations [minimum range 14%; maximum range 67%]. Conclusions Dutch GPs have a positive attitude towards the NHG guidelines, report high adherence rates and low levels of perceived barriers. However, the perceived adherence and perceived barriers varied largely across recommendations. The most perceived barriers across recommendations are patient related, suggesting that current guidelines do not always adequately incorporate patient preferences, needs and abilities. It may be

  10. General guidelines for biomedical software development

    Science.gov (United States)

    Silva, Luis Bastiao; Jimenez, Rafael C.; Blomberg, Niklas; Luis Oliveira, José

    2017-01-01

    Most bioinformatics tools available today were not written by professional software developers, but by people that wanted to solve their own problems, using computational solutions and spending the minimum time and effort possible, since these were just the means to an end. Consequently, a vast number of software applications are currently available, hindering the task of identifying the utility and quality of each. At the same time, this situation has hindered regular adoption of these tools in clinical practice. Typically, they are not sufficiently developed to be used by most clinical researchers and practitioners. To address these issues, it is necessary to re-think how biomedical applications are built and adopt new strategies that ensure quality, efficiency, robustness, correctness and reusability of software components. We also need to engage end-users during the development process to ensure that applications fit their needs. In this review, we present a set of guidelines to support biomedical software development, with an explanation of how they can be implemented and what kind of open-source tools can be used for each specific topic. PMID:28443186

  11. Receiving Gifts from Commercial Companies. Part 1: The Need for General Institutional Guidelines. Part 2: Example of General Institutional Guidelines.

    Science.gov (United States)

    Harrison, R. Van

    1994-01-01

    General institutional guidelines for gifts from commercial companies are needed, in light of national trends. Commercially supported continuing medical education, those concerning personal gifts to physicians, and conflict of interest and research are areas to be considered. (SK)

  12. Head injury management guidelines for general practitioners

    Directory of Open Access Journals (Sweden)

    Jeremy C Ganz

    2011-01-01

    Full Text Available A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined

  13. Head injury management guidelines for general practitioners.

    Science.gov (United States)

    Ganz, Jeremy C

    2011-07-01

    A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined.

  14. Contrast media. Safety issues and ESUR guidelines. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [Copenhagen University Hospital, Herlev (Denmark). Dept. of Diagnostic Radiology; Copenhagen Univ., Herlev (Denmark). Dept. of Diagnostic Sciences; Webb, Judith A.W. (eds.) [St. Bartholomew' s Hospital London Univ. (United Kingdom). Dept. of Radiology

    2009-07-01

    In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned members, reviewed the literature, proposed guidelines and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006. This second edition not only updates the previous edition, but also contains some completely new chapters, for example on gadolinium-based contrast agents, meta-analyses in contrast media research and various regulatory issues. Comprehensive consideration is given to the many different safety issues relating to iodinated, MR, ultrasound and barium contrast media. The text includes chapters on both acute and delayed non-renal adverse reactions and on renal adverse reactions. All those questions frequently raised in radiological practice are addressed, and the well-known ESUR guidelines on contrast media are included. This book, presented in a handy, easy to use format, provides an invaluable, unique and unparalleled source of information on the safety issues relating to contrast media. (orig.)

  15. The Italian National Guidelines for the fire safety of facades

    Directory of Open Access Journals (Sweden)

    Lamberto Mazziotti

    2013-11-01

    Full Text Available Traditionally, the facades' design buildings where once only focused on architectural or aesthetic purposes (in addition, of course, of whether protective issues. Nowadays, thanks to the technological development of the construction works and the use of new types of materials, the facades' design should also address fire safety related aspects. In Europe and especially in Italy – where the types of building façades are built with windows of small surface and natural stone coverings – the green building/sustainability movement has resulted in the development of new concepts in facade or curtain wall design that intended to enhance the energy efficiency of building façades. These new building surfaces are covered by extensive panelling fitted with insulating materials or by wide glass surfaces, capable of carry out the most diverse purposes including, just to name a few: energy reduction, climate comfort, recovery of electricity through photovoltaic panels that convert sunlight into electricity, large space for advertising purpose. One of the main fire safety goal for a building design is to restrict the vertical fire spread so that the smoke and flames are limited to the fire origin floor. The new building façade and curtain wall topologies could overwhelms concerns for fire safety, therefore the Italian National fire service has released a Fire Code Guideline in order to address the fire safety design for an high rise building façade. This paper aims to show the guideline contents and the related fire safety façades concerns.

  16. Contrast media. Safety issues and ESUR guidelines. 3. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [Copenhagen University Hospital, Herlev (Denmark). Dept. of Diagnostic Radiology; Webb, Judith A.W. (ed.) [St. Bartholomew' s Hospital, London (United Kingdom). Dept. of Radiology

    2014-06-01

    Fully updates the previous edition and includes new chapters on various complex topics. Represents a unique and unparalleled source of information on the many safety issues relating to different contrast media. Includes chapters on acute and delayed non-renal adverse reactions and on renal adverse reactions. Presented in a handy, easy-to-use format. In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned ESUR members, reviewed the literature, proposed guidelines, and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006, which was followed by an equally successful second edition in 2009. This third edition not only fully updates the previous edition, but also includes new chapters on complex topics such as use of contrast media in children and practical aspects of off-label contrast media use. The authorship includes members, past members, and non-members of the Contrast Media Safety Committee.

  17. Appropriateness of colonoscopy: Diagnostic yield and safety in guidelines

    Institute of Scientific and Technical Information of China (English)

    Mario Grassini; Carlo Verna; Paolo Niola; Monica Navino; Edda Battaglia; Gabrio Bassotti

    2007-01-01

    AIM:To evaluate if the guidelines for the appropriateness of performing colonoscopy by American Society for Gastrointestinal Endoscopy (AGSE) and Italian Society of Digestive Endoscopy (SIED) yield a good diagnostic efficacy and do not present risks of missing important colonic pathologies in an Italian population sample.METHODS:A total of 1017 consecutive patients (560 men and 457 women; mean age 64.4 ± 16 years)referred to an open-access endoscopy unit for colonoscopy from July 2004 to May 2006 were evaluated according to ASGE and SIED guidelines for appropriateness of performing the procedure. Diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of colonoscopies performed.RESULTS:About 85.2% patients underwent colonoscopy that was considered appropriate based on at least one ASGE or SIED criterion,while it was considered inappropriate for 14.8% of patients. The diagnostic yield of colonoscopy was significantly higher for appropriate colonoscopies (26.94% vs 10.6%,P<0.001) than for inappropriate colonoscopies (5.3%). There was no missed colorectal cancer following the ASGE/SIED criteria.CONCLUSION:ASGE/SIED guidelines have shown a good diagnostic yield and the rate of missing relevant colonic pathologies seems very low. Unfortunately,the percentage of inappropriate referrals for colonoscopy in an open-access endoscopy system is still high,despite the number of papers published on the issue and the definition of international guidelines. Further steps are required to update and standardize the guidelines toincrease their diffusion and to promote educational programs for general practitioners.

  18. Occupational safety and health guidelines for chemical hazards. Supplement IV-OHG

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This document is the fourth in a seris of supplements to the 1981 Publication NIOSH/OSHA Occupational Health Guidelines for Chemical Hazards. The 62 guidelines presented here in the fourth supplement include 11 revisions of previously issued guidelines and 51 new guidelines. The 62 occupational safety and health guidelines presented here are being published to disseminate technical information about chemical hazards to workers, employers, and occupational safety and health professionals. Each guideline includes (1) data on the chemical name and synonyms, cemnical and physical properties, exposure limits, and signs and symptoms of exposure, personal protective equipment, and control procedures.

  19. Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

    DEFF Research Database (Denmark)

    Gadegaard Jensen, Anders; Callesen, T; Hagemo, J S;

    2010-01-01

    Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care...... Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high-grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients...

  20. [General Strategies for Implementation of Clinical Practice Guidelines].

    Science.gov (United States)

    Valenzuela-Flores, Adriana Abigail; Viniegra-Osorio, Arturo; Torres-Arreola, Laura Laura

    2015-01-01

    The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture.

  1. Nuclear space power safety and facility guidelines study

    Energy Technology Data Exchange (ETDEWEB)

    Mehlman, W.F.

    1995-09-11

    This report addresses safety guidelines for space nuclear reactor power missions and was prepared by The Johns Hopkins University Applied Physics Laboratory (JHU/APL) under a Department of Energy grant, DE-FG01-94NE32180 dated 27 September 1994. This grant was based on a proposal submitted by the JHU/APL in response to an {open_quotes}Invitation for Proposals Designed to Support Federal Agencies and Commercial Interests in Meeting Special Power and Propulsion Needs for Future Space Missions{close_quotes}. The United States has not launched a nuclear reactor since SNAP 10A in April 1965 although many Radioisotope Thermoelectric Generators (RTGs) have been launched. An RTG powered system is planned for launch as part of the Cassini mission to Saturn in 1997. Recently the Ballistic Missile Defense Office (BMDO) sponsored the Nuclear Electric Propulsion Space Test Program (NEPSTP) which was to demonstrate and evaluate the Russian-built TOPAZ II nuclear reactor as a power source in space. As of late 1993 the flight portion of this program was canceled but work to investigate the attributes of the reactor were continued but at a reduced level. While the future of space nuclear power systems is uncertain there are potential space missions which would require space nuclear power systems. The differences between space nuclear power systems and RTG devices are sufficient that safety and facility requirements warrant a review in the context of the unique features of a space nuclear reactor power system.

  2. NASA System Safety Handbook. Volume 2: System Safety Concepts, Guidelines, and Implementation Examples

    Science.gov (United States)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Feather, Martin; Rutledge, Peter; Sen, Dev; Youngblood, Robert

    2015-01-01

    This is the second of two volumes that collectively comprise the NASA System Safety Handbook. Volume 1 (NASASP-210-580) was prepared for the purpose of presenting the overall framework for System Safety and for providing the general concepts needed to implement the framework. Volume 2 provides guidance for implementing these concepts as an integral part of systems engineering and risk management. This guidance addresses the following functional areas: 1.The development of objectives that collectively define adequate safety for a system, and the safety requirements derived from these objectives that are levied on the system. 2.The conduct of system safety activities, performed to meet the safety requirements, with specific emphasis on the conduct of integrated safety analysis (ISA) as a fundamental means by which systems engineering and risk management decisions are risk-informed. 3.The development of a risk-informed safety case (RISC) at major milestone reviews to argue that the systems safety objectives are satisfied (and therefore that the system is adequately safe). 4.The evaluation of the RISC (including supporting evidence) using a defined set of evaluation criteria, to assess the veracity of the claims made therein in order to support risk acceptance decisions.

  3. The General Safety Group Annual Report 2001/2002

    CERN Document Server

    Weingarten, W

    2003-01-01

    This report summarizes the main activities of the General Safety (GS) Group of the Technical Inspection and Safety Division during 2001 and 2002, and the results obtained. The different topics in which the group is active are covered: general safety inspections and ergonomics, electrical, chemical and gas safety, chemical pollution containment and control, industrial hygiene, the safety of civil engineering works and outside contractors, fire prevention and the safety aspects of the LHC experiments.

  4. [The Dutch College of General Practitioners' practice guideline "Dizziness"; reaction from a general practitioner's perspective

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The Dutch College of General Practitioners' practice guideline entitled 'Dizziness' concerns a complaint experienced by many people, yet it provides few scientific data to support the recommendations. The standard does, however, provide the general practitioner with some concrete advice: the diagnos

  5. Review guidelines on software languages for use in nuclear power plant safety systems. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hecht, H.; Hecht, M.; Graff, S.; Green, W.; Lin, D.; Koch, S.; Tai, A.; Wendelboe, D. [SoHaR, Inc., Beverly Hills, CA (United States)

    1996-06-01

    Guidelines for the programming and auditing of software written in high level languages for safety systems are presented. The guidelines are derived from a framework of issues significant to software safety which was gathered from relevant standards and research literature. Language-specific adaptations of these guidelines are provided for the following high level languages: Ada, C/C++, Programmable Logic Controller (PLC) Ladder Logic, International Electrotechnical Commission (IEC) Standard 1131-3 Sequential Function Charts, Pascal, and PL/M. Appendices to the report include a tabular summary of the guidelines and additional information on selected languages.s

  6. [Summary of the practice guideline 'Thyroid disorders' (first revision) from the Dutch College of General Practitioners

    NARCIS (Netherlands)

    Lieshout, J. van; Wessels, P.; Rijswijk, E. van; Boer, A.M; Wiersma, A.; Goudswaard, A.N.

    2007-01-01

    --The practice guideline 'Thyroid disorders' developed by the Dutch College of General Practitioners replaces the practice guideline 'Functional thyroid disorders' from 1996. Recommendations for palpable thyroid disorders have been added. --Hypothyroidism can often be treated by the general practiti

  7. Development of Manitoba Hydro's public water safety around dams management guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Bonin, Dave; McPhail, Gord; Murphy, Shayla; Schellenberg, Gord [KGS Acres, Winnipeg, (Canada); Read, Nick [Manitoba Hydro, Winnipeg, (Canada)

    2010-07-01

    Several drowning fatalities and safety incidents have occurred around dams in Ontario, Manitoba and other jurisdictions in Canada. Following these incidents, Manitoba Hydro implemented several measures to improve public safety around its dams with the development of a warning signs manual. Manitoba Hydro found that a standard centralized approach to the process of improving public safety is better for ensuring compliance and consistency, even though they have safety measures in place. This paper described the process that Manitoba Hydro has followed in developing a formal set of public water safety around dams (PWSD) guidelines and a program for implementing these guidelines. This program was developed with the intent of providing a high standard of public protection and continuous improvement and monitoring on par with the effect spent on similar dam safety type programs. This paper focused on the development of the pilot PWSD management plan for Pine Falls generating station in order to test the effectiveness and usability of the guidelines.

  8. Video-assisted feedback in general practice internships using German general practitioner's guidelines.

    Science.gov (United States)

    Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

    2012-01-01

    The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient - student - consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The Following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence

  9. Cytotoxic Drug Dispersal, Cytotoxic Safety, and Cytotoxic Waste Management: Practices and Proposed India-specific Guidelines.

    Science.gov (United States)

    Capoor, Malini R; Bhowmik, Kumar Tapas

    2017-01-01

    This article deals with practices related to cytotoxic drug dispersal, cytotoxic safety, and cytotoxic waste management and attempts at India-specific guidelines for their dispersal and disposal. The articles related to cytotoxic drug dispersal, cytotoxic safety, and cytotoxic waste management were reviewed from PubMed and their applicability in Indian health-care facilities (HCFs) was also reviewed. All HCFs dealing with cytotoxic drugs should consider cytotoxic policy, patient safety and health-care worker safety, and environmental monitoring program as per the available international guidelines customized as per Indian conditions. Utmost care in handling cytotoxic waste is quintessential. The formation of India-specific cytotoxic guidelines requires the inputs from all stakeholders. Cytotoxic waste, cytotoxic safety, and cytotoxic waste management should be the subject of a national strategy with an infrastructure, cradle-to-grave legislation, competent regulatory authority, and trained personnel.

  10. Safety in the Cybervillage: Some Guidelines for Teachers and Parents.

    Science.gov (United States)

    Burriss, Larry L.

    2003-01-01

    Details seven ways adults can ensure children's safety on the Internet: become familiar with the Internet community; learn how the Internet works; identify quality sites; learn what sites to avoid; teach children basic rules for Internet safety; place computers in high traffic areas and monitor use; and respond thoughtfully if a child visits an…

  11. Improving the safety features of general practice computer systems

    OpenAIRE

    Anthony Avery; Boki Savelyich; Sheila Teasdale

    2003-01-01

    General practice computer systems already have a number of important safety features. However, there are problems in that general practitioners (GPs) have come to rely on hazard alerts when they are not foolproof. Furthermore, GPs do not know how to make best use of safety features on their systems. There are a number of solutions that could help to improve the safety features of general practice computer systems and also help to improve the abilities of healthcare professionals to use these ...

  12. General Quality Control (QC) Guidelines for SAM Methods

    Science.gov (United States)

    Learn more about quality control guidelines and recommendations for the analysis of samples using the methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  13. 78 FR 71715 - Amendments to Highway Safety Program Guidelines

    Science.gov (United States)

    2013-11-29

    ...), James Stowe, and the University of North Carolina Highway Safety Research Center (UNC). The majority of... Board (NTSB), New York State Office for the Aging (NYSOA), University of North Carolina (UNC), as well... autonomy possible; Establish a Medical Advisory Board (MAB), consisting of a range of medical...

  14. Measure Guideline: Combustion Safety for Natural Draft Appliances Through Appliance Zone Isolation

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, J. [Center for Energy and Environment, Minneapolis, MN (United States); Bohac, D. [Center for Energy and Environment, Minneapolis, MN (United States)

    2014-04-01

    This measure guideline covers how to assess and carry out the isolation of natural draft combustion appliances from the conditioned space of low-rise residential buildings. It deals with combustion appliances located either within the living space in enclosed closets or side rooms or outside the living space in an adjacent area like an attic or garage. This subset of houses does not require comprehensive combustion safety tests and simplified prescriptive procedures can be used to address safety concerns. This allows residential energy retrofit contractors inexperienced in advanced combustion safety testing to effectively address combustion safety issues and allow energy retrofits including tightening and changes to distribution and ventilation systems to proceed.

  15. Appropriate small dam management for minimizing catchment-wide safety threats: International benchmarked guidelines and demonstrative cases studies

    Science.gov (United States)

    Pisaniello, John D.; Tingey-Holyoak, Joanne; Burritt, Roger L.

    2012-01-01

    Small dam safety is generally being ignored. The potential for dam failure resulting in catastrophic consequences for downstream communities, property, and the environment, warrants exploration of the threats and policy issues associated with the management of small/farm dams. The paper achieves this through a comparative analysis of differing levels of dam safety assurance policy: absent, driven, strong, and model. A strategic review is undertaken to establish international dam safety policy benchmarks and to identify a best practice model. A cost-effective engineering/accounting tool is presented to assist the policy selection process and complement the best practice model. The paper then demonstrates the significance of the small-dam safety problem with a case study of four Australian States,policy-absent South Australia, policy-driven Victoria, policy-strong New South Wales, and policy-modelTasmania. Surveys of farmer behavior practices provide empirical evidence of the importance of policy and its proper implementation. Both individual and cumulative farm dam failure threats are addressed and, with supporting empirical evidence, the need for "appropriate" supervision of small dams is demonstrated. The paper adds to the existing international dam policy literature by identifying acceptable minimum level practice in private/farm dam safety assurance policy as well as updated international best practice policy guidelines while providing case study demonstration of how to apply the guidelines and empirical reinforcement of the need for "appropriate" policy. The policy guidelines, cost-effective technology, and comparative lessons presented can assist any jurisdiction to determine and implement appropriate dam safety policy.

  16. Street smarts. Guidelines to safety for home care aides.

    Science.gov (United States)

    Myers, H W

    1998-04-01

    Home care aides--perhaps more than professionals--have to take a number of precautions to stay safe on the job. Part of the responsibility for keeping them safe falls to the agency that employs them. But a good deal of the responsibility is up to the individuals themselves. There's a lot the street smart home care aide can do to ensure his or her own safety on the job.

  17. Patient safety in primary care: a survey of general practitioners in the Netherlands

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2010-01-01

    Full Text Available Abstract Background Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general practitioners (GPs on patient safety were examined. Methods A web-based survey of a sample of GPs was undertaken. The items were derived from aspects of patient safety issues identified in a prior interview study. The questionnaire used 10 clinical cases and 15 potential risk factors to explore GPs' views on patient safety. Results A total of 68 GPs responded (51.5% response rate. None of the clinical cases was uniformly judged as particularly safe or unsafe by the GPs. Cases judged to be unsafe by a majority of the GPs concerned either the maintenance of medical records or prescription and monitoring of medication. Cases which only a few GPs judged as unsafe concerned hygiene, the diagnostic process, prevention and communication. The risk factors most frequently judged to constitute a threat to patient safety were a poor doctor-patient relationship, insufficient continuing education on the part of the GP and a patient age over 75 years. Language barriers and polypharmacy also scored high. Deviation from evidence-based guidelines and patient privacy in the reception/waiting room were not perceived as risk factors by most of the GPs. Conclusion The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy

  18. KAERI software verification and validation guideline for developing safety-critical software in digital I and C system of NPP

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jang Yeol; Lee, Jang Soo; Eom, Heung Seop

    1997-07-01

    This technical report is to present V and V guideline development methodology for safety-critical software in NPP safety system. Therefore it is to present V and V guideline of planning phase for the NPP safety system in addition to critical safety items, for example, independence philosophy, software safety analysis concept, commercial off the shelf (COTS) software evaluation criteria, inter-relationships between other safety assurance organizations, including the concepts of existing industrial standard, IEEE Std-1012, IEEE Std-1059. This technical report includes scope of V and V guideline, guideline framework as part of acceptance criteria, V and V activities and task entrance as part of V and V activity and exit criteria, review and audit, testing and QA records of V and V material and configuration management, software verification and validation plan production etc., and safety-critical software V and V methodology. (author). 11 refs.

  19. [The Dutch College of General Practitioners practice guideline 'The menopause'; reaction of the field of general practice

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2002-01-01

    The Dutch College of General Practitioners' practice guideline on the menopause will not be any major cause for discussion. The hot issue of giving oestrogens to peri- and postmenopausal women to prevent osteoporosis or cardiovascular disease was already covered in the practice guideline on osteopor

  20. General aviation air traffic pattern safety analysis

    Science.gov (United States)

    Parker, L. C.

    1973-01-01

    A concept is described for evaluating the general aviation mid-air collision hazard in uncontrolled terminal airspace. Three-dimensional traffic pattern measurements were conducted at uncontrolled and controlled airports. Computer programs for data reduction, storage retrieval and statistical analysis have been developed. Initial general aviation air traffic pattern characteristics are presented. These preliminary results indicate that patterns are highly divergent from the expected standard pattern, and that pattern procedures observed can affect the ability of pilots to see and avoid each other.

  1. Limiting the risk of injury through safety guidelines in a physical education setting

    Directory of Open Access Journals (Sweden)

    Andrew Fitzgerald

    2016-06-01

    Full Text Available Physical activity involves risk and thus the physical education classroom requires safety standards to be established and maintained to ensure safety. The number of physical education related injuries in elementary, middle school, and high school increased 150% from 1997 to 2007 and they have continued to rise in the last decade as well. The classroom teacher must employ the highest level of organization and management in order to limit their risk. Working together with administration to establish policy and review safety standards ensures that multiple entities are involved in ensuring safety. Having safety guidelines within a physical education setting could potentially help protect the students from unnecessary injuries and may prevent the school district from legal action in the case of an injury.

  2. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general

  3. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general practi

  4. Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2012-01-01

    Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

  5. Guidelines for confirmatory inplant tests of safety-relief valve discharges for BWR plants

    Energy Technology Data Exchange (ETDEWEB)

    Su, T.M.

    1981-05-01

    Inplant tests of safety/relief valve (SRV) discharges may be required to confirm generically established specifications for SRV loads and the maximum suppression pool temperature, and to evaluate possible effects of plant-unique parameters. These tests are required in those plants which have features that differ substantially from those previously tested. Guidelines for formulating appropriate test matrices, establishing test procedures, selecting necessary instrumentation, and reporting the test results are provided in this report. Guidelines to determine if inplant tests are required on the basis of the plant unique parameters are also included in the report.

  6. Measure Guideline: Combustion Safety for Natural Draft Appliances Using Indoor Air

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L. [Partnership for Advanced Residential Retrofit, Des Plaines, IL (United States)

    2014-04-01

    This measure guideline covers how to assess and carry out the combustion safety procedures for appliances and heating equipment that uses indoor air for combustion in low-rise residential buildings. Only appliances installed in the living space, or in an area freely communicating with the living space, vented alone or in tandem with another appliance are considered here. A separate measure guideline addresses combustion appliances located either within the living space in enclosed closets or side rooms or outside the living space in an adjacent area like an attic or garage that use outdoor air for combustion. This document is for inspectors, auditors, and technicians working in homes where energy upgrades are being conducted whether or not air infiltration control is included in the package of measures being applied. In the indoor combustion air case, guidelines summarized here are based on language provided in several of the codes to establish minimum requirements for the space using simplified prescriptive measures. In addition, building performance testing procedures are provided by testing agencies. The codes in combination with the test procedures offer comprehensive combustion safety coverage to address safety concerns, allowing inexperienced residential energy retrofit inspectors to effectively address combustion safety issues and allow energy retrofits to proceed.

  7. 10 CFR 1047.5 - Exercise of arrest authority-general guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Exercise of arrest authority-general guidelines. 1047.5 Section 1047.5 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) LIMITED ARREST AUTHORITY AND USE OF FORCE BY PROTECTIVE FORCE OFFICERS General Provisions § 1047.5 Exercise of arrest authority—general...

  8. Participatory design of a preliminary safety checklist for general practice.

    Science.gov (United States)

    Bowie, Paul; Ferguson, Julie; MacLeod, Marion; Kennedy, Susan; de Wet, Carl; McNab, Duncan; Kelly, Moya; McKay, John; Atkinson, Sarah

    2015-05-01

    The use of checklists to minimise errors is well established in high reliability, safety-critical industries. In health care there is growing interest in checklists to standardise checking processes and ensure task completion, and so provide further systemic defences against error and patient harm. However, in UK general practice there is limited experience of safety checklist use. To identify workplace hazards that impact on safety, health and wellbeing, and performance, and codesign a standardised checklist process. Application of mixed methods to identify system hazards in Scottish general practices and develop a safety checklist based on human factors design principles. A multiprofessional 'expert' group (n = 7) and experienced front-line GPs, nurses, and practice managers (n = 18) identified system hazards and developed and validated a preliminary checklist using a combination of literature review, documentation review, consensus building workshops using a mini-Delphi process, and completion of content validity index exercise. A prototype safety checklist was developed and validated consisting of six safety domains (for example, medicines management), 22 sub-categories (for example, emergency drug supplies) and 78 related items (for example, stock balancing, secure drug storage, and cold chain temperature recording). Hazards in the general practice work system were prioritised that can potentially impact on the safety, health and wellbeing of patients, GP team members, and practice performance, and a necessary safety checklist prototype was designed. However, checklist efficacy in improving safety processes and outcomes is dependent on user commitment, and support from leaders and promotional champions. Although further usability development and testing is necessary, the concept should be of interest in the UK and internationally. © British Journal of General Practice 2015.

  9. Management of asthma and COPD patients: feasibility of the application of guidelines in general practice.

    NARCIS (Netherlands)

    Jans, M.P.; Schellevis, F.G.; Hensbergen, W. van; Dukkers van Emden, T.; Eijk, J.T.M. van

    1998-01-01

    Objective: To examine the feasibility of the application of guidelines to the management of asthma and chronic obstructive pulmonary disease (COPD) by assessing compliance with the guidelines and listing the barriers general practitioners (GPs) encountered during implementation. Insight into the fea

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

    Science.gov (United States)

    Susi, Frank; Mundell, Robert

    1980-01-01

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

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

    Science.gov (United States)

    Susi, Frank; Mundell, Robert

    1980-01-01

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

  12. Issues in the management of acute agitation: how much current guidelines consider safety?

    Directory of Open Access Journals (Sweden)

    Bruno ePacciardi

    2013-05-01

    Full Text Available Agitated behavior constitutes up to 10% of emergency psychiatric interventions. Pharmacological tranquilization is often used as a valid treatment for agitation but a strong evidence base does not underpin it. Available literature shows different recommendations, supported by research data, theoretical considerations or clinical experience. Rapid tranquilization is mainly based on parenteral drug treatment and the few existing guidelines on this topic, when suggesting the use of first generation antipsychotics and benzodiazepines, include drugs with questionable tolerability profile such as chlorpromazine, haloperidol, midazolam and lorazepam. In order to systematically evaluate safety concerns related to the adoption of such guidelines, we reviewed them independently from principal diagnosis while examining tolerability data for suggested treatments. There is a growing evidence about safety profile of second generation antipsychotics for rapid tranquilization but further controlled studies providing definitive data in this area are urgently needed.

  13. Major depressive disorder in the general hospital: adaptation of clinical practice guidelines.

    Science.gov (United States)

    Voellinger, Rachel; Berney, Alexandre; Baumann, Pierre; Annoni, Jean Marie; Bryois, Christian; Buclin, Thierry; Büla, Christophe; Camus, Vincent; Christin, Laurent; Cornuz, Jacques; de Goumoëns, Pierre; Lamy, Olivier; Strnad, Jindrich; Burnand, Bernard; Stiefel, Frederic

    2003-01-01

    Major Depressive Disorder is particularly frequent among physically ill inpatients. Despite the considerable human burden and financial costs, Major Depressive Disorder remains under-detected and under-treated. To improve this situation, clinical practice guidelines for the management of Major Depressive Disorder were developed for patients in the general hospital. They were adapted from existing good quality guidelines. A literature search has been conducted to identify guidelines and systematic reviews about the management of Major Depressive Disorder. The quality of the existing guidelines was evaluated by means of the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Complementary literature searches were necessary to answer questions such as "depression and physical illness" or "antidepressants and somatic medication". The guidelines were discussed by a multidisciplinary internal panel. The final version was reviewed by an external panel. This paper presents the development process and a summary of these guidelines for the management of Major Depressive Disorder. The adaptation of good quality guidelines to local needs requires much time, effort and skills. Easier ways for the adaptation and use of high quality guidelines at the local level may result from better coordination, organization and updating of guidelines at a national or supranational level.

  14. Review guidelines for software languages for use in nuclear power plant safety systems: Final report. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Hecht, M.; Decker, D.; Graff, S.; Green, W.; Lin, D.; Dinsmore, G.; Koch, S. [SoHaR, Inc., Beverly Hills, CA (United States)

    1997-10-01

    Guidelines for the programming and auditing of software written in high level languages for safety systems are presented. The guidelines are derived from a framework of issues significant to software safety which was gathered from relevant standards and research literature. Language-specific adaptations of these guidelines are provided for the following high level languages: Ada83 and Ada95; C and C++; International Electrochemical Commission (IEC) Standard 1131-3 Ladder Logic, Sequential Function Charts, Structured Text, and Function Block Diagrams; Pascal; and PL/M. Appendices to the report include a tabular summary of the guidelines and additional information on selected languages.

  15. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (long Version)

    DEFF Research Database (Denmark)

    Lorentzen, T; Nolsøe, C P; Ewertsen, C;

    2015-01-01

    This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (long version)....

  16. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Science.gov (United States)

    Rietveld, Remco P; ter Riet, Gerben; Bindels, Patrick JE; Schellevis, François G; van Weert, Henk CPM

    2007-01-01

    Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes) were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%). In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation. PMID:17868475

  17. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  18. [The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Weel, C. van

    2008-01-01

    This article reviews the practice guideline from the Dutch College of General Practitioners on smoking cessation. General practitioners (GP) should strive after smoking cessation when patients consult and ask for support to stop smoking. Moreover, the practitioner should also show such initiative wh

  19. Safe Use of Pesticides, Guidelines. Occupational Safety and Health Series No. 38.

    Science.gov (United States)

    International Labour Office, Geneva (Switzerland).

    This document provides guidance on the safe use of pesticides in agricultural work. General principles are given and followed by more detailed safety requirements for the various pesticide application techniques. Finally, the medical aspects of pesticides are considered. (BB)

  20. Safe Use of Pesticides, Guidelines. Occupational Safety and Health Series No. 38.

    Science.gov (United States)

    International Labour Office, Geneva (Switzerland).

    This document provides guidance on the safe use of pesticides in agricultural work. General principles are given and followed by more detailed safety requirements for the various pesticide application techniques. Finally, the medical aspects of pesticides are considered. (BB)

  1. Radiation Safety Management Guidelines for PET-CT: Focus on Behavior and Environment

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Wook [Cancer Imaging Center, National University Cancer Hospital, Seoul (Korea, Republic of); Han, Eun Ok [Dept. of Radiological Technology, Daegu Health College, Seoul (Korea, Republic of)

    2011-09-15

    Our purpose is to specify behavior and environmental factors aimed at reducing the exposed dosage caused by PET-CT and to develop radiation safety management guidelines adequate for domestic circumstances. We have used a multistep-multimethod as the methodological approach to design and to carry out the research both in quality and quantity, including an analysis on previous studies, professional consultations and a survey. The survey includes responses from 139 practitioners in charged of 109 PET-CTs installed throughout Korea(reported by the Korean Society of Nuclear Medicine, 2010). The research use 156 questions using Cronbach's {alpha} (alpha) coefficients which were: 0.818 for 'the necessity of setting and installing the radiation protective environment'; 0.916 for 'the necessity of radiation protection', 'setting and installing the radiation protective environment'; and 0.885 for 'radiation protection'. The check list, derived from the radiation safety management guidelines focused on behavior and environment, was composed of 20 items for the radiation protective environment: including 5 items for the patient; 4 items for the guardian; 3 items for the radiologist; and 8 items applied to everyone involved; for a total of 26 items for the radiation protective behavior including: 12 items for the patient; 1 item for the guardian, 7 items for the radiologist; and 6 items applied to everyone involved. The specific check list is shown in (Table 5-6). Since our country has no safety management guidelines of its own to reduce the exposed dosage caused by PET-CTs, we believe the guidelines developed through this study means great deal to the field as it is not only appropriate for domestic circumstances, but also contains specific check lists for each target who may be exposed to radiation in regards to behavior and environment.

  2. ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

    Science.gov (United States)

    Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

    2010-09-01

    Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

  3. A Review of General Aviation Safety (1984-2017).

    Science.gov (United States)

    Boyd, Douglas D

    2017-07-01

    General aviation includes all civilian aviation apart from operations involving paid passenger transport. Unfortunately, this category of aviation holds a lackluster safety record, accounting for 94% of civil aviation fatalities. In 2014, of 1143 general aviation accidents, 20% were fatal compared with 0 of 29 airline mishaps in the United States. Herein, research findings over the past 30 yr will be reviewed. Accident risk factors (e.g., adverse weather, geographical region, post-impact fire, gender differences) will be discussed. The review will also summarize the development and implementation of stringent crashworthiness designs with multi-axis dynamic testing and head-injury protection and its impact on mitigating occupant injury severity. The benefits and drawbacks of new technology and human factor considerations associated with increased general aviation automation will be debated. Data on the safety of the aging general aviation population and increased drug usage will also be described. Finally, areas in which general aviation occupant survival could be improved and injury severity mitigated will be discussed with the view of equipping aircraft with 1) crash-resistant fuel tanks to reduce post-impact conflagration; 2) after-market ballistic parachutes for older aircraft; and 3) current generation electronic locator beacons to hasten site access by first responders.Boyd DD. A review of general aviation safety (1984-2017). Aerosp Med Hum Perform. 2017; 88(7):657-664.

  4. Updating Human Factors Engineering Guidelines for Conducting Safety Reviews of Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    O, J.M.; Higgins, J.; Stephen Fleger - NRC

    2011-09-19

    The U.S. Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) programs of applicants for nuclear power plant construction permits, operating licenses, standard design certifications, and combined operating licenses. The purpose of these safety reviews is to help ensure that personnel performance and reliability are appropriately supported. Detailed design review procedures and guidance for the evaluations is provided in three key documents: the Standard Review Plan (NUREG-0800), the HFE Program Review Model (NUREG-0711), and the Human-System Interface Design Review Guidelines (NUREG-0700). These documents were last revised in 2007, 2004 and 2002, respectively. The NRC is committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool. To this end, the NRC is updating its guidance to stay current with recent research on human performance, advances in HFE methods and tools, and new technology being employed in plant and control room design. This paper describes the role of HFE guidelines in the safety review process and the content of the key HFE guidelines used. Then we will present the methodology used to develop HFE guidance and update these documents, and describe the current status of the update program.

  5. Biological effects of electromagnetic fields and recently updated safety guidelines for strong static magnetic fields.

    Science.gov (United States)

    Yamaguchi-Sekino, Sachiko; Sekino, Masaki; Ueno, Shoogo

    2011-01-01

    Humans are exposed daily to artificial and naturally occurring magnetic fields that originate from many different sources. We review recent studies that examine the biological effects of and medical applications involving electromagnetic fields, review the properties of static and pulsed electromagnetic fields that affect biological systems, describe the use of a pulsed electromagnetic field in combination with an anticancer agent as an example of a medical application that incorporates an electromagnetic field, and discuss the recently updated safety guidelines for static electromagnetic fields. The most notable modifications to the 2009 International Commission on Non-Ionizing Radiation Protection guidelines are the increased exposure limits, especially for those who work with or near electromagnetic fields (occupational exposure limits). The recommended increases in exposure were determined using recent scientific evidence obtained from animal and human studies. Several studies since the 1994 publication of the guidelines have examined the effects on humans after exposure to high static electromagnetic fields (up to 9.4 tesla), but additional research is needed to ascertain further the safety of strong electromagnetic fields.

  6. General guidelines about performance specifications for purchasing equipment for x-ray diagnostics, with comments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    These general guidelines are intended to be used as a basis for what requirements are reasonable from a radiation protection point of view and should be part of the contract in connection with the purchase of equipment for x-ray diagnostics. Technical performance requirements are addressed as well as items like documentation, instructions for use and education and training. The guidelines are also useful for the design of quality assurance programs. In the comments in addition to these guidelines legal aspects are noted, including a list of relevant laws, regulations and directives. Standards, both national and international, within the field are referred to with a short description of their content. 40 refs.

  7. Safety of transcranial magnetic stimulation: review of international guidelines and new findings

    Directory of Open Access Journals (Sweden)

    N. A. Suponeva

    2017-01-01

    Full Text Available Transcranial magnetic stimulation (TMS is a rapidly developing method of neuromodulation. The use of TMS has increased significantly in both research and clinical practice. This allows not only to better understand this method, but also assess possible risks and consequences for both healthy individuals and patients. In 1998 and 2009 safety, ethical considerations, and application guidelines for the use of TMS in clinical practice and research were published. These recommendations are now the basis for safe application of the method in clinical practice and research. Safety of brain stimulation includes several aspects: the prevention and treatment of adverse effects, the strategy of patient and stimulation protocols selection, as well as safety and monitoring procedures. The most common adverse effects of TMS include headache and neck pain, syncope, transient hearing impairment. The risk of epileptic seizureis extremely low and can be minimized by careful selection of patients and the use of safe stimulation protocols. Careful selection of patients is important, taking into account a large number of factors that influence the risk of adverse effects. These factors are considered in the questionnaires to identify limitations and absolute or relative contraindications to TMS. Another important part of TMS safety is the choice of the stimulation protocol and parameters such as intensity, frequency, duration of one train of stimuli, and the interstimulus interval. Currently, the recommended limits of stimulation parameters are covered in the safety guidelines. It is also necessary to follow the procedure, including the monitoring the patient's condition during TMS and the providing qualified assistance in case of adverse effects.

  8. 10 CFR 1049.5 - Exercise of arrest authority-General guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Exercise of arrest authority-General guidelines. 1049.5 Section 1049.5 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) LIMITED ARREST AUTHORITY AND USE OF FORCE BY PROTECTIVE FORCE OFFICERS OF THE STRATEGIC PETROLEUM RESERVE § 1049.5 Exercise of arrest authority...

  9. [Summary of the 'Stroke' guideline of the Dutch College of General Practitioners' (NHG)

    NARCIS (Netherlands)

    Verburg, A.F.; Tjon, A.T.M.R.; Verstappen, W.H.J.M.; Beusmans, G.H.M.I.; Wiersma, T.; Burgers, J.S.

    2014-01-01

    The Dutch College of General Practitioners (NHG) guideline 'Stroke' covers the diagnosis, management and long-term care of stroke in general practice. Patients with neurological symptoms suspected to be due to cerebral infarction or haemorrhage should be transferred directly to a stroke unit. The

  10. 21 CFR 610.11a - Inactivated influenza vaccine, general safety test.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Inactivated influenza vaccine, general safety test... Inactivated influenza vaccine, general safety test. For inactivated influenza vaccine, the general safety test... pig. The requirements for general safety for inactivated influenza vaccine shall not be considered...

  11. System Guidelines for EMC Safety-Critical Circuits: Design, Selection, and Margin Demonstration

    Science.gov (United States)

    Lawton, R. M.

    1996-01-01

    Demonstration of required safety margins on critical electrical/electronic circuits in large complex systems has become an implementation and cost problem. These margins are the difference between the activation level of the circuit and the electrical noise on the circuit in the actual operating environment. This document discusses the origin of the requirement and gives a detailed process flow for the identification of the system electromagnetic compatibility (EMC) critical circuit list. The process flow discusses the roles of engineering disciplines such as systems engineering, safety, and EMC. Design and analysis guidelines are provided to assist the designer in assuring the system design has a high probability of meeting the margin requirements. Examples of approaches used on actual programs (Skylab and Space Shuttle Solid Rocket Booster) are provided to show how variations of the approach can be used successfully.

  12. Radiation safety awareness among medical interns: are EU guidelines being implemented?

    Science.gov (United States)

    Lee, A M; Lee, M J

    2016-11-14

    European recommendations suggest that medical students should be taught radiation safety before entering clinical practice. The aim of this study was to produce a summative assessment of radiation protection training in medical school in Ireland. A web-based questionnaire was distributed to the 2014 intern population (n = 683) via network intern-coordinators. The survey encompassed knowledge of radiation dose in X-ray investigations, laws governing the prescribing of radiation and complications of radiation exposure to staff and patients. Response rate was 14.2% (97/683) with all Irish medical schools represented. 64% of interns reported no formal training in radiation safety. 80% correctly identified MRI and 94% US as not posing a radiation risk. 54% identified CT PET as emitting the highest radiation dose to patients. Only 32% correctly identified one CT abdomen/pelvis as equivalent to the dose from 300 to 500 chest X-rays and 22% correctly identified the theoretical lifetime risk of cancer induction from CT abdomen/pelvis as 1 in 2000. While 71% thought it was very important that prescribers should be aware of patient radiation dose and 28% thought it was moderately important, 74% were not aware of any laws governing the prescribing of radiology investigations. Currently, there is little formal radiation safety training in Irish medical schools. Knowledge of radiation dose and the laws governing prescribing is limited among qualifying interns. Implementation of a formal radiation safety curriculum in Irish Medical Schools would adhere to EU guidelines and improve prescriber knowledge, patient, and personal radiation safety.

  13. [Summary of the 'Thyroid disorders' guideline of the Dutch College of General Practitioners' (NHG)

    NARCIS (Netherlands)

    Sijbom, M.; Lieshout, J. van; Felix-Schollaart, B.; Burgers, J.S.; Bouma, M.

    2013-01-01

    - The 'Thyroid disorders' guideline of the Dutch College of General Practitioners (NHG) provides recommendations for the diagnosis and management of hypothyroidism, hyperthyroidism and changes in the size of the thyroid gland, such as goitre and thyroid nodules. - Hypothyroid patients younger than 6

  14. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (Short Version)

    DEFF Research Database (Denmark)

    Lorentzen, T.; Nolsøe, C P; Ewertsen, C;

    2015-01-01

    This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (short version; the long version is published online)....

  15. [Summary of the Dutch College of General Practitioners' practice guideline on food hypersensitivity

    NARCIS (Netherlands)

    Luning-Koster, M.N.; Lucassen, P.L.B.J.; Boukes, F.S.; Goudswaard, A.

    2011-01-01

    October 2010 the Dutch College of General Practitioners issued a revised version of their previous practice guideline of 1995 on food hypersensitivity in infants. If patients suspect either themselves or their child of having a food allergy, this is usually not demonstrated in subsequent investigati

  16. [Summary of the Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'

    NARCIS (Netherlands)

    Weele, G.M. van der; Olde Rikkert, M.G.M.; Eizenga, W.H.; Assendelft, W.J.J.

    2003-01-01

    The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people' contains a number of key messages. These are: Consider the diagnosis of delirium in the case of changes in consciousness and attention, incoherent thinking or disorientation, if this picture developed over a

  17. GENERAL CONSIDERATIONS ON REGULATIONS AND SAFETY REQUIREMENTS FOR QUADRICYCLES

    Directory of Open Access Journals (Sweden)

    Ana Pavlovic

    2015-12-01

    Full Text Available In recent years, a new class of compact vehicles has been emerging and wide-spreading all around Europe: the quadricycle. These four-wheeled motor vehicles, originally derived from motorcycles, are a small and fuel-efficient mean of transportation used in rural or urban areas as an alternative to motorbikes or city cars. In some countries, they are also endorsed by local authorities and institutions which support small and environmentally-friendly vehicles. In this paper, several general considerations on quadricycles will be provided including the vehicle classification, evolution of regulations (as homologation, driver licence, emissions, etc, technical characteristics, safety requirements, most relevant investigations, and other additional useful information (e.g. references, links. It represents an important and actual topic of investigation for designers and manufacturers considering that the new EU regulation on the approval and market surveillance of quadricycles will soon enter in force providing conclusive requirements for functional safety environmental protection of these promising vehicles.

  18. Overview of resulting tools, guidelines, and instruments. IN-SAFETY Workpackage 3: New models, tools and guidelines for road safety assessment, Deliverable 3.4.

    OpenAIRE

    Dijkstra, A. Bald, S. Benz, T. & Gaitanidou, E. (eds.)

    2009-01-01

    Road safety will most probably be influenced by introducing Advanced Driver Assistance Systems (ADAS) or Intelligent Vehicle Safety Systems (IVSS). The effects of these systems on road safety can be assessed in different ways. This document gives a short overview of methodologies which allow for assessing road safety effects (Chapter 2), This Deliverable gives an overview of the outcome of work package 3 of IN-SAFETY. Two methodologies have basically been applied: • simulation model • risk an...

  19. Video-assisted feedback in general practice internships using German general practitioner's guidelines

    NARCIS (Netherlands)

    Bolter, R.; Freund, T.; Ledig, T.; Boll, B.; Szecsenyi, J.; Roos, M.

    2012-01-01

    Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the

  20. Overview of resulting tools, guidelines, and instruments. IN-SAFETY Workpackage 3: New models, tools and guidelines for road safety assessment, Deliverable 3.4.

    NARCIS (Netherlands)

    Dijkstra, A. Bald, S. Benz, T. & Gaitanidou, E. (eds.)

    2009-01-01

    Road safety will most probably be influenced by introducing Advanced Driver Assistance Systems (ADAS) or Intelligent Vehicle Safety Systems (IVSS). The effects of these systems on road safety can be assessed in different ways. This document gives a short overview of methodologies which allow for ass

  1. [Dutch College of General Practitioners' practice guideline 'Peripheral facial paralysis': a summary].

    Science.gov (United States)

    Klomp, M A Rien; Verdaasdonk, Aard L; Striekwold, Manuela P; Teunissen, H Eric; Opstelten, Wim; Goudswaard, A N Lex

    2010-01-01

    The practice guideline 'Peripheral facial paralysis' of the Dutch College of General Practitioners provides the general practitioner with guidelines for diagnosis and management of patients with a peripheral facial paralysis. In about two-thirds of cases of peripheral facial paralysis no cause can be found. The diagnosis of this so-called idiopathic peripheral facial paralysis is based on the patient's history and physical examination; additional investigations are not indicated. The natural course is usually good: without treatment 65-85% of patients will regain normal function of the facial muscles. Treatment with corticosteroids is recommended for all patients with an idiopathic peripheral facial paralysis, irrespective of the degree of the paralysis. This increases the chance of complete recovery by approximately 10%. Antiviral treatment is not recommended.

  2. Development of safety and regulatory requirements for Korean next generation reactor - Development of human factors design review guidelines (II)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Oh, In Suk; Lee, Hyun Chul; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-02-01

    The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25. Human Factors Engineering Program Review Model' and '26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation', which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and the characteristics of the KNGR design, and reviewing the reference documents of NURGE-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides at KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system design review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we updated the guidelines by reviewing the literature related to alarm design that published after 1994. 12 refs., 11 figs., 2 tabs. (Author)

  3. Generalized anxiety disorder: clinical presentation, diagnostic features, and guidelines for clinical practice.

    Science.gov (United States)

    van der Heiden, Colin; Methorst, Gerda; Muris, Peter; van der Molen, Henk T

    2011-01-01

    Generalized anxiety disorder (GAD) is a prevalent and disabling disorder characterised by persistent worrying, anxiety symptoms, and tension. General practitioners and mental healthcare professionals frequently misdiagnose the presenting symptoms. This article addresses the clinical presentation of GAD and provides guidelines for discriminating GAD from other disorders, based on theoretical considerations and clinical experience. Debate relating to the validity of the definition of GAD is discussed, and suggestions are made for improving the criteria for GAD, which may guide future versions of classification systems such as the Diagnostic and Statistical Manual.

  4. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mazza Danielle

    2013-01-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. Methods We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. Results Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations

  5. A study of the safety of tenoxicam in general practice.

    Science.gov (United States)

    Caughey, D; Waterworth, R F

    1989-11-08

    An open, noncomparative study was undertaken to examine the safety of tenoxicam, a new nonsteroidal antiinflammatory drug (NSAID) in general practice. One thousand two hundred and sixty-seven patients with rheumatic conditions were recruited by 392 general practitioners throughout New Zealand. Forty-three point six percent of patients recruited were over 65 years of age, 62.5% had some form of concomitant disease and 76.3% of patients were already receiving NSAIDs. Three hundred and four (23.9%) patients experienced adverse drug reactions, the commonest being gastrointestinal (11.4%), central and peripheral nervous system disorders (2.8%) and skin reactions (2.5%). The profile of adverse drug reactions in those more than 65 was similar to those in patients under 65 years. Of the reactions reported, 14.7% were considered severe. Three peptic ulcers were reported. There were no unexpected adverse drug reactions. Eight hundred and forty-nine patients completed 6 months treatment. Subjective assessments of overall efficacy, pain at night, pain on movement and stiffness made before treatment and at 1, 3 and 6 months posttreatment showed that tenoxicam significantly improved all parameters. The clinical response was maintained throughout the 6 month study period and was not different in patients less than or greater than 65 years.

  6. Improving patient safety culture in general practice: An interview study

    NARCIS (Netherlands)

    N.J. Verbakel (Natasha J.); A.A. de Bont (Antoinette); T.J. Verheij; C. Wagner (Cordula); D.L.M. Zwart (Dorien Lyd Marieke)

    2015-01-01

    textabstractBackground When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an interventio

  7. The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice

    Directory of Open Access Journals (Sweden)

    Mette Mogensen

    2010-10-01

    Full Text Available Mette Mogensen1, Gregor BE Jemec21Department of Dermatology, Gentofte Hospital, Hellerup, Denmark; 2Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, DenmarkIntroduction: In 2009, the WHO listed ultraviolet (UV radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice.Methods: A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers.Results: Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior.Discussion: The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers.Keywords: tanning beds, skin cancers, melanoma, nonmelanoma

  8. Usability and Safety in Electronic Medical Records Interface Design: A Review of Recent Literature and Guideline Formulation.

    Science.gov (United States)

    Zahabi, Maryam; Kaber, David B; Swangnetr, Manida

    2015-08-01

    The objectives of this study were to (a) review electronic medical record (EMR) and related electronic health record (EHR) interface usability issues, (b) review how EMRs have been evaluated with safety analysis techniques along with any hazard recognition, and (c) formulate design guidelines and a concept for enhanced EMR interfaces with a focus on diagnosis and documentation processes. A major impact of information technology in health care has been the introduction of EMRs. Although numerous studies indicate use of EMRs to increase health care quality, there remain concerns with usability issues and safety. A literature search was conducted using Compendex, PubMed, CINAHL, and Web of Science databases to find EMR research published since 2000. Inclusion criteria included relevant English-language papers with subsets of keywords and any studies (manually) identified with a focus on EMR usability. Fifty studies met the inclusion criteria. Results revealed EMR and EHR usability problems to include violations of natural dialog, control consistency, effective use of language, effective information presentation, and customization principles as well as a lack of error prevention, minimization of cognitive load, and feedback. Studies focusing on EMR system safety made no objective assessments and applied only inductive reasoning methods for hazard recognition. On the basis of the identified usability problems and structure of safety analysis techniques, we provide EMR design guidelines and a design concept focused on the diagnosis process and documentation. The design guidelines and new interface concept can be used for prototyping and testing enhanced EMRs. © 2015, Human Factors and Ergonomics Society.

  9. Adherence by midwives to the Dutch national guidelines on threatened miscarriage in general practice: a prospective study.

    NARCIS (Netherlands)

    Fleuren, M.; Grol, R.; Haan, M. de; Wijkel, D.; Oudshoorn, C.

    1997-01-01

    Objective: To determine the feasibility for midwives to adhere to Dutch national guidelines on threatened miscarriage in general practice. Design: Prospective recording of appointments by midwives who agreed to adhere to the guidelines on threatened miscarriage. Interviews with the midwives after th

  10. Design guidelines for PWR pressurizer safety and relief valve discharge piping to minimize potential operating and piping qualification problems

    Energy Technology Data Exchange (ETDEWEB)

    Adams, T.M.; Chang, K.C.; Campbell, T.E.

    1982-01-01

    General system design considerations such as functional requirements, valve types and operation, and various loading conditions are discussed. General guidelines for the piping layout, support design, and embedment selection are presented and discussed. Also presented and discussed are potential system operating problems which can arise from an improper design. 3 refs.

  11. Adherence to COPD guidelines in general practice: impact of an educational programme delivered on location in Danish general practices.

    Science.gov (United States)

    Ulrik, Charlotte Suppli; Sørensen, Tina Brandt; Højmark, Torben Brunse; Olsen, Kim Rose; Vedsted, Peter

    2013-03-01

    The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD guidelines. A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted of a 3-hr teaching lesson with a respiratory specialist and five visits by a representative from the sponsoring pharmaceutical company focusing on assessment and management of patients including written algorithms. A one-to-one propensity-matched control group of practices was selected. Register data were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. Data for 102 participating GP practices were analysed. Participating clinics had a significant increase in preventive consultations and influenza vaccinations (ppractices may improve adherence to COPD guidelines, not least for clinics with a high potential for improvement.

  12. Social safety, general health and physical activity: changes in neighbourhood safety and the role of social cohesion.

    NARCIS (Netherlands)

    Ruijsbroek, A.; Droomers, M.; Groenewegen, P.P.; Hardyns, W.; Stronks, K.

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated

  13. Social safety, general health and physical activity: changes in neighbourhood safety and the role of social cohesion.

    NARCIS (Netherlands)

    Ruijsbroek, A.; Droomers, M.; Groenewegen, P.P.; Hardyns, W.; Stronks, K.

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated

  14. Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines

    Directory of Open Access Journals (Sweden)

    Salem A. Beshyah

    2016-06-01

    Full Text Available Sodium-glucose co-transporter 2 (SGLT2 inhibitors are a new glucose-lowering therapy for T2DM with documented benefits on blood glucose, hypertension, weight reduction and long term cardiovascular benefit. They have an inherent osmotic diuretic effect and lead to some volume loss and possible dehydration. There is some concern about the safety of using SGLT2 inhibitors in Muslim type 2 diabetes mellitus (T2DM patients during the fast during Ramadan. Currently, there is a dearth of research data to help guide physicians and reassure patients.  One study confirmed good glycemic control with less risk of hypoglycemia and no marked volume depletion. Data in the elderly and in combination with diuretics are reassuring of their safe to use in Ramadan in general. SGLT2 inhibitor-related diabetic ketoacidosis has not been reported during Ramadan and is unlikely to be relevant. Survey of physicians revealed that the majority felt that SGLT2 inhibitors are generally safe in T2DM patients during Ramadan fasting but should be discontinued in certain high risk patients. Some professional groups with interest in diabetes and Ramadan fasting included SGLT2 inhibitors in their guidelines on management of diabetes during Ramadan. They acknowledged the lack of trial data, recommended caution in high risk groups, advised regular monitoring and emphasized pre-Ramadan patients’ education. In conclusion, currently, knowledge, data and experience with SGLT2 inhibitors in Ramadan are limited. Nonetheless, stable patients with normal kidney function and low risk of dehydration may safely use the SGLT2 inhibitors therapy. Higher risk patients should be observed carefully and managed on individual basis.

  15. [The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners; a response from the perspective of pulmonary medicine].

    Science.gov (United States)

    van Spiegel, P I

    2008-06-28

    The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners has been published. If general practitioners are going to use the standard, this can have a great impact on smoking in the Dutch population. A decrease in smokers among the population will also have an impact on several smoking-related chronic diseases from a preventive point of view. The guideline emphasizes that smoking cessation is not a one-stop shop but that it requires a long-term effort.

  16. Guideline for collection, analysis and presentation of safety data in clinical trials of vaccines in pregnant women

    OpenAIRE

    Jones, CE; Munoz, FM; Spiegel, HML; Heininger, U; Zuber, PLF; Edwards, KM; Lambach, P.; Neels, P; Kohl, KS; Gidudu, J; Hirschfeld, S; Oleske, JM; Khuri-Bulos, N.; Bauwens, J.; Eckert, LO

    2016-01-01

    Vaccination during pregnancy is increasingly being used as an effective approach for protecting both young infants and their mothers from serious infections. Drawing conclusions from published studies in this area can be difficult because of the inability to compare vaccine trial results across different studies and settings due to the heterogeneity in the definitions of terms used to assess the safety of vaccines in pregnancy and the data collected in such studies.\\ud \\ud The guidelines prop...

  17. Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents

    Directory of Open Access Journals (Sweden)

    J.B. Calixto

    2000-02-01

    Full Text Available This review highlights the current advances in knowledge about the safety, efficacy, quality control, marketing and regulatory aspects of botanical medicines. Phytotherapeutic agents are standardized herbal preparations consisting of complex mixtures of one or more plants which contain as active ingredients plant parts or plant material in the crude or processed state. A marked growth in the worldwide phytotherapeutic market has occurred over the last 15 years. For the European and USA markets alone, this will reach about $7 billion and $5 billion per annum, respectively, in 1999, and has thus attracted the interest of most large pharmaceutical companies. Insufficient data exist for most plants to guarantee their quality, efficacy and safety. The idea that herbal drugs are safe and free from side effects is false. Plants contain hundreds of constituents and some of them are very toxic, such as the most cytotoxic anti-cancer plant-derived drugs, digitalis and the pyrrolizidine alkaloids, etc. However, the adverse effects of phytotherapeutic agents are less frequent compared with synthetic drugs, but well-controlled clinical trials have now confirmed that such effects really exist. Several regulatory models for herbal medicines are currently available including prescription drugs, over-the-counter substances, traditional medicines and dietary supplements. Harmonization and improvement in the processes of regulation is needed, and the general tendency is to perpetuate the German Commission E experience, which combines scientific studies and traditional knowledge (monographs. Finally, the trend in the domestication, production and biotechnological studies and genetic improvement of medicinal plants, instead of the use of plants harvested in the wild, will offer great advantages, since it will be possible to obtain uniform and high quality raw materials which are fundamental to the efficacy and safety of herbal drugs.

  18. [Summary of the Dutch College of General Practitioners' practice guideline on food hypersensitivity].

    Science.gov (United States)

    Luning-Koster, Marleen N; Lucassen, Peter L B J; Boukes, Froukje S; Goudswaard, A N Lex

    2011-01-01

    October 2010 the Dutch College of General Practitioners issued a revised version of their previous practice guideline of 1995 on food hypersensitivity in infants. If patients suspect either themselves or their child of having a food allergy, this is usually not demonstrated in subsequent investigation. Wrongly prescribed elimination diets may have adverse effects. Examination of serum specific IgE levels has no place in the diagnosis of food allergy in general practice. An open elimination challenge is especially suitable in order to exclude a food allergy. A sure diagnosis of food allergy can only be made by a double-blind placebo-controlled food challenge. There are no proven effective measures that can prevent food allergy.

  19. [Summary of the Dutch College of General Practitioners (NHG) practice guideline on 'Diverticulitis'].

    Science.gov (United States)

    de Wit, Niek J; Berger, Marjolein Y; Vogelenzang, Rogier; Wetzels, Raymond V; van Rijn-van Kortenhof, Nathalie M M; Opstelten, Wim; Goudswaard, A N Lex

    2012-01-01

    The NHG practice guideline on 'Diverticulitis' provides general practitioners with directions on the diagnosis and treatment of uncomplicated and complicated diverticulitis. Diverticulitis is primarily a clinical diagnosis which can be supported by assessment of CRP. Uncomplicated diverticulitis is strongly suspected if the patient reports the development of persistent sharp, stabbing pain in the lower left abdomen within a couple of days; if there is pressure or rebound tenderness only in the lower left abdomen; and if there are no alarm signals. Alarm signals of complicated diverticulitis are: guarded muscle response, signs of intestinal obstruction, locally palpable resistance, rectal loss of blood, hypotension, and high fever. The policy for uncomplicated diverticulitis is waiting without specific measures, provided that the general practitioner monitors the course actively. There is no indication for antibiotics in patients with uncomplicated diverticulitis. Patients with signs of complicated diverticulitis or with persisting symptoms should be referred.

  20. Safety of robotic general surgery in elderly patients.

    Science.gov (United States)

    Buchs, Nicolas C; Addeo, Pietro; Bianco, Francesco M; Ayloo, Subhashini; Elli, Enrique F; Giulianotti, Pier C

    2010-08-01

    As the life expectancy of people in Western countries continues to rise, so too does the number of elderly patients. In parallel, robotic surgery continues to gain increasing acceptance, allowing for more complex operations to be performed by minimally invasive approach and extending indications for surgery to this population. The aim of this study is to assess the safety of robotic general surgery in patients 70 years and older. From April 2007 to December 2009, patients 70 years and older, who underwent various robotic procedures at our institution, were stratified into three categories of surgical complexity (low, intermediate, and high). There were 73 patients, including 39 women (53.4%) and 34 men (46.6%). The median age was 75 years (range 70-88 years). There were 7, 24, and 42 patients included, respectively, in the low, intermediate, and high surgical complexity categories. Approximately 50% of patients underwent hepatic and pancreatic resections. There was no statistically significant difference between the three groups in terms of morbidity, mortality, readmission or transfusion. Mean overall operative time was 254 ± 133 min (range 15-560 min). Perioperative mortality and morbidity was 1.4% and 15.1%, respectively. Transfusion rate was 9.6%, and median length of stay was 6 days (range 0-30 days). Robotic surgery can be performed safely in the elderly population with low mortality, acceptable morbidity, and short hospital stay. Age should not be considered as a contraindication to robotic surgery even for advanced procedures.

  1. SAFETY

    CERN Document Server

    Niels Dupont

    2013-01-01

    CERN Safety rules and Radiation Protection at CMS The CERN Safety rules are defined by the Occupational Health & Safety and Environmental Protection Unit (HSE Unit), CERN’s institutional authority and central Safety organ attached to the Director General. In particular the Radiation Protection group (DGS-RP1) ensures that personnel on the CERN sites and the public are protected from potentially harmful effects of ionising radiation linked to CERN activities. The RP Group fulfils its mandate in collaboration with the CERN departments owning or operating sources of ionising radiation and having the responsibility for Radiation Safety of these sources. The specific responsibilities concerning "Radiation Safety" and "Radiation Protection" are delegated as follows: Radiation Safety is the responsibility of every CERN Department owning radiation sources or using radiation sources put at its disposition. These Departments are in charge of implementing the requi...

  2. [Management of bronchiolitis in general practice and determinants of treatment being discordant with guidelines of the HAS].

    Science.gov (United States)

    Branchereau, E; Branger, B; Launay, E; Verstraete, M; Vrignaud, B; Levieux, K; Senand, R; Gras-Le Guen, C

    2013-12-01

    The Haute autorité de santé released clinical practice guidelines in 2000 to assist in the management of bronchiolitis. These guidelines emphasized supportive care with nasal suctioning and encouraged chest physiotherapy. The aim of this study was to examine the adherence to the french guidelines for the management of bronchiolitis by general practitioners. The study included infants less than 24 months of age with bronchiolitis, consulting a general practitioner in Vendée or in Loire-Atlantique, from November 2011 to April 2012 and whose parents accepted to participate to the study. The primary endpoint was the concordance of therapeutic practice with the french guidelines (administrated treatments, refer to pediatric emergencies). Data were collected through questionaires completed by general practitioners. Of the 1236 questionnaires distributed, 134 were completed and 118 therapeutic practice were analyzed. A total of 52.5% of therapeutic practice were concordant with guidelines and 57.5% in case of first bronchiolitis. 50% of infants with a hospitalization criteria according to the guidelines, have not been, which probably shows the interest of new guidelines, with highlighting of hospitalization criteria. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Patient safety culture measurement in general care: clinimetric properties of 'SCOPE'.

    NARCIS (Netherlands)

    Zwart, D.L.M.; Langelaan, M.; Vooren, R.C. van de; Kuyvenhoven, M.M.; Kalkman, C.J.; Verheij, T.J.M.; Wagner, C.

    2011-01-01

    BACKGROUND: A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safet

  4. Patient safety in primary care: A survey of general practitioners in the Netherlands

    NARCIS (Netherlands)

    Gaal, S.; Verstappen, W.H.J.M.; Wensing, M.J.P.

    2010-01-01

    BACKGROUND: Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general prac

  5. Maintenance Use of Antidepressants in Dutch General Practice: Non-Guideline Concordant

    Science.gov (United States)

    Piek, Ellen; Kollen, Boudewijn J.; van der Meer, Klaas; Penninx, Brenda W. J. H.; Nolen, Willem A.

    2014-01-01

    Background There is hardly evidence on maintenance treatment with antidepressants in primary care. Nevertheless, depression guidelines recommend maintenance treatment i.e. treatment to prevent recurrences, in patients with high risk of recurrence, and many patients use maintenance treatment with antidepressants. This study explores the characteristics of patients on maintenance treatment with antidepressants in general practice, and compares these characteristics with guideline recommendations for maintenance treatment. Methods We used data (baseline, two-year and four-year follow-up) of primary care respondents with remitted depressive disorder (≥6 months) from the Netherlands Study of Depression and Anxiety (n = 776). Maintenance treatment was defined as the use of an antidepressant for ≥12 months. Multilevel logistic regression was used to describe the association between sociodemographic, clinical and care characteristics and use of maintenance treatment with antidepressants. Results Older patients, patients with a lower education, those using benzodiazepines or receiving psychological/psychiatric care and patients with a concurrent history of a dysthymic or anxiety disorder more often received maintenance treatment with antidepressants. Limitations Measurements were not made at the start of an episode, but at predetermined points in time. Diagnoses were based on interview (CIDI) data and could therefore in some cases have been different from the GP diagnosis. Conclusions Since patients with chronic or recurrent depression do not use maintenance treatment with antidepressants more often, characteristics of patients on maintenance treatment do not fully correspond with guideline recommendations. However, patients on maintenance treatment appear to be those with more severe disorder and/or more comorbidity. PMID:24858011

  6. Safety assessment of a novel active ingredient, acetyl aspartic acid, according to the EU Cosmetics Regulation and the Scientific Committee on Consumer Safety guidelines.

    Science.gov (United States)

    Daly, P; Moran, G

    2015-10-01

    Acetyl aspartic acid (A-A-A) was proposed as a new novel active ingredient for use in cosmetics. The safety of A-A-A was assessed by following an in-house-developed 'New Ingredient Testing Strategy', which was designed in accordance with the Scientific Committee on Consumer Safety (SCCS) notes of guidance and the requirements of Annex I of the EU Cosmetics Regulation. The aim of the project was to determine whether A-A-A was safe for use in cosmetics and to determine a maximum permitted safe level in the formulations. A literature review was conducted, consulting over 40 different information sources. This highlighted a number of gaps which required testing data. A-A-A was tested for phototoxicity according to OECD test guideline 432, skin irritation according to OECD test guideline 439 and eye irritation according to OECD test guideline 437. Dermal absorption of A-A-A was measured according to OECD test guideline 428 and was used to calculate the margin of safety (MoS). Finally, A-A-A was tested in a human repeat insult patch test (HRIPT) and a 14-day in-use tolerance study. A-A-A was non-phototoxic and was non-irritating to skin and eyes in in vitro testing. Dermal absorption was calculated to be 5%. The MoS for A-A-A was 351, at a level of 5%, for all cosmetic product types, indicating no systemic safety toxicity concern. A-A-A at 5% under occlusive patch on a panel of 50 adult volunteers induced no skin irritation or allergic reaction in the HRIPT study. Finally, repeated application of A-A-A to the periocular area, twice per day for 14 days, in 21 female volunteers, demonstrated that 1% A-A-A was well tolerated following dermatological and ophthalmological assessment in a cosmetic formulation. A-A-A was assessed as safe by the cosmetic safety assessor for use in cosmetics at a level of 5% in all cosmetic product types, in line with the requirements of the EU Cosmetics Regulation and in accordance with the SCCS notes of guidance. © 2015 Society of Cosmetic

  7. Prevention of generalized reactions to contrast media: a consensus report and guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Morcos, S.K. [Dept. of Diagnostic Imaging, Northern General Hospital, Sheffield (United Kingdom); Thomsen, H.S. [Dept. of Diagnostic Radiology, Herlev Hospital, University of Copenhagen (Denmark); Webb, J.A.W. [Diagnostic Radiology Department, St. Bartholomew' s Hospital, London (United Kingdom)

    2001-09-01

    The aim of this study was to document, using consensus methodology, current practice for prevention of generalized reactions to contrast media, to identify areas where there is disagreement or confusion and to draw up guidelines for reducing the risk of generalized contrast media reactions based on the survey and a review of the literature. A document with 165 questions was mailed to 202 members of the European Society of Urogenital Radiology. The questions covered risk factors and prophylactic measures for generalized contrast media reactions. Sixty-eight members (34%) responded. The majority indicated that a history of moderate and severe reaction(s) to contrast media and asthma are important risk factors. The survey also indicated that patients with risk factors should receive non-ionic contrast media. In patients at high risk of reaction, if the examination is deemed absolutely necessary, a resuscitation team should be available at the time of the procedure. The majority (91%) used corticosteroid prophylaxis given at least 11 h before contrast medium to patients at increased risk of reaction. The frequency of the dosage varied from one to three times. Fifty-five percent also use antihistamine Hl, mainly administered orally and once. Antihistamine H2 and ephedrine are rarely used. All essential drugs are available on the emergency resuscitation trolley. Patients with risk factors are observed up to 30 min by 48% and up to 60 min by 43% of the responders. Prophylactic measures are not taken before extravascular use of contrast media. Prophylactic drugs are given to patients with a history of moderate or severe generalized reaction to contrast media. In patients with asthma, opinion is divided with only half of the responders giving prophylactic drugs. Aspirin, {beta}-blockers, interleukin-2 and non-steroid anti-inflammatory drugs are not considered risk factors and therefore are not stopped before injection of contrast media. The survey showed some variability in

  8. [The practice guideline 'Stable angina pectoris' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

    Science.gov (United States)

    Mazel, J A

    2004-11-06

    The Dutch College of General Practitioners' (Dutch acronym: NHG) practice guideline 'Stable angina pectoris' (second revision) provides clear guidelines for the diagnosis and treatment of patients who experience chest pains as a result of angina pectoris, especially if coronary artery disease is the underlying cause of the complaints. The practice guideline clearly indicates for which complaints the general practitioner should suspect angina pectoris and which information from the anamnesis, family history and risk factors can contribute to distinguishing between stable and unstable angina pectoris. However, the physical examination should not be omitted because this can provide important indications for coronary or pulmonary dysfunction. According to the practice guideline, the treatment policy is determined by the estimated risk of significant coronary artery disease. However, additional tests can be useful even in the case of a small risk, as these can reassure patients. The indications and contraindications for medicinal substances are clearly presented.

  9. KAERI software safety guideline for developing safety-critical software in digital instrumentation and control system of nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jang Soo; Kim, Jang Yeol; Eum, Heung Seop

    1997-07-01

    Recently, the safety planning for safety-critical software systems is being recognized as the most important phase in the software life cycle, and being developed new regulatory positions and standards by the regulatory and the standardization organization. The requirements for software important to safety of nuclear reactor are described in such positions and standards. Most of them are describing mandatory requirements, what shall be done, for the safety-critical software. The developers of such a software. However, there have been a lot of controversial factors on whether the work practices satisfy the regulatory requirements, and to justify the safety of such a system developed by the work practices, between the licenser and the licensee. We believe it is caused by the reason that there is a gap between the mandatory requirements (What) and the work practices (How). We have developed a guidance to fill such gap, which can be useful for both licenser and licensee to conduct a justification of the safety in the planning phase of developing the software for nuclear reactor protection systems. (author). 67 refs., 13 tabs., 2 figs.

  10. KAERI software safety guideline for developing safety-critical software in digital instrumentation and control system of nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jang Soo; Kim, Jang Yeol; Eum, Heung Seop

    1997-07-01

    Recently, the safety planning for safety-critical software systems is being recognized as the most important phase in the software life cycle, and being developed new regulatory positions and standards by the regulatory and the standardization organization. The requirements for software important to safety of nuclear reactor are described in such positions and standards. Most of them are describing mandatory requirements, what shall be done, for the safety-critical software. The developers of such a software. However, there have been a lot of controversial factors on whether the work practices satisfy the regulatory requirements, and to justify the safety of such a system developed by the work practices, between the licenser and the licensee. We believe it is caused by the reason that there is a gap between the mandatory requirements (What) and the work practices (How). We have developed a guidance to fill such gap, which can be useful for both licenser and licensee to conduct a justification of the safety in the planning phase of developing the software for nuclear reactor protection systems. (author). 67 refs., 13 tabs., 2 figs.

  11. Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of safety checklists.

    Science.gov (United States)

    Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A

    2015-05-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  12. [The practice guideline 'Bacterial skin infections' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Olde Hartman, T.C.; Uijen, A.A.

    2008-01-01

    The revised guideline 'Bacterial skin infections' from the Dutch College ofGeneral Practitioners offers a clear and extensive overview of the most prevalent superficial and deep bacterial infections in general practice. Given the lack of evidence, it is no longer recommended to keep children with im

  13. [The practice guideline 'Problematic alcohol consumption' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2006-01-01

    The recently revised version of the practice guideline 'Problematic alcohol consumption' from the Dutch College of General Practitioners offers realistic advice to general practitioners on how to manage problem drinkers. The number of patients with alcohol problems tends to increase among women of m

  14. The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'; response from a geriatric perspective

    NARCIS (Netherlands)

    Izaks, GJ

    2003-01-01

    Delirium in elderly people is a severe condition that requires vigorous medical attention. Therefore, the Dutch College of General Practitioners has duly chosen to develop a practice guideline 'Delirium in elderly people'. It is likely that many general practitioners are only partly familiar with

  15. The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'; response from a geriatric perspective

    NARCIS (Netherlands)

    Izaks, GJ

    2003-01-01

    Delirium in elderly people is a severe condition that requires vigorous medical attention. Therefore, the Dutch College of General Practitioners has duly chosen to develop a practice guideline 'Delirium in elderly people'. It is likely that many general practitioners are only partly familiar with de

  16. [Relationship between te general practice guidelines for the diagnosis of hypertension and the indication for treatment and practice in the Nijmegen region, the Netherlands, 1983-2001

    NARCIS (Netherlands)

    Bakx, J.C.; Deunk, L.; Gerwen, W.H.E.M. van; Aalst, M. van der; Hoogen, H.J.M. van den; Bosch, W.J.H.M. van den

    2003-01-01

    OBJECTIVE: To determine whether patients with hypertension in general practice are diagnosed and treated according to the criteria of the Dutch College of General Practitioners guidelines. DESIGN: Retrospective, descriptive. METHOD: Using data from 9 general practices belonging to the general

  17. Guidelines for retrospective safety analysis. Prepared for DRIVE II Project V2002 Horizontal Project for the Evaluation of Safety HOPES.

    NARCIS (Netherlands)

    Oppe, S. (ed.)

    1994-01-01

    This report contains the following contributions: Concepts and definitions (Oppe, S); Traffic in its social context (Chaloupka, C and Risser, R); The checklist as a retrospective safety tool (Chaloupka, C and Risser, R); Experimental design (Kulmala, R); Evaluation of the traffic process and its saf

  18. Occupational Safety and Health Program Guidelines for Colleges and Universities. An Administrative Resource Manual.

    Science.gov (United States)

    Godbey, Frank W.; Hatch, Loren L.

    Designed as an aid for establishing and strengthening occupational safety and health programs on college and university campuses, this administrator guide is divided into four chapters. The first chapter defines and gives background information on the Occupational Safety and Health Act (OSHA). In addition, it presents a discussion of what the OSHA…

  19. [The practice guideline 'Anxiety disorders' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

    Science.gov (United States)

    van Weel-Baumgarten, E M; van Rijswijk, E

    2005-05-28

    The recommendations provided by the revised guideline 'Anxiety disorders' are well suited to every-day practice. The multidisciplinary approach reflects the increasing cooperation between primary and secondary care in the management of mental-health problems. The description of the various anxiety disorders and the questions that can be asked to elicit the symptoms will facilitate recognition. The indications for treatment with medication are clear: a limited number of antidepressants should be used. Although it is agreed that patient education is an important part of treatment, the guidelines could have described in more detail how this should be done. Cognitive-behavioural techniques may be used but this requires extra training; its effectiveness when used by general practitioners needs further study. This guideline will add to existing knowledge and improve the skills of general practitioners in dealing with anxiety.

  20. Guidelines for nuclear power plant safety issue prioritization information development. Supplement 4

    Energy Technology Data Exchange (ETDEWEB)

    Tabatabai, A.S.; Fecht, B.A.; Powers, T.B.; Bickford, W.E.; Andrews, W.B.; Gallucci, R.H.V.; Bian, S.H.; Daling, P.M.; Eschbach, E.J.; Allen, C.H.

    1986-07-01

    This is the fifth in a series of reports to document the use of a methodology developed by the Pacific Northwest Laboratory to calculate, for prioritization purposes, the risk, dose and cost impacts of implementing resolutions to reactor safety issues (NUREG/CR-2800, Andrews et al. 1983). This report contains results of issue-specific analyses for 23 issues. Each issue was considered within the constraints of available information as of winter 1986, and two staff-weeks of labor. The results are referenced, as one consideration in setting priorities for reactor safety issues, in NUREG-0933, ''A Prioritization of Generic Safety Issues.''

  1. Guidelines for nuclear power plant safety issue prioritization information development. Supplement 2

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, W.B.; Gallucci, R.H.V.; Konzek, G.J.; Heaberlin, S.W.; Fecht, B.A.; Allen, C.H.; Allen, R.D.; Bickford, W.E., Carbaugh, E.H.; Lewis, J.R.

    1983-12-01

    This is the third in a series of reports to document the use of a methodology developed by the Pacific Northwest Laboratory to calculate, for prioritization purposes, the risk, dose and cost impacts of implementing resolutions to reactor safety issues (NUREG/CR-2800, Andrews et al. 1983). This report contains results of issue-specific analyses for 31 issues. Each issue was considered within the constraints of available information as of summer 1983, and two staff-weeks of labor. The results are referenced, as one consideration in setting priorities for reactor safety issues, in NUREG-0933, A Prioritization of Generic Safety Issues.

  2. [Methodological guideline for the efficacy and safety assessment of new pharmaceuticals: implementation of EUnetHTA's recommendations].

    Science.gov (United States)

    Ubago Pérez, Ruth; Castillo Muñoz, María Auxiliadora; Banqueri, Mercedes Galván; García Estepa, Raúl; Alfaro Lara, Eva Rocío; Vega Coca, María Dolores; Beltrán Calvo, Carmen; Molina López, Teresa

    2017-01-03

    The European network for Health Technology Assessment (EUnetHTA) is the network of public health technology assessment (HTA) agencies and entities from across the EU. In this context, the HTA Core Model(®), has been developed. The Andalusian Agency for Health Technology Assessment (AETSA) is a member of the Spanish HTA Network and EUnetHTA collaboration In addition, AETSA participates in the new EUnetHTA Joint Action 3 (JA, 2016-2019). Furthermore, AETSA works on pharmaceutical assessments. Part of this work involves drafting therapeutic positioning reports (TPRs) on drugs that have recently been granted marketing authorisation, which is overseen by the Spanish Agency of Medicines and Medical Devices (AEMPS). AETSA contributes by drafting "Evidence synthesis reports: pharmaceuticals" in which a rapid comparative efficacy and safety assessment is performed for drugs for which a TPR will be created. To create this type of report, AETSA follows its own methodological guideline based on EUnetHTA guidelines and the HTA Core Model(®). In this paper, the methodology that AETSA has developed to create the guideline for "Evidence synthesis reports: pharmaceuticals" is described. The structure of the report itself is also presented.

  3. Interpretation of NCCN Guidelines: General Therapies on Non-small Cell Lung Cancer (Version 6. 2015

    Directory of Open Access Journals (Sweden)

    Xin-en HUANG

    2015-06-01

    Full Text Available Lung cancer is one of the most common malignant tumors in China and ranks the first of cancer-related death. The major etiological agent of lung cancer is an industry-made and promoted addictive product, so lung cancer is considered to be a unique disease in all cancers. Effective policies for public health are required to prevent the smoking initiation so as to reduce the mortality of lung cancer, so Food and Drug Administration (FDA has introduced a series of measures to monitor the tobacco products. As to patients with strong suspicion of lung cancer in stage Ⅰ-Ⅱ, a preoperative biopsy is needed and intra-operative diagnosis is necessary before pneumonectomy, bilobectomy or lobectomy if the preoperative tissue diagnosis is not obtained. However, lung cancer still cannot be easily diagnosed and cured, so the annual improvement and update of new therapeutic protocols and the development of new agents is of great significance. Non-small cell lung cancer (NSCLC accounts for about 80% of all lung cancer, and above 75% NSCLC patients are in middle-advanced stage when diagnosed, so they have lost the optimal therapeutic opportunity and the 5-year survival rate is relatively low. Therefore, this study mainly interpreted the National Comprehensive Cancer Network (NCCN guidelines on the general therapies on NSCLC, hoping to provide references for the treatment of NSCLC patients and prolong their long-term survival.

  4. 21 CFR 570.20 - General principles for evaluating the safety of food additives.

    Science.gov (United States)

    2010-04-01

    ... food additives. 570.20 Section 570.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food Additive Safety § 570.20 General principles for evaluating the safety of food additives. (a) In reaching...

  5. 21 CFR 170.20 - General principles for evaluating the safety of food additives.

    Science.gov (United States)

    2010-04-01

    ... food additives. 170.20 Section 170.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive Safety § 170.20 General principles for evaluating the safety of food additives. (a) In reaching...

  6. Communication guidelines as a learning tool: an exploration of user preferences in general practice

    NARCIS (Netherlands)

    Veldhuijzen, W.; Ram, P.M.; Weijden, T.T. van der; Vleuten, C.P.M. van der

    2013-01-01

    OBJECTIVE: To explore characteristics of written communication guidelines that enhance the success of training aimed at the application of the recommendations in the guidelines. METHODS: Seven mixed focus groups were held consisting of communication skill teachers and communication skill learners an

  7. Management of COPD in general practice in Denmark--participating in an educational program substantially improves adherence to guidelines

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Hansen, Ejvind Frausing; Jensen, Michael Skov

    2010-01-01

    BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease. ...

  8. [Summary of the practice guideline 'allergic and non-allergic rhinitis' (first revision) from the Dutch College of General Practitioners

    NARCIS (Netherlands)

    Balen, J.A. van; Verduijn, M.M.; Sachs, A.P.; Berger, M.Y.; Lucassen, P.L.B.J.; Wiersma, T.J.; Goudswaard, A.N.

    2007-01-01

    The practice guideline 'Allergic and non-allergic rhinitis' of the Dutch College ofGeneral Practitioners has been revised based on developments that have occurred in recent years. The most important modifications are: Impermeable covers for beddings are advised only for patients with serious complai

  9. Knowledge of asthma guidelines: results of a UK General Practice Airways Group (GPIAG) web-based 'Test your Knowledge' quiz.

    Science.gov (United States)

    Pinnock, Hilary; Holmes, Steve; Levy, Mark L; McArthur, Ruth; Small, Iain

    2010-06-01

    A web-based questionnaire, comprising 11 multiple choice questions, tested the knowledge of visitors to the General Practice Airways Group (GPIAG) online summary of the British Asthma guideline. On average, the 413 respondents answered less than half the questions correctly. GP scores were significantly lower than practice nurses. Improving clinicians' knowledge of asthma is a prerequisite for improving management.

  10. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    Energy Technology Data Exchange (ETDEWEB)

    James, J; Place, V; Panda, A [Mayo Clinic, Scottsdale, AZ (United States); Edmonson, H [Mayo Clinic College of Medicine, Rochester, MN (United States); Felmlee, J [Mayo Clinic, Rochester, MN (United States); Pooley, R [Mayo Clinic, Jacksonville, FL (United States)

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

  11. Avoidance, Safety Behavior, And Reassurance Seeking In Generalized Anxiety Disorder

    NARCIS (Netherlands)

    Beesdo-Baum, K.; Jenjahn, E.; Höfler, M.; Lüken, U.; Becker, E.S.; Hoyer, J.

    2012-01-01

    Background The behavioral symptoms of Generalized Anxiety Disorder (GAD) are not well characterized. This study examines behavioral symptoms in patients with GAD compared to healthy participants, their change during behavioral therapy, and their role for predicting short- and long-term outcome. Meth

  12. Poor compliance with antifungal drug use guidelines by transplant physicians: a framework for educational guidelines and an international consensus on patient safety.

    Science.gov (United States)

    Muñoz, Patricia; Rojas, Loreto; Cervera, Carlos; Garrido, Gregorio; Fariñas, Maria Carmen; Valerio, Maricela; Giannella, Maddalena; Bouza, Emilio

    2012-01-01

    The rate of compliance with antifungal drug use guidelines by transplant physicians is mostly unknown. We performed a nationwide electronic survey to assess antifungal use by different types of transplant physicians. Sixty-one percent (53/87) of the transplant programs responded (accounting for 85% of heart transplant procedures, 65% of kidney transplantations, and 71.5% of liver transplantations). Antifungal prophylaxis was used in 41.5% programs (liver 93.3%, heart 30.8%, and kidney 16%). Prophylaxis was universal in 32% of the programs and targeted only to selected patients in 68%, mainly indicated after re-transplantation (73.3%), re-intervention (66.7%) and hemodialysis (60%). Main drugs for universal prophylaxis were fluconazole and itraconazole (42.9% each), while fluconazole (60%), L-amphotericin B (AMB), and caspofungin (13.4% each) were preferred for targeted prophylaxis. Overall, 84.9% of the programs used galactomannan for the diagnosis of invasive aspergillosis (only 34% in BAL) and 66.6% used voriconazole as first-line monotherapy. Combination first-line therapy for invasive aspergillosis was used by 31.3%, mainly with voriconazole with caspofungin (40%) or anidulafungin (26.7%) or L-AMB-caspofungin (26.7%). Adherence of transplant physicians to current recommendations on antifungal treatment and prophylaxis is poor. An international consensus that responds to differences in patients and centers and emphasizes patient safety is clearly needed.

  13. Investigation of assumptions underlying current safety guidelines on EM-induced nerve stimulation

    Science.gov (United States)

    Neufeld, Esra; Vogiatzis Oikonomidis, Ioannis; Iacono, Maria Ida; Angelone, Leonardo M.; Kainz, Wolfgang; Kuster, Niels

    2016-06-01

    An intricate network of a variety of nerves is embedded within the complex anatomy of the human body. Although nerves are shielded from unwanted excitation, they can still be stimulated by external electromagnetic sources that induce strongly non-uniform field distributions. Current exposure safety standards designed to limit unwanted nerve stimulation are based on a series of explicit and implicit assumptions and simplifications. This paper demonstrates the applicability of functionalized anatomical phantoms with integrated coupled electromagnetic and neuronal dynamics solvers for investigating the impact of magnetic resonance exposure on nerve excitation within the full complexity of the human anatomy. The impact of neuronal dynamics models, temperature and local hot-spots, nerve trajectory and potential smoothing, anatomical inhomogeneity, and pulse duration on nerve stimulation was evaluated. As a result, multiple assumptions underlying current safety standards are questioned. It is demonstrated that coupled EM-neuronal dynamics modeling involving realistic anatomies is valuable to establish conservative safety criteria.

  14. General Guidelines on Criteria for Adoption or Rejection of Evaluated Libraries and Data by the Nuclear Data Team

    Energy Technology Data Exchange (ETDEWEB)

    Neudecker, Denise [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Conlin, Jeremy Lloyd [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gray, Mark Girard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); McCartney, Austin Paul [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Parsons, Donald Kent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); White, Morgan Curtis [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-04-12

    This memo contains general guidelines on what documentation and tools need to be in place as well as format and data testing requirements such that evaluated nuclear data sets or entire libraries can be adopted by the nuclear data team. Additional requirements beyond this memo might apply for specific nuclear data observables. These guidelines were established based on discussions between J.L. Conlin, M.G. Gray, A.P. McCartney, D. Neudecker, D.K. Parsons and M.C. White.

  15. Guideline Adherence of Antithrombotic Treatment Initiated by General Practitioners in Patients With Nonvalvular Atrial Fibrillation: A Danish Survey

    DEFF Research Database (Denmark)

    Brandes, Axel; Overgaard, Mikkel; Plauborg, Liane

    2013-01-01

    .001) of the patients. Of all patients, 66.3% were treated with oral anticoagulants, 18.7% with antiplatelet drugs only, and 15% received no antithrombotic therapy. Based on the CHADS(2) score, 75.7% of the patients were treated in adherence with the guidelines, 16% were undertreated, and 8.4% overtreated......) score. Applying the CHA(2)DS(2)-VASc score, this proportion was only 53.4%. Antiplatelet drug treatment was in adherence to the guidelines (CHADS(2) and CHA(2)DS(2)-VASc score of 1) in only 31% and 12% of the patients, respectively. ConclusionsAntithrombotic treatment of AF patients is in general well...

  16. Validation of antibiotic susceptibility testing guidelines in a routine clinical microbiology laboratory exemplifies general key challenges in setting clinical breakpoints.

    Science.gov (United States)

    Hombach, Michael; Courvalin, Patrice; Böttger, Erik C

    2014-07-01

    This study critically evaluated the new European Committee for Antimicrobial Susceptibility Testing (EUCAST) antibiotic susceptibility testing guidelines on the basis of a large set of disk diffusion diameters determined for clinical isolates. We report several paradigmatic problems that illustrate key issues in the selection of clinical susceptibility breakpoints, which are of general importance not only for EUCAST but for all guidelines systems, i.e., (i) the need for species-specific determinations of clinical breakpoints/epidemiological cutoffs (ECOFFs), (ii) problems arising from pooling data from various sources, and (iii) the importance of the antibiotic disk content for separating non-wild-type and wild-type populations.

  17. Guidelines for nuclear-power-plant safety-issue-prioritization information development

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, W.B.; Gallucci, R.H.V.; Heaberlin, S.W.; Bickford, W.E.; Konzek, G.J.; Strenge, D.L.; Smith, R.I.; Weakley, S.A.

    1983-02-01

    Pacific Northwest Laboratory has developed a methodology, with examples, to calculate - to an approximation serviceable for prioritization purposes - the risk, dose and cost impacts of implementing resolutions to reactor safety issues. This report is an applications guide to issue-specific calculations. A description of the approach, mathematical models, worksheets and step-by-step examples are provided. Analysis using this method is intended to provide comparable results for many issues at a cost of two staff-weeks per issue. Results will be used by the NRC to support decisions related to issue priorities in allocation of resources to complete safety issue resolutions.

  18. Guidelines for nuclear power plant safety issue prioritization information development. Supplement 5

    Energy Technology Data Exchange (ETDEWEB)

    Daling, P.M.; Lavender, J.C. [Pacific Northwest National Lab., Richland, WA (United States)

    1996-07-01

    This is the sixth in a series of reports to document the development and use of a methodology developed by the Pacific Northwest Laboratory (PNL) to calculate, for prioritization purposes, the risk, dose, and cost impacts of implementing potential resolutions to reactor safety issues (see NUREG/CR-2800, Andrews, et al., 1983). This report contains the results of issue-specific analyses for 34 generic issues. Each issue was considered within the constraints of available information at the time the issues were examined and approximately 2 staff-weeks of labor. The results are referenced as one consideration in NUREG-0933, A Prioritization of Generic Safety Issues (Emrit, et al., 1983).

  19. Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke: Findings From Get With The Guidelines-Stroke.

    Science.gov (United States)

    Adams, Robert J; Cox, Margueritte; Ozark, Shelly D; Kanter, Julie; Schulte, Phillip J; Xian, Ying; Fonarow, Gregg C; Smith, Eric E; Schwamm, Lee H

    2017-03-01

    The recommended treatment for ischemic stroke is tPA (tissue-type plasminogen activator). Although sickle cell disease (SCD) represents no known contraindication to tPA, National Heart Lung and Blood Institute of the National Institutes of Health recommended acute exchange transfusion for stroke in SCD, not tPA. Data on safety and outcomes of tPA in patients are needed to guide tPA use in SCD. We matched patients from the American Heart Association and American Stroke Association Get With The Guidelines-Stroke registry with SCD to patients without SCD and compared usage, complications, and discharge outcomes after tPA. Multivariable logistic regression models using generalized estimating equations were used to assess outcomes. From 2 016 652 stroke patients admitted to Get With The Guidelines-Stroke sites in the United States, 832 SCD and 3328 non-SCD controls with no differences in admission National Institutes of Health Stroke Scale or blood pressure were identified. Neither the fraction receiving thrombolytic therapy (8.2% for SCD versus 9.4% non-SCD) nor symptomatic intracranial hemorrhage (4.9% of SCD versus 3.2% non-SCD; P=0.4502) was different. There was no difference in a prespecified set of outcome measures for those with SCD compared with controls. Coexistent SCD had no significant impact on the safety or outcome of thrombolytic therapy in acute ischemic stroke. Although the sample size is relatively small, these data suggest that adults with SCD and acute ischemic stroke should be treated with thrombolysis, if they otherwise qualify. Addition studies, however, should track the intracranial hemorrhage rate and provide information on other SCD-related care such as transfusion. © 2017 American Heart Association, Inc.

  20. GENERAL GUIDELINES CONCERNING THE RELATION INTERNATIONAL INTELLECTUAL PROPERTY BUSINESS VERSUS HUMAN RIGHTS AND CIVIL LIBERTIES

    Directory of Open Access Journals (Sweden)

    Speriusi-Vlad Alin

    2014-07-01

    Full Text Available Today, the intellectual property protection is no longer an absolute social and legal that justifies adoption of any measures necessary to protect it. Initially seen as the prerequisite for sustainable development, implementation of new technologies, and encouragement of international trade, the intellectual property, especially prior to ACTA (Anti-Counterfeiting Trade Agreement international trial implementation, and also thereafter, was increasingly identified as a source of violation of fundamental rights and civil liberties, i.e. the right to protection of personal data, the right to privacy, freedom to send and receive information freedom of information, freedom to contract, and freedom to carry out economic activities (freedom of commerce. As far as international trade transactions have often a component of intellectual property that requires to be protected, it is necessary to identify the landmarks, the rules establishing de facto limits in order to protect the intellectual property without risk of infringement of fundamental rights and civil liberties of other persons, in particular users or potential users of goods and services incorporating intellectual property. The best guidelines in this regard may be provided by the CJEU (Court of Justice of the European Union case-law both due to its reasoning underlying the decision of the Parliament to reject ACTA ratification and the fact that the case-law of this Court, especially the most recent one, is highly complex and nuanced, not denying in any way the importance of intellectual property, and identifying certain cases where their primacy persist and whose analysis leads to laying down some general rules in the field.

  1. 75 FR 39582 - Submission for OMB Review, Comment Request, Proposed Collection: General Clearance for Guidelines...

    Science.gov (United States)

    2010-07-09

    ..., libraries, institutions of higher education, library and museum professional associations, and museum and... for Guidelines, Applications, and Reporting Forms AGENCY: Institute of Museum and Library Services.... SUMMARY: The Institute of Museum and Library Services announces the following information collection...

  2. Safety Barrier Guidelines for Home Pools [and] How To Plan for the Unexpected.

    Science.gov (United States)

    Consumer Product Safety Commission, Washington, DC.

    Each year, hundreds of young children die and thousands come close to death due to submersion in residential swimming pools. The United States Consumer Products Safety Commission studied data on drownings and child behavior, as well as information on pool and pool barrier construction, and concluded that the best way to reduce child drownings in…

  3. Changing guidelines of cardiopulmonary resuscitation and basic life support for general dental practitioners and oral and maxillofacial surgeons.

    Science.gov (United States)

    Gadipelly, Srinivas; Neshangi, Srisha

    2015-06-01

    Every general dental practitioner and oral and maxillofacial surgeon needs a thorough knowledge of the diagnosis and management of medical emergencies. Cardiopulmonary arrest is the most urgent of emergencies and diagnosis must be done as soon as possible. This paper discusses the importance of the International Liaison Committee on Resuscitation which forms the guidelines for cardiopulmonary resuscitation (CPR), highlighting the important changes in the guidelines of CPR from the year 2000 to 2010, the basic sequence of performing CPR and also the role of defibrillation and the use of automated external defibrillators. Finally the five part chain of survival which is of utmost importance to dental health care professionals and oral and maxillofacial surgeons. All dental health care personnel and oral & maxillofacial surgeons should recognize the importance of the changes in the guidelines of CPR, be trained and allowed to use a properly maintained defibrillator, to respond to cardiac arrest victims.

  4. Safety Standard for Hydrogen and Hydrogen Systems: Guidelines for Hydrogen System Design, Materials Selection, Operations, Storage and Transportation. Revision

    Science.gov (United States)

    1997-01-01

    The NASA Safety Standard, which establishes a uniform process for hydrogen system design, materials selection, operation, storage, and transportation, is presented. The guidelines include suggestions for safely storing, handling, and using hydrogen in gaseous (GH2), liquid (LH2), or slush (SLH2) form whether used as a propellant or non-propellant. The handbook contains 9 chapters detailing properties and hazards, facility design, design of components, materials compatibility, detection, and transportation. Chapter 10 serves as a reference and the appendices contained therein include: assessment examples; scaling laws, explosions, blast effects, and fragmentation; codes, standards, and NASA directives; and relief devices along with a list of tables and figures, abbreviations, a glossary and an index for ease of use. The intent of the handbook is to provide enough information that it can be used alone, but at the same time, reference data sources that can provide much more detail if required.

  5. Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'

    Directory of Open Access Journals (Sweden)

    Zwart Dorien LM

    2011-11-01

    Full Text Available Abstract Background A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS. Methods The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire. Results Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not. Conclusions The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.

  6. Introducing Proper Chemical Hygiene and Safety in the General Chemistry Curriculum

    Science.gov (United States)

    Miller, Gordon J.; Heideman, Stephen A.; Greenbowe, Thomas J.

    2000-09-01

    Chemical safety is an important component of science education for everyone, not just for chemistry majors. Developing a responsible and knowledgeable attitude towards chemical safety best starts at the early stages of a student's career. In many colleges and universities, safety education in undergraduate chemistry has been relegated primarily to a few regulatory documents at the beginning of a laboratory course, or an occasional warning in the description of a specific experiment in a prelaboratory lecture. Safety issues are seldom raised in general chemistry or organic chemistry lecture-based chemistry courses. At Iowa State University we have begun to implement a program, Chemical Hygiene and Safety in the Laboratory, into the undergraduate chemistry curriculum. This program is designed to increase the awareness and knowledge of proper chemical hygiene and laboratory safety issues among all students taking general chemistry and organic chemistry courses. Laboratory protocol, use of safety equipment, familiarity with MSD sheets, basics of first aid, some specific terminology surrounding chemical hygiene, EPA and OSHA requirements, and the use of the World Wide Web to search and locate chemical safety information are topics that are applied throughout the chemistry curriculum. The novelty of this approach is to incorporate MSD sheets and safety information that can be located on the World Wide Web in a series of safety problems and assignments, all related to the chemistry experiments students are about to perform. The fundamental idea of our approach is not only to teach students what is required for appropriate safety measures, but also to involve them in the enforcement of basic prudent practices.

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

    NARCIS (Netherlands)

    Marres, H.A.M.

    2008-01-01

    In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and t

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

    NARCIS (Netherlands)

    Marres, H.A.M.

    2008-01-01

    In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and t

  9. Mechanical Safety Subcommittee Guideline for Design of Thin Windows Regarding Roark’s Edge Condition Coefficient

    Energy Technology Data Exchange (ETDEWEB)

    Ader, C. [Fermilab; Voirin, E. [Fermilab; McGee, M. [Fermilab; Nobrega, L. [Fermilab

    2017-06-15

    An error was found in an edge stress coefficient used to calculate stresses in thin windows. This error is present in “Roark’s Formulas for Stress and Strain” 7th and 8th Edition. The 6th Edition is correct. This guideline specially discusses a major difference in regards to a coefficient used in calculating the edge stress in “Roark’s Formulas for Stress and Strain” 6th Edition compared to the 7th and 8th Editions. In Chapter 10: Flat Plates under “Circular plates under distributed load producing large deflections,” Case 3, which is “Fixed and held. Uniform pressure q over entire plate.” The coefficient for a fixed edge condition in the 6th Edition1 K4 = 0.476 while in the 7th and 8th Edition2, the coefficient is 1.73 which is significant difference.

  10. General practitioner's reported use of clinical guidelines for hypertension and ambulatory blood pressure.

    LENUS (Irish Health Repository)

    Flynn, E

    2012-03-01

    ABPM is an invaluable clinical tool, as it has been shown to improve blood pressure control in primary care. Many clinical guidelines for hypertension advocate ambulatory blood pressure monitoring. This study aims to quantify the use of clinical guidelines for hypertension and to explore the role of ABPM in Primary Care. A questionnaire survey was sent to GPs working in the West of Ireland. 88% (n=139) of GPs use clinical guidelines that recommend the use of ABPM. 82% (n=130) of GPs find use of clinic blood pressure monitoring insufficient for the diagnosis and monitoring of hypertension. Despite good access to ABPM, GPs report lack of remuneration, 72% (n=116), cost 68% (n=108), and lack of time, 51% (n=83) as the main limiting factors to use of ABPM. GPs recognise the clinical value of ABPM, but this study identifies definite barriers to the use of ABPM in Primary Care.

  11. Musculoskeletal symptoms as related to ergonomic factors in Iranian hand-woven carpet industry and general guidelines for workstation design.

    Science.gov (United States)

    Choobineh, Alireza; Lahmi, Mohammadali; Shahnavaz, Houshang; Jazani, Reza Khani; Hosseini, Mostafa

    2004-01-01

    Carpet weaving is a high risk occupation for developing musculoskeletal disorders (MSDs). The objectives of the present study, which was carried out in the Iranian hand-woven carpet industry, were determination of the prevalence of MSD symptoms, identification of major factors associated with MSD symptoms and development of guidelines for workstation design. 1,439 randomly selected weavers participated in this study. A questionnaire was used to collect data on MSD symptoms. The results revealed that the prevalence rates for symptoms in different body regions were high as compared to the general Iranian population (for neck, back and large joints, p loom type, working posture, daily working time and seat type. Based on the results, some general guidelines for designing weaving workstations were developed. A prototype test showed that the new workstation was acceptable for subject tests and that it improved working posture.

  12. Management of COPD in general practice in Denmark--participating in an educational program substantially improves adherence to guidelines

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Hansen, Ejvind Frausing; Jensen, Michael Skov;

    2010-01-01

    BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease....... DESIGN AND SETTING: Two cross-sectional surveys were performed precisely one year apart before and after an educational program for the participating GPs. A total of 124 GPs completed the study; 1716 and 1342 patients with GP-diagnosed COPD and no concomitant asthma, respectively, were included...... activity, and referral for rehabilitation; use of inhaled corticosteroids in patients with mild COPD (FEV(1) > 80%pred) declined from 76% to 45%. CONCLUSION: Diagnosis and management of COPD in general practice in Denmark is not according to guidelines, but substantial improvements can be achieved...

  13. GUIDELINES FOR THE CONSTRUCTION OF THE IT ROAD SAFETY MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Jacek CHMIELEWSKI

    2016-07-01

    Full Text Available The article presents the role, need and idea of implementing an IT system to manage road safety, which is a proposal of the practical implementation of the Gambit programme elements prepared for the Kujawsko-Pomorskie Voivodeship. The usefulness of constructing the system has been presented, together with its users, the proposed content and possibility of its funding. The whole article has been summarised by outlining the opportunities and threats that may occur in the course of system implementation.

  14. Adherence to guidelines on cervical cancer screening in general practice : programme elements of successful implementation

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Braspenning, J C; Grol, R P

    2001-01-01

    BACKGROUND: There is still only limited understanding of whether and why interventions to facilitate the implementation of guidelines for improving primary care are successful. It is therefore important to look inside the 'black box' of the intervention, to ascertain which elements work well or less

  15. [Summary of the practice guideline 'Rheumatoid arthritis' (first revision) from the Dutch College of General Practitioners

    NARCIS (Netherlands)

    Wiersma, T.J.; Flikweert, S.; Bosch, W.J.H.M. van den

    2004-01-01

    The guideline covers the evaluation of patients with one or more painful joints without previous injury and focuses on the distinction between rheumatoid arthritis and other joint complaints. In the case of rheumatoid arthritis, the arthritis is based on aseptic synovitis and is nearly always associ

  16. Legalization: Phase Two Requirements and Guidelines for Courses of Study Recognized by the Attorney General.

    Science.gov (United States)

    Immigration and Naturalization Service, Washington, DC. Office of Outreach.

    Information concerning the federal regulations governing the basic citizenship skills requirement for immigrant legalization, as amended, is presented. Materials include: (1) a sample memorandum to educational service providers relaying information concerning the requirement; (2) revised requirements and guidelines for courses of study recognized…

  17. 77 FR 41453 - Submission for OMB Review, Comment Request, Proposed Collection: General Clearance for Guidelines...

    Science.gov (United States)

    2012-07-13

    .... The mission of IMLS is to inspire libraries and museums to advance innovation, lifelong learning, and... for Guidelines, Applications, and Reporting Forms AGENCY: Institute of Museum and Library Services.... SUMMARY: The Institute of Museum and Library Services announces the following information collection...

  18. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines.

    Science.gov (United States)

    Antal, A; Alekseichuk, I; Bikson, M; Brockmöller, J; Brunoni, A R; Chen, R; Cohen, L G; Dowthwaite, G; Ellrich, J; Flöel, A; Fregni, F; George, M S; Hamilton, R; Haueisen, J; Herrmann, C S; Hummel, F C; Lefaucheur, J P; Liebetanz, D; Loo, C K; McCaig, C D; Miniussi, C; Miranda, P C; Moliadze, V; Nitsche, M A; Nowak, R; Padberg, F; Pascual-Leone, A; Poppendieck, W; Priori, A; Rossi, S; Rossini, P M; Rothwell, J; Rueger, M A; Ruffini, G; Schellhorn, K; Siebner, H R; Ugawa, Y; Wexler, A; Ziemann, U; Hallett, M; Paulus, W

    2017-09-01

    Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1-2mA and during tACS at higher peak-to-peak intensities above 2mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity 'conventional' TES defined as stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in

  19. Direct mail improves knowledge of basic life support guidelines in general practice

    DEFF Research Database (Denmark)

    Secher, Niels; Mikkelsen, Mette Marie; Adelborg, Kasper

    2012-01-01

    Dette studie viste, at ved at fremsende vejledning i basal genoplivning direkte til alment praktiserende læger var det muligt at øge lægernes viden om dette område samt implementere de nye guidelines på området. Enhver praktiserende læge er til stadighed i kontakt med personer, der potentielt kan...

  20. Conformity to the surviving sepsis campaign international guidelines among physicians in a general intensive care unit in Nairobi.

    Science.gov (United States)

    Mung'ayi, V; Karuga, R

    2010-08-01

    There are emerging therapies for managing septic critically-ill patients. There is little data from the developing world on their usage. To determine the conformity rate for resuscitation and management bundles for septic patients amongst physicians in a general intensive care unit. Cross sectional observational study. The general intensive care unit, Aga Khan University Hospital,Nairobi. Admitting physicians from all specialties in the general intensive care unit. The physicians had high conformity rates of 92% and 96% for the fluid resuscitation and use of va so pressors respectively for the initial resuscitation bundle. They had moderate conformity rates for blood cultures prior to administering antibiotics (57%) and administration of antibiotics within first hour of recognition of septic shock (54%). There was high conformity rate to the glucose control policy (81%), use of protective lung strategy in acute lung injury/Acute respiratory distress syndrome, venous thromboembolism prophylaxis (100%) and stress ulcer prophylaxis (100%) in the management bundle. Conformity was moderate for use of sedation, analgesia and muscle relaxant policy (69%), continuous renal replacement therapies (54%) and low for steroid policy (35%), administration ofdrotrecogin alfa (0%) and selective digestive decontamination (15%). There is varying conformity to the international sepsis guidelines among physicians caring for patients in our general ICU. Since increased conformity would improve survival and reduce morbidity, there is need for sustained education and guideline based performance improvement.

  1. Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

    NARCIS (Netherlands)

    Giesen, P.H.J.; Ferwerda, R.; Tijssen, R.; Mokkink, H.G.A.; Drijver, R.; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: In recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed. OBJECTIVES: To investigate whether triage

  2. National Standard of "General Request on Biological Safety" Was Officially Issued

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ May 28 2004, sponsored by Standardization Administration of P.R. China ( SAC ) and Certification and Accreditation Administration of P.R. China (CNCA), China National Accreditation Board For Laboratories (CNAL) organized the press conference on National Standard of "General Request on Biological Safety" in Beijing.

  3. General guidelines for medically screening mixed population groups potentially exposed to nerve or vesicant agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.; Munro, N.B. (Oak Ridge National Lab., TN (United States)); Sidell, F.R. (Army Medical Research Inst. of Chemical Defense, Aberdeen Proving Ground, MD (United States)); Leffingwell, S.S. (Centers for Disease Control, Atlanta, GA (United States). Center for Environmental Health and Injury Control)

    1992-01-01

    A number of state and local planners have requested guidance on screening protocols and have expressed interest in sampling body fluids from exposed or potentially exposed individuals as a means of estimating agent dose. These guidelines have been developed to provide a clear statement that could be used by state and local emergency response personnel in the event of a nerve or vesicant agent incident resulting in off-post contamination; maximum protection from harm is the goal. The assumption is that any population group so exposed would be heterogeneous for age, gender, reproductive status, and state of health.

  4. General guidelines for medically screening mixed population groups potentially exposed to nerve or vesicant agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.; Munro, N.B. [Oak Ridge National Lab., TN (United States); Sidell, F.R. [Army Medical Research Inst. of Chemical Defense, Aberdeen Proving Ground, MD (United States); Leffingwell, S.S. [Centers for Disease Control, Atlanta, GA (United States). Center for Environmental Health and Injury Control

    1992-01-01

    A number of state and local planners have requested guidance on screening protocols and have expressed interest in sampling body fluids from exposed or potentially exposed individuals as a means of estimating agent dose. These guidelines have been developed to provide a clear statement that could be used by state and local emergency response personnel in the event of a nerve or vesicant agent incident resulting in off-post contamination; maximum protection from harm is the goal. The assumption is that any population group so exposed would be heterogeneous for age, gender, reproductive status, and state of health.

  5. [Less ethnic knowledge in the Dutch College of General Practitioner's practice guidelines on type 2 diabetes mellitus, hypertension and asthma in adults than in the supporting literature

    NARCIS (Netherlands)

    Manna, D.R.; Bruijnzeels, M.A.; Mokkink, H.G.A.; Berg, M. van den

    2003-01-01

    OBJECTIVE: To assess whether ethnic differences present in the scientific literature used as the basis for the Dutch College of General Practitioner's (NHG) practice guidelines were reflected in the ethnic-specific information the guidelines contained. DESIGN: Analysis of published information.

  6. [The practice guideline 'Otitis externa' (first revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology

    NARCIS (Netherlands)

    Mylanus, E.A.M.

    2008-01-01

    The first revision of the practice guideline 'Otitis externa' from the Dutch College of General Practitioners describes diagnostic, therapeutic and preventive aspects of care and focuses mainly on the acute form of the disease. In comparison with the previous guideline, some modest but valuable impr

  7. Awareness of Iranian’s General Dentists Regarding the Latest Prophylaxis Guideline for Prevention of Infective Endocarditis

    Directory of Open Access Journals (Sweden)

    Ghaderi F.

    2013-03-01

    Full Text Available Statement of Problem: Dental procedures leading to oral tissue injuries may provoke bacterial release to the blood stream causing infective endocarditis (IE in vulnerable patients. The guideline which was proposed by AHA has been updated 9 times having the last update published in 2007. This study was endeavored to uncover the level of knowledge of general dental practitioners in Shiraz, concerning the 2007 AHA guidelines for endocarditis prophylaxis in patients with cardiac problems receiving dental treatments.Materials and Method: This cross- sectional and descriptive analytical study included 150 dentists as participants. All practitioners were given a self –report questionnaire which consisted of three sections. Questions were designed to assess their knowledge of antibiotic prophylaxis in patients with cardiac disease. Results: Almost all participants (93% were aware of antibiotic prophylaxis to be essential for tooth extraction. Most participants did not believe in prophylaxis for noninvasive procedures (such as shedding of primary teeth, impression, intraoral radiography. From all of the respondents, 75% considered Amoxicillin to be the anti-biotic of choice and 57% were acquainted with the correct dose of Amoxicillin for high risk patients.Conclusion: The study identified a potential for under/over prescription of antibiotic prophylaxis under the current guideline. Burden of IE necessitates more accurate knowledge of antibiotic prophylaxis in the undergraduate curriculum and continuing education programs of dentistry.

  8. Validation in Support of Internationally Harmonised OECD Test Guidelines for Assessing the Safety of Chemicals.

    Science.gov (United States)

    Gourmelon, Anne; Delrue, Nathalie

    Ten years elapsed since the OECD published the Guidance document on the validation and international regulatory acceptance of test methods for hazard assessment. Much experience has been gained since then in validation centres, in countries and at the OECD on a variety of test methods that were subjected to validation studies. This chapter reviews validation principles and highlights common features that appear to be important for further regulatory acceptance across studies. Existing OECD-agreed validation principles will most likely generally remain relevant and applicable to address challenges associated with the validation of future test methods. Some adaptations may be needed to take into account the level of technique introduced in test systems, but demonstration of relevance and reliability will continue to play a central role as pre-requisite for the regulatory acceptance. Demonstration of relevance will become more challenging for test methods that form part of a set of predictive tools and methods, and that do not stand alone. OECD is keen on ensuring that while these concepts evolve, countries can continue to rely on valid methods and harmonised approaches for an efficient testing and assessment of chemicals.

  9. Perceptions of general education on occupational health and safety among college students in Taiwan.

    Science.gov (United States)

    Tong, Yu-Huei; Lin, Yu-Wen; Chen, Chih-Chieh; Lin, Jia-Ming

    2009-08-01

    Undergraduate students were surveyed to assess their awareness of and interest in health and safety education. Out of 5258 questionnaires distributed among 66 colleges and universities in Taiwan, 4474 questionnaires were returned. The respondents were asked to provide demographic information and to respond to questions about a proposed college course in general occupational health and safety (OHS) and questions about 30 OHS topics. Their awareness and learning interest about each topic were evaluated on a 4-point scale. Statistical analysis of variance and logistic linear regression were performed. Only 13% of respondents had previously taken health and safety courses. More than 39% of respondents indicated that they would take general OHS courses if the courses were offered by their colleges. Student motivation to take OHS courses was apparently related to their experience in OHS coursework, their academic background, and their current learning interest in the 30 OHS topics. Students with natural science or engineering backgrounds tended to express strong interest in OHS topics and courses. In conclusion, implementing general health and safety education in college is recommended. In addition, developing an OHS course module system would meet student expectations, as courses would consider the learning interests and needs of students with different college majors.

  10. Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study using the theoretical domains framework.

    Science.gov (United States)

    Murphy, Kerry; O'Connor, Denise A; Browning, Colette J; French, Simon D; Michie, Susan; Francis, Jill J; Russell, Grant M; Workman, Barbara; Flicker, Leon; Eccles, Martin P; Green, Sally E

    2014-03-03

    Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia; however, there are gaps between recommended and current practice. The aim of this study was to explore GPs' reported practice in diagnosing and managing dementia and to describe, in theoretical terms, the proposed explanations for practice that was and was not consistent with evidence-based guidelines. Semi-structured interviews were conducted with GPs in Victoria, Australia. The Theoretical Domains Framework (TDF) guided data collection and analysis. Interviews explored the factors hindering and enabling achievement of 13 recommended behaviours. Data were analysed using content and thematic analysis. This paper presents an in-depth description of the factors influencing two behaviours, assessing co-morbid depression using a validated tool, and conducting a formal cognitive assessment using a validated scale. A total of 30 GPs were interviewed. Most GPs reported that they did not assess for co-morbid depression using a validated tool as per recommended guidance. Barriers included the belief that depression can be adequately assessed using general clinical indicators and that validated tools provide little additional information (theoretical domain of 'Beliefs about consequences'); discomfort in using validated tools ('Emotion'), possibly due to limited training and confidence ('Skills'; 'Beliefs about capabilities'); limited awareness of the need for, and forgetting to conduct, a depression assessment ('Knowledge'; 'Memory, attention and decision processes'). Most reported practising in a manner consistent with the recommendation that a formal cognitive assessment using a validated scale be undertaken. Key factors enabling this were having an awareness of the need to conduct a cognitive assessment ('Knowledge'); possessing the necessary skills and confidence ('Skills'; 'Beliefs

  11. Road Safety Audit RSA : best practice guidelines, qualification for auditors and 'programming'. Deliverable D4 of the RiPCORD-iSEREST project (Road Infrastructure Safety Protection - Core-Research and Development for Road Safety in Europe; Increasing safety and reliability of secondary roads for a sustainable Surface Transport).

    NARCIS (Netherlands)

    Matena, S. Weber, R. Huber, C.A. Hruby, Z. Pokorny, P. Gaitanidou, E. Vaneerdewegh, P. Strnad, B. Cardoso, J. Schermers, G. & Elvik, R.

    2009-01-01

    This report contains 'best practice' guidelines for road safety audits (RSA) and summarises practices which have been successfully applied in European countries or abroad. The goals of this report are to inform the reader on the reasons why carrying out audits is beneficial and how to successfully c

  12. Road Safety Audit RSA : best practice guidelines, qualification for auditors and 'programming'. Deliverable D4 of the RiPCORD-iSEREST project (Road Infrastructure Safety Protection - Core-Research and Development for Road Safety in Europe; Increasing safety and reliability of secondary roads for a sustainable Surface Transport).

    NARCIS (Netherlands)

    Matena, S. Weber, R. Huber, C.A. Hruby, Z. Pokorny, P. Gaitanidou, E. Vaneerdewegh, P. Strnad, B. Cardoso, J. Schermers, G. & Elvik, R.

    2009-01-01

    This report contains 'best practice' guidelines for road safety audits (RSA) and summarises practices which have been successfully applied in European countries or abroad. The goals of this report are to inform the reader on the reasons why carrying out audits is beneficial and how to successfully

  13. Road Safety Audit RSA : best practice guidelines, qualification for auditors and 'programming'. Deliverable D4 of the RiPCORD-iSEREST project (Road Infrastructure Safety Protection - Core-Research and Development for Road Safety in Europe; Increasing safety and reliability of secondary roads for a sustainable Surface Transport).

    NARCIS (Netherlands)

    Matena, S. Weber, R. Huber, C.A. Hruby, Z. Pokorny, P. Gaitanidou, E. Vaneerdewegh, P. Strnad, B. Cardoso, J. Schermers, G. & Elvik, R.

    2009-01-01

    This report contains 'best practice' guidelines for road safety audits (RSA) and summarises practices which have been successfully applied in European countries or abroad. The goals of this report are to inform the reader on the reasons why carrying out audits is beneficial and how to successfully c

  14. Social safety, self-rated general health and physical activity : Changes in area crime, area safety feelings and the role of social cohesion

    NARCIS (Netherlands)

    Ruijsbroek, Annemarie; Droomers, Mariël; Groenewegen, Peter P.; Hardyns, Wim; Stronks, Karien

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated

  15. Social safety, self-rated general health and physical activity : Changes in area crime, area safety feelings and the role of social cohesion

    NARCIS (Netherlands)

    Ruijsbroek, Annemarie; Droomers, Mariël; Groenewegen, Peter P.; Hardyns, Wim; Stronks, Karien

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated

  16. Screening Tool for Older Persons' Appropriate Prescriptions for Japanese: Report of the Japan Geriatrics Society Working Group on "Guidelines for medical treatment and its safety in the elderly".

    Science.gov (United States)

    Kojima, Taro; Mizukami, Katsuyoshi; Tomita, Naoki; Arai, Hiroyuki; Ohrui, Takashi; Eto, Masato; Takeya, Yasushi; Isaka, Yoshitaka; Rakugi, Hiromi; Sudo, Noriko; Arai, Hidenori; Aoki, Hiroaki; Horie, Shigeo; Ishii, Shinya; Iwasaki, Koh; Takayama, Shin; Suzuki, Yusuke; Matsui, Toshifumi; Mizokami, Fumihiro; Furuta, Katsunori; Toba, Kenji; Akishita, Masahiro

    2016-09-01

    In 2005, the Japan Geriatrics Society published a list of potentially inappropriate medication that was an extract from the "Guidelines for medical treatment and its safety in the elderly 2005." The 2005 guidelines are due for a revision, and a new comprehensive list of potentially inappropriate medications is required. A total of 15 diseases, conditions and special areas related to their clinical care were selected. We originated clinical questions and keywords for these 15 areas, carried out a systematic review using these search criteria, and formulated guidelines applying the Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. If we did not find good evidence despite the drug being clinically important, we looked for evidence of efficacy and for disease-specific guidelines, and incorporated them into our guidelines. We selected 2098 articles (140 articles per area), and extracted another 186 articles through a manual search. We further added guidelines based on disease entity and made two lists, one of "drugs to be prescribed with special caution" and the other of "drugs to consider starting," primarily considering individuals aged 75 years or older or those who are frail or in need of special care. New lists of potentially inappropriate medications and potential prescribing omissions called "Screening Tool for Older Person's Appropriate Prescriptions for Japanese" were constructed. We anticipate that future studies will highlight more evidence regarding the safety of high-quality drugs, further improving the provision of appropriate medical care for the elderly. Geriatr Gerontol Int 2016: 16: 983-1001. © 2016 Japan Geriatrics Society.

  17. General guidelines for biomedical software development [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Luis Bastiao Silva

    2017-07-01

    Full Text Available Most bioinformatics tools available today were not written by professional software developers, but by people that wanted to solve their own problems, using computational solutions and spending the minimum time and effort possible, since these were just the means to an end. Consequently, a vast number of software applications are currently available, hindering the task of identifying the utility and quality of each. At the same time, this situation has hindered regular adoption of these tools in clinical practice. Typically, they are not sufficiently developed to be used by most clinical researchers and practitioners. To address these issues, it is necessary to re-think how biomedical applications are built and adopt new strategies that ensure quality, efficiency, robustness, correctness and reusability of software components. We also need to engage end-users during the development process to ensure that applications fit their needs. In this review, we present a set of guidelines to support biomedical software development, with an explanation of how they can be implemented and what kind of open-source tools can be used for each specific topic.

  18. Safety Factor of Anisotropic Bars in the Space of Generalized Forces

    Science.gov (United States)

    Sibgatullin, K. E.; Sibgatullin, E. S.

    2017-01-01

    Bars of arbitrary shape made of a homogeneous anisotropic material are considered. In the general case, in their cross section, nonzero are all internal force factors (IFF) — three forces and three moments. The values of the IFF are known from solutions of the corresponding problem. The safety factor for the load-carrying capacity of the beams is determined by comparing the known vector R ∗ of IFF with the corresponding desired strength vector R in the IFF space.

  19. Do general practices adhere to organizational guidelines for effective cervical cancer screening?

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Braspenning, J C; Grol, R P

    1998-01-01

    BACKGROUND: Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to org

  20. SAFETY

    CERN Multimedia

    C. Schaefer and N. Dupont

    2013-01-01

      “Safety is the highest priority”: this statement from CERN is endorsed by the CMS management. An interpretation of this statement may bring you to the conclusion that you should stop working in order to avoid risks. If the safety is the priority, work is not! This would be a misunderstanding and misinterpretation. One should understand that “working safely” or “operating safely” is the priority at CERN. CERN personnel are exposed to different hazards on many levels on a daily basis. However, risk analyses and assessments are done in order to limit the number and the gravity of accidents. For example, this process takes place each time you cross the road. The hazard is the moving vehicle, the stake is you and the risk might be the risk of collision between both. The same principle has to be applied during our daily work. In particular, keeping in mind the general principles of prevention defined in the late 1980s. These principles wer...

  1. Social safety, general health and physical activity: changes in neighbourhood safety and the role of social cohesion.

    NARCIS (Netherlands)

    Ruijsbroek, A.; Droomers, M.; Groenewegen, P.P.; Hardyns, W.; Stronks, K.

    2014-01-01

    Background: Area crime and perceived safety are two components of social safety that are presumed to affect individual health and health related behaviour. So far, most studies have used cross-sectional data to study this relation. We have investigated changes in social safety in relation to self-ra

  2. [Summary of the practice guideline 'Urinary-tract infections' (second revision) from the Dutch College of General Practitioners].

    Science.gov (United States)

    van Pinxteren, B; van Vliet, S M; Wiersma, T J; Goudswaard, A N

    2006-04-01

    The 1999 practice guideline 'Urinary-tract infections' from the Dutch College of General Practitioners has been revised. Not only febrile urinary-tract infections are now regarded as 'complicated', but also all urinary-tract infections in men, pregnant women, children, and patients with kidney or urinary-tract disease, impaired immune response or an indwelling catheter. Under certain conditions, in women recognising the symptoms of an earlier uncomplicated urinary-tract infection, treatment may be instituted without performing supplementary urinalysis. The nitrite dipstick test and dipslide culturing are recommended for the diagnosis of urinary-tract infections; the value of the leukocyte esterase dipstick test is limited. A group-B streptococcal urinary-tract infection during pregnancy is an indication for intravenous antibiotic prophylaxis during the delivery. The recommended duration of treatment with nitrofurantoin is extended from three to five days. Both increased bacterial resistance to trimethoprim and the intention to reduce the use of fluoroquinolones in the treatment of uncomplicated urinary-tract infections were reasons for including phosphomycin in the guideline. In addition to antibiotic prophylaxis, cranberry products may be of value in the prevention of recurrent urinary-tract infections.

  3. Improving Knowledge of General Dental Practitioners on Antibiotic Prescribing by Raising Awareness of the Faculty of General Dental Practice (UK Guidelines

    Directory of Open Access Journals (Sweden)

    Sana Zahabiyoun

    2015-10-01

    Full Text Available Objectives: Cases of antimicrobial resistance are increasing, partly due to inappropriate prescribing practices by dentists. The purpose of this study was to investigate the prescrib- ing practices and knowledge of dentists with regards to antibiotics. Moreover, this study aimed to determine whether the prescriptions comply with the recommended guidelines and whether clinical audit can alter the prescribing practices of dentists leading to better use of antibiotics in the dental service.Materials and Methods: A clinical audit (before/after non-controlled trial was carried out in two dental clinics in the northeast of England. Retrospective data were collected from 30 antibiotic prescriptions, analysed and compared with the recommended guide- lines. Data collected included age and gender of patients, type of prescribed antibiotics and their dosage, frequency and duration, clinical condition and reason for prescribing. The principles of appropriate prescribing based on guidance by the Faculty of General Dental Practice in the United Kingdom (UK, FGDP, were discussed with the dental clini- cians. Following this, prospective data were collected and similarly managed. Pre and post audit data were then compared. Changes were tested for significance using McNemar's test and P value<0.05 was considered statistically significant.Results: After intervention, data revealed that antibiotic prescribing practices of dentists improved, as there was an increase in the percentage of prescriptions that were in accor- dance with the FGDP (UK guidelines.Conclusion: In view of the limited data collected, this study concludes that there are inap- propriate antibiotic prescribing practices amongst general dental practitioners and that clinical audit can address this situation, leading to a more rational use of antibiotics in dental practice.

  4. Implementation Guideline for Maintenance Line Operations Safety Assessment (M-LOSA) and Ramp LOSA (R-LOSA) Programs

    Science.gov (United States)

    2012-08-01

    airlines and Maintenance Repair & Overhaul ( MROs ) communities. 53 Appendix A. Organizational Change Management – Stakeholder Strategy...Maintenance Line Operations Safety Audit MRO – Maintenance, Repair & Overhaul NOSS – Normal Operations Safety Survey QA – Quality Assurance RACI

  5. Safety Guide-Line and Requirements for Distributed Raman Amplification and its Applications to WDM Transmission Systems

    Institute of Scientific and Technical Information of China (English)

    Masahito; Tomizawa; Akira; Hirano; Yutaka; Miyamoto

    2003-01-01

    This paper discusses optical safety issues in distributed Raman amplification systems. Given the extremely high pump powers, network service operators have critical issues for safety. This paper focuses on both " eye-hazard" and " fire-hazards" .

  6. Safety Guide-Line and Requirements for Distributed Raman Amplification and its Applications to WDM Transmission Systems

    Institute of Scientific and Technical Information of China (English)

    Masahito Tomizawa; Akira Hirano; Yutaka Miyamoto

    2003-01-01

    This paper discusses optical safety issues in distributed Raman amplification systems. Given the extremely high pump powers, network service operators have critical issues for safety. This paper focuses on both “eye-hazard” and “fire-hazards”.

  7. Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology.

    Science.gov (United States)

    Town, G; Ash, C; Dierickx, C; Fritz, K; Bjerring, P; Haedersdal, M

    2012-07-01

    In the past 5 years since their US introduction, there has been a rapid proliferation of light-based hair removal devices intended for home-use. In the last 2 years in Europe, sales already run into many tens of thousands of units with well-known multi-national companies entering the market. These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some regulations exist, they differ from region to region and there is a specific need for international common principles and guidelines relating to the manufacture, marketing and use of intense pulsed light and laser devices, including manufacturing standards for home-use products intended, amongst others, for cosmetic hair removal and photo-rejuvenation procedures. In these guidelines, the European Society for Laser Dermatology (ESLD) provides a professional view of what 'best practice' may imply for manufacturers and consumers alike.

  8. Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols.

    Science.gov (United States)

    Shearer, Peter; Riviello, James

    2011-02-01

    Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.

  9. A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice

    DEFF Research Database (Denmark)

    Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming

    2016-01-01

    primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS). METHODS: In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate. Practices were....... In an intention-to-treat analysis, the primary and secondary outcomes pertained to the patient, and a cost-effectiveness analysis was performed from a healthcare sector perspective. Patients and the assessment of outcomes were blinded. Practices and caregivers delivering the interventions were not blinded....... RESULTS: Between January 2013 and July 2014, 60 practices were included, of which 54 practices (28 MuIS, 26 PaIS) included 1101 patients (539 MuIS, 562 PaIS). Follow-up data for the primary outcome were available on 100 % of these patients. Twenty-seven patients (5.0 %) in the MuIS group were referred...

  10. Maximising harm reduction in early specialty training for general practice: validation of a safety checklist

    Directory of Open Access Journals (Sweden)

    Bowie Paul

    2012-06-01

    Full Text Available Abstract Background Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. Methods We used mixed methods with different groups of GP educators (n = 127 and specialty trainees (n = 9 in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. Results 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. Conclusion A checklist was developed and

  11. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

    2011-11-03

    To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy

  12. Implementing referral guidelines: lessons from a negative outcome cluster randomised factorial trial in general practice

    Directory of Open Access Journals (Sweden)

    Shaw Lindsey

    2006-11-01

    Full Text Available Abstract Background Few patients with lower bowel symptoms who consult their general practitioner need a specialist opinion. However data from referred patients suggest that those who are referred would benefit from detailed assessment before referral. Methods A cluster randomised factorial trial. 44 general practices in North Trent, UK. Practices were offered either an electronic interactive referral pro forma, an educational outreach visit by a local colorectal surgeon, both or neither. The main outcome measure was the proportion of cases with severe diverticular disease, cancer or precancerous lesions and inflammatory bowel disease in those referred by each group. A secondary outcome was a referral letter quality score. Semi-structured interviews were conducted to identify key themes relating to the use of the software Results From 150 invitations, 44 practices were recruited with a total list size of 265,707. There were 716 consecutive referrals recorded over a six-month period, for which a diagnosis was available for 514. In the combined software arms 14% (37/261 had significant pathology, compared with 19% (49/253 in the non-software arms, relative risk 0.73 (95% CI: 0.46 to 1.15. In the combined educational outreach arms 15% (38/258 had significant pathology compared with 19% (48/256 in the non-educational arms, relative risk 0.79 (95% CI: 0.50 to 1.24. Pro forma practices documented better assessment of patients at referral. Conclusion There was a lack of evidence that either intervention increased the proportion of patients with organic pathology among those referred. The interactive software did improve the amount of information relayed in referral letters although we were unable to confirm if this made a significant difference to patients or their health care providers. The potential value of either intervention may have been diminished by their limited uptake within the context of a cluster randomised clinical trial. A number of

  13. Generalized Safety and Efficacy of Simplified Intravenous Thrombolysis Treatment (SMART) Criteria in Acute Ischemic Stroke

    DEFF Research Database (Denmark)

    Sørensen, Sigrid B; Barazangi, Nobl; Chen, Charlene;

    2016-01-01

    BACKGROUND: Common intravenous recombinant tissue plasminogen activator (IV rt-PA) exclusion criteria may substantially limit the use of thrombolysis. Preliminary data have shown that the SMART (Simplified Management of Acute stroke using Revised Treatment) criteria greatly expand patient...... eligibility by reducing thrombolysis exclusions, but they have not been assessed on a large scale. We evaluated the safety and efficacy of general adoption of SMART thrombolysis criteria to a large regional stroke network. METHODS: Retrospective analysis of consecutive patients who received IV thrombolysis...... application of SMART criteria is safe and effective. Widespread application of these criteria could substantially increase the proportion of patients who might qualify for treatment....

  14. [French Society of Vascular Medicine good medical practice guidelines on safety and environment in vascular medicine: Treatment of varicose veins].

    Science.gov (United States)

    Giordana, P; Miserey, G

    2014-12-01

    These guidelines proposed by the French Society of Vascular Medicine define the optimal environment for vascular medicine practice: outpatient clinic; equipment, layout and maintenance of the care center; infection risk prevention (hand hygiene, individual protective measures, exposure to blood, ultrasound apparatus, etc.); common interventions and techniques (liquid and foam sclerotherapy, endovenous thermal treatments). These guidelines do not include phlebectomy and use of ultrasound contrast agents.

  15. Support for the revocation of general safety test regulations in biologics license applications.

    Science.gov (United States)

    Evans, Dana M; Thorn, Jennifer M; Arch-Douglas, Katherine; Sperry, Justin B; Thompson, Bruce; Davis, Heather L; McCluskie, Michael J

    2016-05-01

    The United States Food and Drug Administration recently removed the requirement for a General Safety Test (GST) for biologics in the Code of Federal Regulations (21 CFR 610.11). The GST, as well as abnormal toxicity (European Pharmacopeia) and innocuity tests (World Health Organization), were designed to test for extraneous toxic contaminants on each product lot intended for human use. Tests require one-week observations for general health and weight following injection of specified volumes of product batches into guinea pigs and mice. At the volumes specified, dose-related toxicity may result when the product is pharmacologically active in rodents. With vaccines, required doses may be > 3 logs higher than intended human dose on a weight-adjusted basis and if an immune modulatory adjuvant is included, systemic immune hyperactivation may cause toxicity. Herein, using the CpG/alum adjuvant combination we evaluated the different test protocols and showed their unsuitability for this adjuvant combination.

  16. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    OpenAIRE

    Mohamed Azmi Hassali; Shafie, Asrul A.; Fahad Saleem; Harith Al-Qazaz; Imran Masood; Muhammad Atif; Hisham Aljadhey

    2012-01-01

    Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistic...

  17. Pharmacotherapy for Pediatric Generalized Anxiety Disorder: A Systematic Evaluation of Efficacy, Safety and Tolerability

    Science.gov (United States)

    Dobson, Eric T.; Strawn, Jeffrey R.

    2016-01-01

    Background Randomized controlled trials consistently support the efficacy of antidepressants in treating youth with generalized anxiety disorder (GAD), although integrated examinations of efficacy, safety, and tolerability of psychotropic medications in GAD specifically are rare. With this in mind, we sought to describe the efficacy, safety and tolerability of psychopharmacologic interventions in youth with GAD. Methods Randomized, double-blind, placebo-controlled, prospective trials of psychopharmacologic interventions in youth with GAD were identified through a PubMed/Medline (1966–2015) search. Both authors manually reviewed trials and, to evaluate comparative efficacy and tolerability across medications, numbers needed to treat (NNT) (based on Pediatric Anxiety Rating Scale (PARS) remission criteria (PARS ≤8 [1]), and number needed to harm (NNH) for selected treatment-emergent adverse events (TEAEs) were calculated. Finally, treatment-emergent suicidality and taper-emergent/post-study adverse events are reported descriptively. Results Five trials that involved 1,186 patients and evaluated four medications were reviewed and efficacy data were extracted with regard to dimensional measures of anxiety. SSRI/SNRIs demonstrated efficacy in the reduction of anxiety symptoms with NNTs ranging from 2.8 to 9.3. TEAEs varied considerably between studies but tended to be mild and generally did not lead to discontinuation. Conclusions Data from five trials of SSRI/SNRI in youth with GAD, many of whom had co-occurring separation and social anxiety disorders, suggest superiority to placebo and favorable tolerability profiles. PMID:26660158

  18. New set of Chemical Safety rules

    CERN Multimedia

    HSE Unit

    2011-01-01

    A new set of four Safety Rules was issued on 28 March 2011: Safety Regulation SR-C ver. 2, Chemical Agents (en); General Safety Instruction GSI-C1, Prevention and Protection Measures (en); General Safety Instruction GSI-C2, Explosive Atmospheres (en); General Safety Instruction GSI-C3, Monitoring of Exposure to Hazardous Chemical Agents in Workplace Atmospheres (en). These documents form part of the CERN Safety Rules and are issued in application of the “Staff Rules and Regulations” and of document SAPOCO 42. These documents set out the minimum requirements for the protection of persons from risks to their occupational safety and health arising, or likely to arise, from the effects of hazardous chemical agents that are present in the workplace or used in any CERN activity. Simultaneously, the HSE Unit has published seven Safety Guidelines and six Safety Forms. These documents are available from the dedicated Web page “Chemical, Cryogenic and Biological Safety&...

  19. Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations

    Directory of Open Access Journals (Sweden)

    Noe eGarin

    2015-07-01

    Full Text Available BACKGROUNDAdherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue.METHODSData on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed search. for HIV patients. We assessed the incorporation of recreational drug issues in HIV treatment guidelines for the following topics: a recreational drugs; b adherence to antiretrovirals; c interactions; d transmission risk. Guidelines included: World Health Organization; European Aids Clinical Society; U.S. Department of Health and Human Services; International Antiviral Society-USA; and seven European national guidelines.RESULTS29 countries reported recreational drug use in general population. The highest prevalences were observed for Cannabis (i.e. 8-10% in Spain, France and Czech Republic followed by cocaine, amphetamines and ecstasy. The 13 studies selected in the systematic review showed a great variability in recreational drug use on the HIV population. Apart from classical recreational drugs, we found a relevant use of new drugs including sexual experience enhancers. Polydrug consumption was about 50% in some studies. Most guidelines included general information about recreational drugs, showing great variability on the inclusion of the evaluated topics. We found more specific, evidence-based recommendations on interactions, followed by medication adherence and transmission risk.CONCLUSIONSAvailable data on the people living with HIV suggest a higher use of recreational drugs than in the general population, which is already relevant. However, recreational drug issues should be included or addressed more thoroughly in most guidelines.

  20. Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations

    Science.gov (United States)

    Garin, Noe; Velasco, Cesar; De Pourcq, Jan T.; Lopez, Belen; Gutierrez, Maria del Mar; Haro, Josep M.; Feliu, Anna; Mangues, Maria A.; Trilla, Antoni

    2015-01-01

    Background: Adherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue. Methods: Data on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed search. for HIV patients. We assessed the incorporation of recreational drug issues in HIV treatment guidelines for the following topics: (a) recreational drugs; (b) adherence to antiretrovirals; (c) interactions; (d) transmission risk. Guidelines included: World Health Organization; European Aids Clinical Society; U.S. Department of Health and Human Services; International Antiviral Society-USA; and seven European national guidelines. Results: 29 countries reported recreational drug use in general population. The highest prevalences were observed for Cannabis (i.e., 8–10% in Spain, France, and Czech Republic) followed by cocaine, amphetamines and ecstasy. The 13 studies selected in the systematic review showed a great variability in recreational drug use on the HIV population. Apart from classical recreational drugs, we found a relevant use of new drugs including sexual experience enhancers. Polydrug consumption was about 50% in some studies. Most guidelines included general information about recreational drugs, showing great variability on the inclusion of the evaluated topics. We found more specific, evidence-based recommendations on interactions, followed by medication adherence and transmission risk. Conclusions: Available data on the people living with HIV suggest a higher use of recreational drugs than in the general population, which is already relevant. However, recreational drug issues should be included or addressed more thoroughly in most guidelines. PMID:26236288

  1. Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology

    DEFF Research Database (Denmark)

    Town, Graham; Ash, C; Dierickx, C

    2012-01-01

    In the past 5 years since their US introduction, there has been a rapid proliferation of light-based hair removal devices intended for home-use. In the last 2 years in Europe, sales already run into many tens of thousands of units with well-known multi-national companies entering the market....... These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers...... home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use...

  2. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    Science.gov (United States)

    Shields, Nora; O'Hare, Neil; Gormley, John

    2004-07-01

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists.

  3. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    Energy Technology Data Exchange (ETDEWEB)

    Shields, Nora [School of Physiotherapy, La Trobe University, Victoria 3086 (Australia); O' Hare, Neil [Department of Medical Physics and Bioengineering, St James' s Hospital, Dublin 8 (Ireland); Gormley, John [School of Physiotherapy, Trinity College Dublin, Trinity Centre for Health Sciences, St James' s Hospital, Dublin 8 (Ireland)

    2004-07-07

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists.

  4. Safety

    CERN Multimedia

    2003-01-01

    Please note that the safety codes A9, A10 AND A11 (ex annexes of SAPOCO/42) entitled respectively "Safety responsibilities in the divisions" "The safety policy committee (SAPOCO) and safety officers' committees" and "Administrative procedure following a serious accident or incident" are available on the web at the following URLs: Code A9: http://edms.cern.ch/document/337016/LAST_RELEASED Code A10: http://edms.cern.ch/document/337019/LAST_RELEASED Code A11: http://edms.cern.ch/document/337026/LAST_RELEASED Paper copies can also be obtained from the TIS divisional secretariat, e-mail: tis.secretariat@cern.ch. TIS Secretariat

  5. New aspects from legislation, guidelines and safety standards for MRI; Neues aus Gesetzen, Richtlinien und Sicherheitsstandards fuer die MRT

    Energy Technology Data Exchange (ETDEWEB)

    Muehlenweg, M. [Krankenhaus Martha-Maria Halle-Doelau, Institut fuer Radiologie, Halle (Saale) (Germany); Schaefers, G. [MR:comp GmbH, Gelsenkirchen (Germany); Trattnig, S. [Exzellenzzentrum Hochfeld-Magnetresonanz, Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2015-08-15

    Many aspects of magnetic resonance (MR) operation are not directly regulated by law but in standards, guidelines and the operating instructions of the MR scanner. The mandatory contents of the operating instructions are regulated in a central standard of the International Electrotechnical Commission (IEC) 60601-2-33. In this standard, the application of static magnetic fields in MRI up to 8 Tesla (T) in the clinical routine (first level controlled mode) has recently been approved. Furthermore, the equally necessary CE certification of ultra-high field scanners (7-8 T) in Europe is expected for future devices. The existing installations will not be automatically certified but will retain their experimental status. The current extension of IEC 60601-2-33 introduces a new add-on option, the so-called fixed parameter option (FPO). This option might also be switched on in addition to the established operating modes and defines a fixed device constellation and certain parameters of the energy output of MR scanners designed to simplify the testing of patients with implants in the future. The employment of pregnant workers in an MRI environment is still not generally regulated in Europe. In parts of Germany and Austria pregnant and lactating employees were prohibited from working in the MR control zone (0.5 mT) in 2014. This is based on the mostly unresolved question of the applicability of limits for employees (exposure of extremities to static magnetic fields up to 8 T allowed) or the thresholds for the general population (maximum 400 mT). According to the European Society of Urogenital Radiology (ESUR), the discarding of breast milk after i.v. administration of gadolinium-based contrast agents in the case of a breastfeeding woman is only recommended when using contrast agents in the nephrogenic systemic fibrosis (NSF) high-risk category. (orig.) [German] Viele Belange des MR-Betriebs sind nicht direkt gesetzlich geregelt, sondern in Normen, Richtlinien und der

  6. Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial.

    NARCIS (Netherlands)

    Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2015-01-01

    Background A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting A three-arm cluster randomised trial was

  7. Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project

    NARCIS (Netherlands)

    O'Reilly-de Brun, M.; Macfarlane, A.; Brun, T. de; Okonkwo, E.; Bonsenge Bokanga, J.S.; Almeida Silva, M. de; Ogbebor, F.; Mierzejewska, A.; Nnadi, L.; Muijsenbergh, M.E.T.C. van den; Weel-Baumgarten, E.M. van; Weel, C. van

    2015-01-01

    OBJECTIVE: The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal

  8. Social safety, self-rated general health and physical activity: changes in area crime, area safety feelings and the role of social cohesion.

    Science.gov (United States)

    Ruijsbroek, Annemarie; Droomers, Mariël; Groenewegen, Peter P; Hardyns, Wim; Stronks, Karien

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated whether social cohesion protects the residents against the negative impact of unsafe areas on health and PA. Multilevel logistic regression analyses were performed on Dutch survey data, including 47,926 respondents living in 2974 areas. An increase in area level unsafety feelings between 2009 and 2011 was associated with more people reporting poor general health in 2012 in that area, but was not related to PA. Changes in reported area crime were not related to either poor general health or PA. The social cohesion in the area did not modify the effect of changes in social safety on health and PA. The results suggest that tackling feelings of unsafety in an area might contribute to the better general health of the residents. Because changes in area social safety were not associated with PA, we found no leads that such health benefits were achieved through an increase in physical activity.

  9. General-purpose heat source safety verification test series: SVT-7 through SVT-10

    Science.gov (United States)

    George, T. G.; Pavone, D.

    1985-09-01

    The General-Purpose Heat Source (GPHS) is a modular component of the radioisotope thermoelectric generator that will supply power for the Galileo and Ulysses (formerly ISPM) space missions. The GPHS provides power by transmitting the heat of (238)PuO2 (ALPHA)-decay to an array of thermoelectric elements. Because the possibility of an orbital abort always exists, the heat source was designed and constructed to minimize plutonia release in any accident environment. The Safety Verification Test (SVT) series was formulated to evaluate the effectiveness of GPHS plutonia containment after atmospheric reentry and Earth impact. The first report (covering SVT-1 through SVT-6) described the results of flat and side-on module impacts. This report describes module impacts at angles of 15(0) and 30(0).

  10. General-purpose heat source safety verification test series: SVT-11 through SVT-13

    Science.gov (United States)

    George, T. G.; Pavone, D.

    1986-05-01

    The General-Purpose Heat Source (GPHS) is a modular component of the radioisotope thermoelectric generator that will provide power for the Galileo and Ulysses (formerly ISPM) space missions. The GPHS provides power by transmitting the heat of Pu -decay to an array of thermoelectric elements. Because the possibility of an orbital abort always exists, the heat source was designed and constructed to minimize plutonia release in any accident environment. The Safety Verification Test (SVT) series was formulated to evaluate the effectiveness of GPHS plutonia containment after atmospheric reentry and Earth impact. The first two reports (covering SVT-1 through SVT-10) described the results of flat, side-on, and angular module impacts against steel targets at 54 m/s. This report describes flat-on module impacts against concrete and granite targets, at velocities equivalent to or higher than previous SVTs.

  11. Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations.

    OpenAIRE

    Garin, Noe; Velasco Muñoz, César; Pourcq, Jan T. De; Lopez, Belen; Gutiérrez, Maria del Mar; Haro Abad, Josep Maria; Feliu, Anna; Mangues, Maria A.; Trilla García, Antoni

    2015-01-01

    BACKGROUND: Adherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue. METHODS: Data on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed search...

  12. Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations

    OpenAIRE

    Noe eGarin; Cesar eVelasco; Pourcq, Jan T. De; Belen eLopez; Maria del Mar eGutierrez; Josep Maria Haro; Anna eFeliu; Maria Antonia Mangues; Antoni eTrilla

    2015-01-01

    BACKGROUNDAdherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue.METHODSData on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed search. for...

  13. Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations

    OpenAIRE

    Garin, Noe; Velasco, Cesar; Pourcq, Jan T. De; Lopez, Belen; Gutierrez, Maria del Mar; Haro, Josep M.; Feliu, Anna; Mangues, Maria A.; Trilla, Antoni

    2015-01-01

    Background: Adherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue. Methods: Data on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed sea...

  14. Development and Validation of Career Development Guidelines by Task/Activity Analysis of Occupational Safety and Health Professions: Industrial Hygiene and Safety Professional. Final Report. Technical Report XII.

    Science.gov (United States)

    Vernon, Ralph J.; And Others

    This report summarizes research findings which resulted in development of curricula for occupational safety and health professions based on task/activity analyses and related performance objectives. The first seven chapters focus on the seven objectives. Chapter 1, Literature Review and Selection of Employers, concerns tasks required for…

  15. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided interventions: General Aspects and EUS-guided Sampling (Short Version).

    Science.gov (United States)

    Jenssen, C; Hocke, M; Fusaroli, P; Gilja, O H; Buscarini, E; Havre, R F; Ignee, A; Saftoiu, A; Vilmann, P; Burmester, E; Nolsøe, C P; Nürnberg, D; D'Onofrio, M; Lorentzen, T; Piscaglia, F; Sidhu, P S; Dietrich, C F

    2016-04-01

    The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-guided sampling. Endoscopic ultrasound combines the most advanced high-resolution ultrasound imaging of lesions within the wall and in the vicinity of the gastrointestinal tract and safe and effective fine needle-based tissue acquisition from these lesions. The guideline addresses the indications, contraindications, techniques, adverse events, training and clinical impact of EUS-guided sampling. Advantages and drawbacks are weighed in comparison with image-guided percutaneous biopsy. Based on the most current evidence, clinical practice recommendations are given for crucial preconditions and steps of EUS-guided sampling as well as for safe performance. Additionally, the guideline deals with the principles and reliability of cytopathological reporting in endoscopic ultrasound-guided sampling (short version; the long version is published online).

  16. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided Interventions: General aspects and EUS-guided sampling (Long Version).

    Science.gov (United States)

    Jenssen, C; Hocke, M; Fusaroli, P; Gilja, O H; Buscarini, E; Havre, R F; Ignee, A; Saftoiu, A; Vilmann, P; Burmester, E; Nolsøe, C P; Nürnberg, D; D'Onofrio, M; Lorentzen, T; Piscaglia, F; Sidhu, P S; Dietrich, C F

    2016-04-01

    The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-guided sampling. Endoscopic ultrasound combines the most advanced high-resolution ultrasound imaging of lesions within the wall and in the vicinity of the gastrointestinal tract and safe and effective fine needle based tissue acquisition from these lesions. The guideline addresses the indications, contraindications, techniques, adverse events, training and clinical impact of EUS-guided sampling. Advantages and drawbacks are weighed in comparison with image-guided percutaneous biopsy. Based on the most current evidence, clinical practice recommendations are given for crucial preconditions and steps of EUS-guided sampling as well as for safe performance. Additionally, the guideline deals with the principles and reliability of cytopathological reporting in endoscopic ultrasound-guided sampling (long version).

  17. [The practice guideline 'Otitis externa' (first revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology].

    Science.gov (United States)

    Mylanus, E A M

    2008-05-24

    The first revision of the practice guideline 'Otitis externa' from the Dutch College of General Practitioners describes diagnostic, therapeutic and preventive aspects of care and focuses mainly on the acute form of the disease. In comparison with the previous guideline, some modest but valuable improvements have been made with regard to diagnosis and medical treatment. For acute otitis externa, treatment with acid and corticosteroid eardrops is considered the treatment of choice, rather than treatment with acid eardrops only. The guideline clearly discusses indications for referral of patients with otitis externa to an otorhinolaryngologist. Hypersensitivity and more severe pathology should be excluded in persistent cases. For chronic otitis externa, an otorhinolaryngologist can provide surgical treatment with a good chance of success and a low recurrence rate.

  18. Assessment of a Conceptual Flap System Intended for Enhanced General Aviation Safety

    Science.gov (United States)

    Campbell, Bryan A.; Carter, Melissa B.

    2017-01-01

    A novel multielement trailing-edge flap system for light general aviation airplanes was conceived for enhanced safety during normal and emergency landings. The system is designed to significantly reduce stall speed, and thus approach speed, with the goal of reducing maneuveringflight accidents and enhancing pilot survivability in the event of an accident. The research objectives were to assess the aerodynamic performance characteristics of the system and to evaluate the extent to which it provided both increased lift and increased drag required for the low-speed landing goal. The flap system was applied to a model of a light general aviation, high-wing trainer and tested in the Langley 12- Foot Low-Speed Wind Tunnel. Data were obtained for several device deflection angles, and component combinations at a dynamic pressure of 4 pounds per square foot. The force and moment data supports the achievement of the desired increase in lift with substantially increased drag, all at relatively shallow angles of attack. The levels of lift and drag can be varied through device deflection angles and inboard/outboard differential deflections. As such, it appears that this flap system may provide an enabling technology to allow steep, controllable glide slopes for safe rapid descent to landing with reduced stall speed. However, a simple flat-plate lower surface spoiler (LSS) provided either similar or superior lift with little impact on pitch or drag as compared to the proposed system. Higher-fidelity studies are suggested prior to use of the proposed system.

  19. Safety of iobitridol in the general population and at-risk patients

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [University Hospital Frankfurt, Johann Wolfgang Goethe-University, Department of Radiology, Frankfurt (Germany); J. W. Goethe University of Frankfurt, Institute of Diagnostic and Interventional Radiology, Frankfurt (Germany); Honold, Elmar [Guerbet GmbH, Sulzbach (Germany); Wolf, Michael [Michael Wolf Information Systems, Puettlingen (Germany); Mohajeri, H.; Hammerstingl, R. [University Hospital Frankfurt, Johann Wolfgang Goethe-University, Department of Radiology, Frankfurt (Germany)

    2006-06-15

    The purpose of this study was to review the rate of adverse events after contrast medium administration in the general population and at-risk patients (renal impairment, heart failure (NYHA III or IV), hypotension or hypertension, coronary artery disease, previous reaction to contrast media, asthma and/or allergies, dehydration, diabetes mellitus, poor general condition) under daily practice conditions in a post-marketing surveillance study. Two hundred and ten radiologists conducted various X-ray examinations in 52,057 patients. To document the safety of iobitridol in routine use, all patients undergoing X-ray examinations were included. Exclusion criteria were contraindications listed in the locally approved summary of product characteristics. The adverse event rate was 0.96% (at-risk patients 1.39%); the rate of serious adverse events 0.044% in all patients (at-risk patients 0.057%). Adverse events occurred more often in women than in men (P<0.001). In patients who had previously reacted to a contrast medium, adverse events were reported in 3.43% with mild to moderate symptoms. In 47.76% of these patients, a premedication was administered. There was no difference in the frequency of adverse events and serious adverse events whether premedicated or not (P=0.311 and P=0.295, respectively). Iobitridol was well-tolerated in 99.04% of cases (at-risk patients 98.61%). (orig.)

  20. 10 CFR Appendix A to Subpart B of... - General Statement of Safety Basis Policy

    Science.gov (United States)

    2010-01-01

    ... components, Navel nuclear fuel elements, Category I and Category II special nuclear materials, special... Safety and Health Program and a site-specific Health and Safety Plan (including elements for...

  1. [Safety profile of rilpivirine: general and neuropsychiatric tolerability, safety in patients with hepatitis B or C viruses, and lipid profile].

    Science.gov (United States)

    López Cortés, Luis F; Martínez, Esteban; von Wichmann, Miguel Ángel

    2013-06-01

    Currently available data on the safety and tolerability of rilpivirine come from the product information document, a phase IIb, dose-finding clinical trial (TMC278-C204), the phase III ECHO and THRIVE clinical trials, and the preliminary data from the STaR and SPIRIT clinical trials, with a total of 1,728 patients. The comparator has usually been efavirenz. All studies have found a lower incidence and severity of neuropsychiatric adverse effects, a better lipid profile, and a lower number of patients with subclinical transaminase elevation in patients treated with rilpivirine. However, because of the relatively low number of patients coinfected with hepatitis B or C virus, definitive conclusions cannot be drawn. Similarly, experience in patients with mild or moderate liver failure is limited and there are no safety data in patients with advanced liver failure.

  2. Economics of food safety in chains: a review of general principles

    NARCIS (Netherlands)

    Valeeva, N.I.; Meuwissen, M.P.M.; Huirne, R.B.M.

    2004-01-01

    The increased demand for safer food has resulted in the development and introduction of new food safety standards and regulations to reach a higher level of food safety. An integrated approach of controlling food safety throughout the entire food chain (`farm to table`) has become an important issue

  3. Economics of food safety in chains: a review of general principles

    NARCIS (Netherlands)

    Valeeva, N.I.; Meuwissen, M.P.M.; Huirne, R.B.M.

    2004-01-01

    The increased demand for safer food has resulted in the development and introduction of new food safety standards and regulations to reach a higher level of food safety. An integrated approach of controlling food safety throughout the entire food chain (`farm to table`) has become an important issue

  4. Bias towards publishing positive results in orthopedic and general surgery: a patient safety issue?

    Directory of Open Access Journals (Sweden)

    Ziran Bruce H

    2007-11-01

    Full Text Available Abstract Background Research articles reporting positive findings in the fields of orthopedic and general surgery appear to be represented at a considerably higher prevalence in the peer-reviewed literature, compared to published studies on negative or neutral data. This "publication bias" may alter the balance of the available evidence-based literature and may affect patient safety in surgery by depriving important information from unpublished negative studies. Methods A comprehensive review of all published articles in a defined 7-year period was performed in 12 representative journals in the fields of orthopedic and general surgery. Every article published in all volumes of these journals between January 2000 and December 2006 was reviewed and rated by three investigators. Rating of articles was performed according to a uniform, standardized algorithm. All original articles were stratified into "positive", "negative" or "neutral", depending on the reported results. All non-original papers were excluded from analysis. Results A total of 30,197 publications were reviewed over a 7-year time-period. After excluding all non-original articles, a total of 16,397 original papers were included in the final analysis. Of these, 12,251 (74% articles were found to report positive findings, 2,709 (17% reported negative results, and 1,437 (9% were neutral. A similar publication pattern was found among all years and all journals analyzed. Altogether, 91% of all original papers reported significant data (positive or negative, whereas only 9% were neutral studies that did not report any significant findings. Conclusion There is a disproportionately high number of articles reporting positive results published in the surgical literature. A bias towards publishing positive data will systematically overestimate the clinical relevance of treatment effects by disregarding important information derived from unpublished negative studies. This "publication bias

  5. General-Purpose Heat Source development: Safety Verification Test Program. Bullet/fragment test series

    Energy Technology Data Exchange (ETDEWEB)

    George, T.G.; Tate, R.E.; Axler, K.M.

    1985-05-01

    The radioisotope thermoelectric generator (RTG) that will provide power for space missions contains 18 General-Purpose Heat Source (GPHS) modules. Each module contains four /sup 238/PuO/sub 2/-fueled clads and generates 250 W/sub (t)/. Because a launch-pad or post-launch explosion is always possible, we need to determine the ability of GPHS fueled clads within a module to survive fragment impact. The bullet/fragment test series, part of the Safety Verification Test Plan, was designed to provide information on clad response to impact by a compact, high-energy, aluminum-alloy fragment and to establish a threshold value of fragment energy required to breach the iridium cladding. Test results show that a velocity of 555 m/s (1820 ft/s) with an 18-g bullet is at or near the threshold value of fragment velocity that will cause a clad breach. Results also show that an exothermic Ir/Al reaction occurs if aluminum and hot iridium are in contact, a contact that is possible and most damaging to the clad within a narrow velocity range. The observed reactions between the iridium and the aluminum were studied in the laboratory and are reported in the Appendix.

  6. [The practice guideline 'Miscarriage' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Lagro-Janssen, A.L.M.

    2005-01-01

    The practice guideline 'Miscarriage' has been reviewed for the second time in fifteen years. It provides the practitioner with distinct diagnostic tools for vaginal bleeding in the first sixteen weeks of pregnancy and a clear management algorithm. The management of miscarriage is based on a joint de

  7. [The practice guideline 'Anxiety disorders' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Weel-Baumgarten, E.M. van; Rijswijk, E. van

    2005-01-01

    The recommendations provided by the revised guideline 'Anxiety disorders' are well suited to every-day practice. The multidisciplinary approach reflects the increasing cooperation between primary and secondary care in the management of mental-health problems. The description of the various anxiety d

  8. Safety of power transformers, power supplies, reactors and similar products - Part 1: General requirements and tests

    CERN Document Server

    International Electrotechnical Commission. Geneva

    1998-01-01

    This International Standard deals with safety aspects of power transformers, power supplies, reactors and similar products such as electrical, thermal and mechanical safety. This standard covers the following types of dry-type transformers, power supplies, including switch mode power supplies, and reactors, the windings of which may be encapsulated or non-encapsulated. It has the status of a group safety publication in accordance with IEC Guide 104.

  9. [The Dutch College of General Practitioners' practice guideline 'Diagnosis of breast cancer': reaction from the field of surgery

    NARCIS (Netherlands)

    Wobbes, Th.

    2003-01-01

    The new guideline is an adaptation to recent developments in the genetics of breast cancer. Hereditary and familial breast cancer may give rise to many questions in women coping with family members with the disease. Recommendations are given in a clear and succinct way. It is regrettable that breast

  10. Assessing the general safety and tolerability of vildagliptin: value of pooled analyses from a large safety database versus evaluation of individual studies

    Directory of Open Access Journals (Sweden)

    Schweizer A

    2011-02-01

    Full Text Available Anja Schweizer1, Sylvie Dejager2, James E Foley3, Wolfgang Kothny31Novartis Pharma AG, Basel, Switzerland; 2Novartis Pharma SAS, Rueil-Malmaison, France; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAim: Analyzing safety aspects of a drug from individual studies can lead to difficult-to-interpret results. The aim of this paper is therefore to assess the general safety and tolerability, including incidences of the most common adverse events (AEs, of vildagliptin based on a large pooled database of Phase II and III clinical trials.Methods: Safety data were pooled from 38 studies of ≥12 to ≥104 weeks' duration. AE profiles of vildagliptin (50 mg bid; N = 6116 were evaluated relative to a pool of comparators (placebo and active comparators; N = 6210. Absolute incidence rates were calculated for all AEs, serious AEs (SAEs, discontinuations due to AEs, and deaths.Results: Overall AEs, SAEs, discontinuations due to AEs, and deaths were all reported with a similar frequency in patients receiving vildagliptin (69.1%, 8.9%, 5.7%, and 0.4%, respectively and patients receiving comparators (69.0%, 9.0%, 6.4%, and 0.4%, respectively, whereas drug-related AEs were seen with a lower frequency in vildagliptin-treated patients (15.7% vs 21.7% with comparators. The incidences of the most commonly reported specific AEs were also similar between vildagliptin and comparators, except for increased incidences of hypoglycemia, tremor, and hyperhidrosis in the comparator group related to the use of sulfonylureas.Conclusions: The present pooled analysis shows that vildagliptin was overall well tolerated in clinical trials of up to >2 years in duration. The data further emphasize the value of a pooled analysis from a large safety database versus assessing safety and tolerability from individual studies.Keywords: type 2 diabetes, dipeptidyl peptidase-4, edema, safety, vildagliptin

  11. A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

    Science.gov (United States)

    O'Heron, Colette T; Jarman, Benjamin T

    2014-01-01

    To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  12. The (safety-related) heat exchangers aging management guideline for commercial nuclear power plants, and developments since 1994

    Energy Technology Data Exchange (ETDEWEB)

    Clauss, J.M.

    1998-08-01

    The US Department of Energy (DOE), in cooperation with the Electric Power Research Institute (EPRI) and US nuclear power plant utilities, is preparing a series of aging management guidelines (AMGs) for commodity types of components (e.g., heat exchangers, electrical cable and terminations, pumps). Commodities are included in this series based on their importance to continued nuclear plant operation and license renewal. The AMGs contain a detailed summary of operating history, stressors, aging mechanisms, and various types of maintenance and surveillance practices that can be combined to create an effective aging management program. Each AMG is intended for use by the systems engineers and plant maintenance staff (i.e., an AMG is intended to be a hands-on technical document rather than a licensing document). The heat exchangers AMG, published in June 1994, includes the following information of interest to nondestructive examination (NDE) personnel: aging mechanisms determined to be non-significant for all applications; aging mechanisms determined to be significant for some applications; effective conventional programs for managing aging; and effective unconventional programs for managing aging. Since the AMG on heat exchangers was published four years ago, a brief review has been conducted to identify emerging regulatory issues, if any. The results of this review and lessons learned from the collective set of AMGs are presented.

  13. Influenza vaccination: key facts for general practitioners in Europe—a synthesis by European experts based on national guidelines and best practices in the United Kingdom and the Netherlands

    Science.gov (United States)

    Kassianos, George; Blank, Patricia; Falup-Pecurariu, Oana; Kuchar, Ernest; Kyncl, Jan; De Lejarazu, Raul Ortiz; Nitsch-Osuch, Aneta; van Essen, Gerrit A

    2016-01-01

    Currently there is no influenza vaccination guidance for European general practitioners. Furthermore, although the European Council recommends a target seasonal influenza vaccination rate of 75% in the elderly (65 years and above) and in anyone aged >6 months with a chronic medical condition, there remain wide discrepancies throughout Europe. A harmonised guideline regarding not only vaccination strategy but also for the consistent diagnosis of influenza across Europe is essential to support a common approach for the implementation of seasonal influenza vaccination across Europe. This document is based on pre-existing guidelines available in the UK and Netherlands and has been approved by a group of European experts for use throughout Europe. As well as providing a standardised influenza diagnosis, it also reviews the current recommendations for influenza vaccination, the types of vaccine available, the contraindications, vaccine use in special populations (in pregnancy, children, and in those with egg allergy), and concomitant administration with other vaccines. The effectiveness, safety, and timing of the seasonal influenza vaccine are also reviewed. A second section provides practical guidance for general practitioners for the implementation of a seasonal influenza vaccination program, including the selection and notification of those eligible for vaccination, as well as suggestions for the organisation of a vaccination programme. Finally, suggested responses to common patient misconceptions and frequently asked questions are included. The aim of this article is to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to seasonal influenza vaccination in order to better identify influenza outbreaks and to move towards reaching the target vaccination rate of 75% throughout Europe. PMID:27540408

  14. SAFETY

    CERN Multimedia

    M. Plagge, C. Schaefer and N. Dupont

    2013-01-01

    Fire Safety – Essential for a particle detector The CMS detector is a marvel of high technology, one of the most precise particle measurement devices we have built until now. Of course it has to be protected from external and internal incidents like the ones that can occur from fires. Due to the fire load, the permanent availability of oxygen and the presence of various ignition sources mostly based on electricity this has to be addressed. Starting from the beam pipe towards the magnet coil, the detector is protected by flooding it with pure gaseous nitrogen during operation. The outer shell of CMS, namely the yoke and the muon chambers are then covered by an emergency inertion system also based on nitrogen. To ensure maximum fire safety, all materials used comply with the CERN regulations IS 23 and IS 41 with only a few exceptions. Every piece of the 30-tonne polyethylene shielding is high-density material, borated, boxed within steel and coated with intumescent (a paint that creates a thick co...

  15. Revocation of General Safety Test Regulations That Are Duplicative of Requirements in Biologics License Applications. Final rule.

    Science.gov (United States)

    2015-07-02

    The Food and Drug Administration (FDA) is amending the biologics regulations by removing the general safety test (GST) requirements for biological products. FDA is finalizing this action because the existing codified GST regulations are duplicative of requirements that are also specified in biologics license applications (BLAs), or are no longer necessary or appropriate to help ensure the safety, purity, and potency of licensed biological products. FDA is taking this action as part of its retrospective review of its regulations to promote improvement and innovation, in response to the Executive order.

  16. Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country

    Directory of Open Access Journals (Sweden)

    Ahmed Abdel-Aziz

    2013-01-01

    Full Text Available Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3% was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5% and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group (P=0.03. Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines.

  17. Style, content and format guide for writing safety analysis documents. Volume 1, Safety analysis reports for DOE nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    The purpose of Volume 1 of this 4-volume style guide is to furnish guidelines on writing and publishing Safety Analysis Reports (SARs) for DOE nuclear facilities at Sandia National Laboratories. The scope of Volume 1 encompasses not only the general guidelines for writing and publishing, but also the prescribed topics/appendices contents along with examples from typical SARs for DOE nuclear facilities.

  18. [French guidelines on the use of repetitive transcranial magnetic stimulation (rTMS): safety and therapeutic indications].

    Science.gov (United States)

    Lefaucheur, J-P; André-Obadia, N; Poulet, E; Devanne, H; Haffen, E; Londero, A; Cretin, B; Leroi, A-M; Radtchenko, A; Saba, G; Thai-Van, H; Litré, C-F; Vercueil, L; Bouhassira, D; Ayache, S-S; Farhat, W-H; Zouari, H-G; Mylius, V; Nicolier, M; Garcia-Larrea, L

    2011-12-01

    During the past decade, a large amount of work on transcranial magnetic stimulation (TMS) has been performed, including the development of new paradigms of stimulation, the integration of imaging data, and the coupling of TMS techniques with electroencephalography or neuroimaging. These accumulating data being difficult to synthesize, several French scientific societies commissioned a group of experts to conduct a comprehensive review of the literature on TMS. This text contains all the consensual findings of the expert group on the mechanisms of action, safety rules and indications of TMS, including repetitive TMS (rTMS). TMS sessions have been conducted in thousands of healthy subjects or patients with various neurological or psychiatric diseases, allowing a better assessment of risks associated with this technique. The number of reported side effects is extremely low, the most serious complication being the occurrence of seizures. In most reported seizures, the stimulation parameters did not follow the previously published recommendations (Wassermann, 1998) [430] and rTMS was associated to medication that could lower the seizure threshold. Recommendations on the safe use of TMS / rTMS were recently updated (Rossi et al., 2009) [348], establishing new limits for stimulation parameters and fixing the contraindications. The recommendations we propose regarding safety are largely based on this previous report with some modifications. By contrast, the issue of therapeutic indications of rTMS has never been addressed before, the present work being the first attempt of a synthesis and expert consensus on this topic. The use of TMS/rTMS is discussed in the context of chronic pain, movement disorders, stroke, epilepsy, tinnitus and psychiatric disorders. There is already a sufficient level of evidence of published data to retain a therapeutic indication of rTMS in clinical practice (grade A) in chronic neuropathic pain, major depressive episodes, and auditory

  19. Mine safety: Occupational health -- general studies. (Latest citations from the NTIS bibliographic database). Published Search

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    The bibliography contains citations concerning occupational hazards in the metals and fossil fuel mining environment. Topics include the detection, control and effects of respirable dust, safety aspects of various mining methods, gas detection, and field surveys of specific operations. Some attention is given to legislative aspects of mine safety and benefits to the disabled.(Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  20. The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

    Science.gov (United States)

    Ramsingh, Brigit

    2014-07-01

    Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

  1. How trust in institutions and organizations builds general consumer confidence in the safety of food: a decomposition of effects.

    Science.gov (United States)

    de Jonge, J; van Trijp, J C M; van der Lans, I A; Renes, R J; Frewer, L J

    2008-09-01

    This paper investigates the relationship between general consumer confidence in the safety of food and consumer trust in institutions and organizations. More specifically, using a decompositional regression analysis approach, the extent to which the strength of the relationship between trust and general confidence is dependent upon a particular food chain actor (for example, food manufacturers) is assessed. In addition, the impact of specific subdimensions of trust, such as openness, on consumer confidence are analyzed, as well as interaction effects of actors and subdimensions of trust. The results confirm previous findings, which indicate that a higher level of trust is associated with a higher level of confidence. However, the results from the current study extend on previous findings by disentangling the effects that determine the strength of this relationship into specific components associated with the different actors, the different trust dimensions, and specific combinations of actors and trust dimensions. The results show that trust in food manufacturers influences general confidence more than trust in other food chain actors, and that care is the most important trust dimension. However, the contribution of a particular trust dimension in enhancing general confidence is actor-specific, suggesting that different actors should focus on different trust dimensions when the purpose is to enhance consumer confidence in food safety. Implications for the development of communication strategies that are designed to regain or maintain consumer confidence in the safety of food are discussed.

  2. General Aviation Aircraft Safety, The Princeton University Conference (119th) Held at Princeton, N.J. on October 24-25 1973

    Science.gov (United States)

    1974-10-01

    Accident Records" 3 Charles 0. Miller, Director, Bureau of Aviation Safety, National Transportation Safety Board "General Aviation Accident Patterns...Accident Records Charles 0. Miller Director, Bureau of Aviation Safety National Transportation Safety Board The title of my paper today, "An Analysis...Bethesda, Maryland 20014 Aviation Consumer Magazine James Holahan Pan Am Bldg., Teterboro Airport Bally Tully Teterboro New Jersey 07608 Bede Aircraft

  3. General safety basis development guidance for environmental restoration decontamination and decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Ellingson, D.R.; Kerr, N. [Westinghouse Hanford Co., Richland, WA (United States); Bohlander, K. [EG and G Rocky Flats, Golden, CO (United States); Hansen, J. [Westinghouse Savannah River Co., Aiken, SC (United States); Crowley, W. [Martin Marietta Energy Systems, Inc., Oak Ridge, TN (United States)

    1994-02-01

    Safety analyses have the objective of contributing to two essential ingredients of a successful operation. The first is promoting the safety of the operation through worker involvement in information development (safety basis). The second is obtaining approval to conduct the operation (authorization). Typically these ingredients are assembled under separate programs covered by separate DOE requirements. DOE authorization relies on successful development of a document containing up to 21 topics written in terms and language suited to reviewers and approvers. Safety relies on successful training and procedures that convert the technical documented information into terms and language understandable to the worker. This separation can lead to successful incorporation of one ingredient independent of the other. At best, this separation may result in a safe but unauthorized operation; at worst, the separation may result in an unsafe operation authorized to proceed. This guide is based on experiences gained by contractors who have integrated rather than separated the safety and authorization. The short duration of ER/D&D activities, the uncertainties of hazards, and the publicly expressed desire for demonstrable progress in cleanup activities add emphasis to the need to integrate rather than separate and develop new programs. Experience-based information has been useful to workers, safety analysis practitioners, and reviewers in the following ways: (1) Acquiring or developing the needed information in a useful form; (2) Managing the uncertainties during activity development and operation; (3) Identifying the subset of applicable requirements for an activity; (4) Developing the appropriate level of documentation detail for a specific activity; and (5) Increasing the usefulness and use of safety analysis (ownership).

  4. Seismic Safety Guide

    Energy Technology Data Exchange (ETDEWEB)

    Eagling, D.G. (ed.)

    1983-09-01

    This guide provides managers with practical guidelines for administering a comprehensive earthquake safety program. The Guide is comprehensive with respect to earthquakes in that it covers the most important aspects of natural hazards, site planning, evaluation and rehabilitation of existing buildings, design of new facilities, operational safety, emergency planning, special considerations related to shielding blocks, non-structural elements, lifelines, fire protection and emergency facilities. Management of risk and liabilities is also covered. Nuclear facilities per se are not dealt with specifically. The principles covered also apply generally to nuclear facilities but the design and construction of such structures are subject to special regulations and legal controls.

  5. General reliability and safety methodology and its application to wind energy conversion systems

    Energy Technology Data Exchange (ETDEWEB)

    Edesess, M.; McConnell, R. D.

    1979-09-01

    In conventional system reliability calculations, each component may be in the Operable state or the Under Repair state. These calculations derive system unavailability, or the probability of the system's being down for repairs. By introducing a third component state between Operable and Under Repair - namely, Defective, But Defect Undetected - the methods developed in this report enable system safety projections to be made in addition to availability projections. Also provided is a mechanism for computing the effect of inspection schedules on both safety and availability. A Reliability and Safety Program (RASP) is detailed which performs these computations and also calculates costs for system inspections and repairs. RASP is applied to a simplified wind energy conversion system example.

  6. [The practice guideline 'Influenza and influenza vaccination' (first revision) from the Dutch College of General Practitioners; a response from the perspective of virology].

    Science.gov (United States)

    de Jong, J C

    2008-09-27

    The main value of the new guideline on influenza and influenza vaccination developed by the Dutch College of General Practitioners is that it provides an update of the old version from 1993. Developments in the fields of vaccination and treatment are adequately described and clearly explained in more detail in numerous notes to the main text. Notable updates include the fact that vaccination will be recommended for people aged more than 60 years rather than 65 years in the coming season, and the introduction ofneuraminidase inhibitors. The complex virological aspects of influenza are well covered.

  7. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  8. Assessment of possible allergenicity of hypothetical ORFs in common food crops using current bioinformatic guidelines and its implications for the safety assessment of GM crops.

    Science.gov (United States)

    Young, Gregory J; Zhang, Shiping; Mirsky, Henry P; Cressman, Robert F; Cong, Bin; Ladics, Gregory S; Zhong, Cathy X

    2012-10-01

    Before a genetically modified (GM) crop can be commercialized it must pass through a rigorous regulatory process to verify that it is safe for human and animal consumption, and to the environment. One particular area of focus is the potential introduction of a known or cross-reactive allergen not previously present within the crop. The assessment of possible allergenicity uses the guidelines outlined by the Food and Agriculture Organization (FAO) and World Health Organization's (WHO) Codex Alimentarius Commission (Codex) to evaluate all newly expressed proteins. Some regulatory authorities have broadened the scope of the assessment to include all DNA reading frames between stop codons across the insert and spanning the insert/genomic DNA junctions. To investigate the utility of this bioinformatic assessment, all naturally occurring stop-to-stop frames in the non-transgenic genomes of maize, rice, and soybean, as well as the human genome, were compared against the AllergenOnline (www.allergenonline.org) database using the Codex criteria. We discovered thousands of frames that exceeded the Codex defined threshold for potential cross-reactivity suggesting that evaluating hypothetical ORFs (stop-to-stop frames) has questionable value for making decisions on the safety of GM crops.

  9. Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners.

    LENUS (Irish Health Repository)

    Drummond, Frances J

    2009-01-01

    BACKGROUND: Increased use of prostate specific antigen (PSA) has been associated with increased prostate cancer incidence. Ireland is estimated to have one of the highest prostate cancer incidences in Europe and has no national guidelines for prostate cancer screening. GPs have a pivotal role in influencing PSA testing, therefore, our aim was to describe GP testing practices and to identify factors influencing these. METHODS: A postal survey, including questions on clinical practice and experience, knowledge and demographics was distributed to all GPs (n = 3,683). The main outcomes were (i) PSA testing asymptomatic men and (ii) "inappropriate" PSA testing, defined as testing asymptomatic men aged < 50 or > 75 years. Factors associated with these outcomes were identified using logistic regression. RESULTS: 1,625 GPs responded (response rate corrected for eligibility = 53%). Most respondents (79%) would PSA test asymptomatic men. Of these, 34% and 51% would test asymptomatic men < 50 and > 75 years, respectively. In multivariate analyses, GPs were more likely to test asymptomatic men if they were >or= 50 years, in practice >or= 10 years, female or less knowledgeable about PSA efficacy. Male GPs who would have a PSA test themselves were > 8-times more likely to PSA test asymptomatic men than GPs who would not have a test. GPs who had an asymptomatic patient diagnosed with prostate cancer following PSA testing, were > 3-times more likely to test asymptomatic men. Practice-related factors positively associated with testing included: running \\'well man\\' clinics, performing occupational health checks and performing other tests routinely with PSA. Factors positively associated with \\'inappropriate\\' testing included; being male and willing to have a PSA test, having worked\\/trained in the UK and supporting annual PSA testing. 91% of respondents supported the development of national PSA testing guidelines. CONCLUSION: Our findings suggest that widespread PSA testing

  10. USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS FOR THE TREATMENT OF AXIAL SPONDYLOARTHRITIS, INCLUDING ANKYLOSING SPONDYLITIS, MONITORING THEIR EFFICACY AND SAFETY (DRAFT GUIDELINES OF THE EXPERT SPONDYLOARTHRITIS DIAGNOSIS AND TREATMENT GROUP

    Directory of Open Access Journals (Sweden)

    I. Z. Gaidukova

    2016-01-01

    Full Text Available The paper gives the draft guidelines elaborated  by the Expert Spondyloarthritis  Diagnosis and Treatment Group  by order of the Association of Rheumatologists  of Russia. The guidelines include the essentials of how to use nonsteroidal  anti-inflammatory drugs in axial spondyloarthrititides, including ankylosing spondylitis, contain  instructions  for how long they should be administered, and describe possible patient  management tactics in the most common  clinical situations and a preferential  algorithm for evaluating the efficiency and safety of treatment.

  11. Effects of a team-based assessment and intervention on patient safety culture in general practice

    DEFF Research Database (Denmark)

    Hoffmann, B; Müller, V; Rochon, J

    2014-01-01

    culture and decided on about 10 actions per practice to improve it. After 12 months, no significant differences were found between intervention and control groups in terms of error management (competing probability = 0.48, 95% CI 0.34 to 0.63, p = 0.823), 11 further patient safety culture indicators...

  12. Measure Guideline: Guide to Attic Air Sealing

    Energy Technology Data Exchange (ETDEWEB)

    Lstiburek, Joseph [Building Science Corporation, Westford, MA (United States)

    2014-09-01

    The purpose of this measure guideline is to provide information and recommendations for the preparation work necessary prior to adding attic insulation. Even though the purpose of this guide is to save energy, health, safety, and durability should not be compromised by energy efficiency. Accordingly, combustion safety and ventilation for indoor air quality are addressed first. Durability and attic ventilation then follow. Finally, to maximize energy savings, air sealing is completed prior to insulating. The guide is intended for home remodelers, builders, insulation contractors, mechanical contractors, general contractors who have previously done remodeling and homeowners as a guide to the work that needs to be done.

  13. GPs' knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England.

    Science.gov (United States)

    Chatterjee, Robin; Chapman, Tim; Brannan, Mike Gt; Varney, Justin

    2017-10-01

    Physical activity (PA) brief advice in health care is effective at getting individuals active. It has been suggested that one in four people would be more active if advised by a GP or nurse, but as many as 72% of GPs do not discuss the benefits of physical activity with patients. To assess the knowledge, use, and confidence in national PA and Chief Medical Officer (CMO) health guidelines and tools among GPs in England. Online questionnaire-based survey of self-selecting GPs in England that took place over a 10-day period in March 2016. The questionnaire consisted of six multiple-choice questions and was available on the Doctors.net.uk (DNUK) homepage. Quotas were used to ensure good regional representation. The final analysis included 1013 responses. Only 20% of responders were broadly or very familiar with the national PA guidelines. In all, 70% of GPs were aware of the General Practice Physical Activity Questionnaire (GPPAQ), but 26% were not familiar with any PA assessment tools, and 55% reported that they had not undertaken any training with respect to encouraging PA. The majority of GPs in England (80%) are unfamiliar with the national PA guidelines. Awareness of the recommended tool for assessment, GPPAQ, is higher than use by GPs. This may be because it is used by other clinical staff, for example, as part of the NHS Health Check programme. Although brief advice in isolation by GPs on PA will only be a part of the behaviour change journey, it is an important prompt, especially if repeated as part of routine practice. This study highlights the need for significant improvement in knowledge, skills, and confidence to maximise the potential for PA advice in GP consultations. © British Journal of General Practice 2017.

  14. Guidelines for environmental monitoring after acute oil spill in the marine environment; Retningslinjer for miljoeundersoekelser i marint miljoe etter akutt oljeforurensning

    Energy Technology Data Exchange (ETDEWEB)

    Joergensen, N.M.; Camus, L.-H.; Larsen, B.; Voegele, G.M.; Spikkerud, C.; Anker-Nilsen, T.; Dijk, J van; Lorentsen, S.-H.; Stabbetorp, O.; Bjoerge, A.; Boitsov, S.; Klungsoeyr, J.

    2012-07-01

    Contents of environmental damage assessments and monitoring of acute oil spills in the marine environment are outlined. The guideline provides general advice on timing, contents and scope of post spill surveys for documenting biological recovery and food safety.(Author)

  15. Sensitivity Analysis for Safety Design Verification of General Aviation Reciprocating Aircraft Engine

    Institute of Scientific and Technical Information of China (English)

    CAO Jiaokun; DING Shuiting

    2012-01-01

    This paper presents an application of global sensitivity analysis for system safety analysis of reciprocating aircraft engine.Compared with local sensitivity analysis results,global sensitivity analysis could provide more information on parameter interactions,which are significant in complex system safety analysis.First,a deterministic aviation reciprocating engine thermodynamics model is developed and parameters of interest are defined as random variables.Then,samples are generated by Monte Carlo method for the parameters used in engine model on the basis of definition of factor distribution.Eventually,results from engine model are generated and importance indices are calculated.Based on the analysis results,design is improved to satisfy the airworthiness requirements.The results reveal that by using global sensitivity analysis,the parameters could be ranked with respect to their importance,including first order indices and total sensitivity indices.By reducing the uncertainty of parameters and adjusting the range of inputs,safety criteria would be satisfied.

  16. Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project

    Science.gov (United States)

    O'Reilly-de Brún, Mary; MacFarlane, Anne; de Brún, Tomas; Okonkwo, Ekaterina; Bonsenge Bokanga, Jean Samuel; Manuela De Almeida Silva, Maria; Ogbebor, Florence; Mierzejewska, Aga; Nnadi, Lovina; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2015-01-01

    Objective The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. Design This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. Participants The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Setting Galway, Ireland. Results There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Conclusions Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice. PMID:26391628

  17. Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children.

    Science.gov (United States)

    Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

    2017-06-01

    Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. To explore how and why general practice clinicians document DVA in families with children. A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. © British Journal of General Practice 2017.

  18. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    2012-01-01

    Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.

  19. Guidelines, evidence, and cultural factors.

    NARCIS (Netherlands)

    Christiaens, T.; Backer, D. de; Burgers, J.S.; Baerheim, A.

    2004-01-01

    OBJECTIVE: To compare four recent guidelines on uncomplicated cystitis and to examine how cultural factors may have affected recommendations. DESIGN: Descriptive study with a qualitative analysis of authors' reasons for recommendations. MATERIAL: Guidelines for general practitioners published

  20. Bathroom safety - children

    Science.gov (United States)

    ... sure your child's daycare also follows these guidelines. Images Child safety References American Academy of Pediatrics: Committee on Injury, Violence, and Poison Prevention. Policy statement -- prevention of drowning. ...

  1. Nonstructural seismic restraint guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Butler, D.M.; Czapinski, R.H.; Firneno, M.J.; Feemster, H.C.; Fornaciari, N.R.; Hillaire, R.G.; Kinzel, R.L.; Kirk, D.; McMahon, T.T.

    1993-08-01

    The Nonstructural Seismic Restraint Guidelines provide general information about how to secure or restrain items (such as material, equipment, furniture, and tools) in order to prevent injury and property, environmental, or programmatic damage during or following an earthquake. All SNL sites may experience earthquakes of magnitude 6.0 or higher on the Richter scale. Therefore, these guidelines are written for all SNL sites.

  2. A review of significant events analysed in general practice: implications for the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Bradley Nick

    2009-09-01

    Full Text Available Abstract Background Significant event analysis (SEA is promoted as a team-based approach to enhancing patient safety through reflective learning. Evidence of SEA participation is required for appraisal and contractual purposes in UK general practice. A voluntary educational model in the west of Scotland enables general practitioners (GPs and doctors-in-training to submit SEA reports for feedback from trained peers. We reviewed reports to identify the range of safety issues analysed, learning needs raised and actions taken by GP teams. Method Content analysis of SEA reports submitted in an 18 month period between 2005 and 2007. Results 191 SEA reports were reviewed. 48 described patient harm (25.1%. A further 109 reports (57.1% outlined circumstances that had the potential to cause patient harm. Individual 'error' was cited as the most common reason for event occurrence (32.5%. Learning opportunities were identified in 182 reports (95.3% but were often non-specific professional issues not shared with the wider practice team. 154 SEA reports (80.1% described actions taken to improve practice systems or professional behaviour. However, non-medical staff were less likely to be involved in the changes resulting from event analyses describing patient harm (p Conclusion The study provides some evidence of the potential of SEA to improve healthcare quality and safety. If applied rigorously, GP teams and doctors in training can use the technique to investigate and learn from a wide variety of quality issues including those resulting in patient harm. This leads to reported change but it is unclear if such improvement is sustained.

  3. Video-assistiertes Feedback im Praktischen Jahr der Allgemeinmedizin – am Beispiel hausärztlicher Leitlinien [Video-assisted feedback in general practice internships using German general practitioner's guidelines

    Directory of Open Access Journals (Sweden)

    Bölter, Regine

    2012-11-01

    Full Text Available [english] Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. Teaching method: First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient – student – consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline is used to structure the feedback content. Feasibility: The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the

  4. 10 CFR 960.4 - Postclosure guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Postclosure guidelines. 960.4 Section 960.4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4 Postclosure guidelines. The guidelines in this subpart specify...

  5. 10 CFR 960.5 - Preclosure guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Preclosure guidelines. 960.5 Section 960.5 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5 Preclosure guidelines. The guidelines in this subpart specify...

  6. 10 CFR 960.3 - Implementation guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  7. K-Basins design guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Roe, N.R.; Mills, W.C.

    1995-06-01

    The purpose of the design guidelines is to enable SNF and K Basin personnel to complete fuel and sludge removal, and basin water mitigation by providing engineering guidance for equipment design for the fuel basin, facility modifications (upgrades), remote tools, and new processes. It is not intended to be a purchase order reference for vendors. The document identifies materials, methods, and components that work at K Basins; it also Provides design input and a technical review process to facilitate project interfaces with operations in K Basins. This document is intended to compliment other engineering documentation used at K Basins and throughout the Spent Nuclear Fuel Project. Significant provisions, which are incorporated, include portions of the following: General Design Criteria (DOE 1989), Standard Engineering Practices (WHC-CM-6-1), Engineering Practices Guidelines (WHC 1994b), Hanford Plant Standards (DOE-RL 1989), Safety Analysis Manual (WHC-CM-4-46), and Radiological Design Guide (WHC 1994f). Documents (requirements) essential to the engineering design projects at K Basins are referenced in the guidelines.

  8. Safety : the challenge of today for transportation safety in the future. General report on theme -V "Safety" at the 14th International Study Week on Traffic Engineering and Safety, Strasbourg, September 7-10, 1982.

    NARCIS (Netherlands)

    Asmussen, E.

    1982-01-01

    Transportation (un)safety is the result of a complex process in the transportation system. A large number of variables (characteristics of the system elements) with many interactions, produce a complex network of relationships expressed in "system behaviour". In this network of relationships, man as

  9. Clinical efficacy and safety of fluoxetine in generalized anxiety disorder in Chinese patients

    Directory of Open Access Journals (Sweden)

    Zou C

    2013-11-01

    Full Text Available Chuan Zou,1 Xiang Ding,1 Joseph H Flaherty,2 Birong Dong1 1The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, People's Republic of China; 2St Louis University, St Louis, MO, USA Background: Generalized anxiety disorder (GAD is a prevalent, disabling disease and is highly comorbid with other psychiatric disorders both in Western countries and the People's Republic of China. Fluoxetine, a selective inhibitor of serotonin reuptake (SSRI, is widely utilized in the management of GAD in clinical practice despite the lack of strong evidence. This article reviews fluoxetine trials to investigate fluoxetine's efficacy and tolerability in Chinese patients with GAD. Methods: A literature review was conducted using the following databases up to and including April 2013: Chinese BioMedical Literature, China National Knowledge Infrastructure, EMBASE, MEDLINE, and PsycINFO. We selected clinical studies that utilized fluoxetine for GAD in which all participants were Chinese. Results: Fifteen open-label, non-placebo trials were identified and analyzed; eleven anxiolytics were compared with fluoxetine separately. Short-term efficacy of fluoxetine had been established in these open-label, head-to-head controlled trials. Fluoxetine had rapid onset of action (approximately 1–2 weeks and seemed to be effective in maintenance treatment. Fluoxetine was generally well-tolerated with the most common side effect of dry month and nausea. Compared to other anxiolytic agents, fluoxetine was equivalent with all of the comparative anxiolytics in terms of efficacy except mirtazapine which showed conflicting results with fluoxetine in two studies. In terms of side effects, fluoxetine was better tolerated than diazepam, doxepine, and amitriptyline, less tolerated than escitalopram, and had similar tolerability with duloxetine as well as alprazolam. Conclusion: Given the high risk of bias of the included studies, the overall small sample

  10. Effects of patient safety culture interventions on incident reporting in general practice : A cluster randomised trial a cluster randomised trial

    NARCIS (Netherlands)

    Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M

    2015-01-01

    Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial

  11. Improved outcomes with European Society of Cardiology guideline-adherent antithrombotic treatment in high-risk patients with atrial fibrillation: a report from the EORP-AF General Pilot Registry.

    Science.gov (United States)

    Lip, Gregory Y H; Laroche, Cécile; Popescu, Mircea Iaochim; Rasmussen, Lars Hvilsted; Vitali-Serdoz, Laura; Dan, Gheorghe-Andrei; Kalarus, Zbigniew; Crijns, Harry J G M; Oliveira, Mario Martins; Tavazzi, Luigi; Maggioni, Aldo P; Boriani, Giuseppe

    2015-12-01

    Guideline-adherent therapy for stroke prevention in atrial fibrillation has been associated with better outcomes, in terms of thromboembolism (TE) and bleeding. In this report from the EuroObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot General Registry, we describe the associated baseline features of 'high risk' AF patients in relation to guideline-adherent antithrombotic treatment, i.e. whether they were adherent, over-treated, or under-treated based on the 2012 European Society of Cardiology (ESC) guidelines. Secondly, we assessed the predictors of guideline-adherent antithrombotic treatment. Thirdly, we evaluated outcomes for all-cause mortality, TE, bleeding, and the composite endpoint of 'any TE, cardiovascular death or bleeding' in relation to whether they were ESC guideline-adherent treatment. From the EORP-AF cohort, the follow-up dataset of 2634 subjects was used to assess the impact of guideline adherence or non-adherence. Of these, 1602 (60.6%) were guideline adherent, whilst 458 (17.3%) were under-treated, and 574 (21.7%) were over-treated. Non-guideline-adherent treatment can be related to region of Europe as well as associated clinical features, but not age, AF type, symptoms, or echocardiography indices. Over-treatment per se was associated with symptoms, using the EHRA score, as well as other comorbidities. Guideline-adherent antithrombotic management based on the ESC guidelines is associated with significantly better outcomes. Specifically, the endpoint of 'all cause death and any TE' is increased by >60% by undertreatment [hazard ratio (HR) 1.679 (95% confidence interval (CI) 1.202-2.347)] or over-treatment [HR 1.622 (95% CI 1.173-2.23)]. For the composite endpoint of 'cardiovascular death, any TE or bleeding', over-treatment increased risk by >70% [HR 1.722 (95% CI 1.200-2.470)]. Even in this cohort with high overall rates of oral anticoagulation use, ESC guideline-adherent antithrombotic management is associated with

  12. Practical guidelines for the registration and monitoring of serious traffic injuries, Deliverable 7.1 of the H2020 project SafetyCube (Safety CaUsation, Benefits and Efficiency).

    NARCIS (Netherlands)

    Pérez, K. Weijermars, W.A.M. Amoros, E. Bauer, R. Bos, N. Dupont, E. Filtness, A. Houwing, S. Johannsen, H. Leskovsek, B. Machata, K. Martin, JL. Nuyttens, N. Olabarria, M. Pascal, L. & Van den Berghe, W.

    2017-01-01

    Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported Horizon 2020 project. The project’s main objective is the development of an innovative road safety Decision Support System (DSS) that will enable policy-makers and stakeholders to select and implement the most

  13. General-Purpose Heat Source Development: Safety Test Program. Postimpact evaluation, Design Iteration Test 3

    Energy Technology Data Exchange (ETDEWEB)

    Schonfeld, F.W.; George, T.G.

    1984-07-01

    The General-Purpose Heat Source(GPHS) provides power for space missions by transmitting the heat of /sup 238/PuO/sub 2/ decay to thermoelectric elements. Because of the inevitable return of certain aborted missions, the heat source must be designed and constructed to survive both re-entry and Earth impact. The Design Iteration Test (DIT) series is part of an ongoing test program. In the third test (DIT-3), a full GPHS module was impacted at 58 m/s and 930/sup 0/C. The module impacted the target at an angle of 30/sup 0/ to the pole of the large faces. The four capsules used in DIT-3 survived impact with minimal deformation; no internal cracks other than in the regions indicated by Savannah River Plant (SRP) preimpact nondestructive testing were observed in any of the capsules. The 30/sup 0/ impact orientation used in DIT-3 was considerably less severe than the flat-on impact utilized in DIT-1 and DIT-2. The four capsules used in DIT-1 survived, while two of the capsules used in DIT-2 breached; a small quantity (approx. = 50 ..mu..g) of /sup 238/PuO/sub 2/ was released from the capsules breached in the DIT-2 impact. All of the capsules used in DIT-1 and DIT-2 were severely deformed and contained large internal cracks. Postimpact analyses of the DIT-3 test components are described, with emphasis on weld structure and the behavior of defects identified by SRP nondestructive testing.

  14. Programming Guidelines for FBD Programs in Reactor Protection System Software

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Se Jin; Lee, Dong Ah; Kim, Eui Sub; Yoo, Jun Beom [Division of Computer Science and Engineering College of Information and Communication, Konkuk University, Seoul (Korea, Republic of); Lee, Jang Su [Man-Machine Interface System team Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    Properties of programming languages, such as reliability, traceability, etc., play important roles in software development to improve safety. Several researches are proposed guidelines about programming to increase the dependability of software which is developed for safety critical systems. Misra-c is a widely accepted programming guidelines for the C language especially in the sector of vehicle industry. NUREG/CR-6463 helps engineers in nuclear industry develop software in nuclear power plant systems more dependably. FBD (Function Block Diagram), which is one of programming languages defined in IEC 61131-3 standard, is often used for software development of PLC (programmable logic controllers) in nuclear power plants. Software development for critical systems using FBD needs strict guidelines, because FBD is a general language and has easily mistakable elements. There are researches about guidelines for IEC 61131-3 programming languages. They, however, do not specify details about how to use languages. This paper proposes new guidelines for the FBD based on NUREG/CR-6463. The paper introduces a CASE (Computer-Aided Software Engineering) tool to check FBD programs with the new guidelines and shows availability with a case study using a FBD program in a reactor protection system. The paper is organized as follows.

  15. Examining variations in prescribing safety in UK general practice: cross sectional study using the Clinical Practice Research Datalink

    Science.gov (United States)

    Kontopantelis, Evangelos; Akbarov, Artur; Rodgers, Sarah; Avery, Anthony J; Ashcroft, Darren M

    2015-01-01

    Study question What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices? Methods A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin. Study answer and limitations 49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators. Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in

  16. Realisation of the guidelines for faculty-internal exams at the Department of General Medicine at the University of Munich: Pushing medical exams one step ahead with IMSm.

    Science.gov (United States)

    Boeder, Niklas; Holzer, Matthias; Schelling, Jörg

    2012-01-01

    Graded exams are prerequisites for the admission to the medical state examination. Accordingly the exams must be of good quality in order to allow benchmarking with the faculty and between different universities. Criteria for good quality need to be considered - namely objectivity, validity and reliability. The guidelines for the processing of exams published by the GMA are supposed to help maintaining those criteria. In 2008 the Department of General Medicine at the University of Munich fulfils only 14 of 18 items. A review process, appropriate training of the staff and the introduction of the IMSm software were the main changes that helped to improve the 'GMA-score' to 30 fulfilled items. We see the introduction of the IMSm system as our biggest challenge ahead. IMSm helps to streamline the necessary workflow and improves their quality (e.g. by the detection of cueing, item analysis). Overall, we evaluate the steps to improve the exam process as very positive. We plan to engage co-workers outside the department to assist in the various review processes in the future. Furthermore we think it might be of value to get into contact with other departments and faculties to benefit from each other's question pools.

  17. Investigating Patients with Recent Onset of Chest Pain Against NICE Guidelines in a District General Hospital Setting in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Azeem S Sheikh

    2012-09-01

    Full Text Available Background: Chest pain is a very common symptom leading to a significant number of patients visiting the primary care trusts, emergency departments and a huge number of emergency hospital admissions.Objective: The objective of our audit was to investigate whether patients with recent onset of chest pain referred to the Rapid Access Chest Pain Clinic were being investigated in accordance with the recommendations by the National Institute for Health and Clinical Excellence (NICE, in a busy District General Hospital setting.Design: Retrospective collection of dataSetting: Southend University Hospital NHS Foundation TrustPatients: We collected data over a period of three months for all the patients who underwent invasive coronary angiogram after being referred via Rapid Access Chest Pain Clinic (RACPC or General Cardiology Clinic presenting with recent onset of chest pain. A total of 157 patients were enrolled in the study. The patients were then categorised into four groups based upon their description of symptoms, age and risk factors, as defined by NICE.Results: We found that 86% (135/157 patients had estimated likelihood of CAD >60% and 51% of these had unnecessary non-invasive investigations contrary to what NICE recommends. This shows that adhering to the NICE guidelines would have saved a substantial amount of hospital resources and time of the healthcare team and the patients.Conclusions: The development of strategies for cost-conscious quality care must begin with the history, risk factors for coronary artery disease and patients’ investigations should be based on their risk stratification.

  18. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: a cross-sectional study.

    Science.gov (United States)

    Smink, Agnes J; Bierma-Zeinstra, Sita M A; Dekker, Joost; Vliet Vlieland, Thea P M; Bijlsma, Johannes W J; Swierstra, Bart A; Kortland, Joke H; Voorn, Theo B; van den Ende, Cornelia H M; Schers, Henk J

    2013-03-11

    To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in the general practice may be hampered by the negative attitude of general practitioners (GPs) towards the strategy. In order to develop a tailored implementation plan, we assessed the GPs' views regarding specific recommendations in the SCS and their working procedures with regard to OA. A survey was conducted among a random sample of Dutch GPs. Questions included the GP's demographical characteristics and the practice setting as well as how the management of OA was organized and whether the GPs supported the SCS recommendations. In particular, we assessed GP's views regarding the effectiveness of 14 recommended and non-recommended treatment modalities. Furthermore, we calculated their agreement with 7 statements based on the SCS recommendations regarding the sequence for care. With a linear regression model, we identified factors that seemed to influence the GPs' agreement with the SCS recommendations. Four hundred fifty-six GPs (37%) aged 30-65 years, of whom 278 males (61%), responded. Seven of the 11 recommended modalities (i.e. oral Non-Steroidal Anti-Inflammatory Drugs, physical therapy, glucocorticoid intra-articular injections, education, lifestyle advice, acetaminophen, and tramadol) were considered effective by the majority of the GPs (varying between 95-60%). The mean agreement score, based on a 5-point scale, with the recommendations regarding the sequence for care was 2.8 (SD = 0.5). Ten percent of the variance in GPs' agreement could be explained by the GPs' attitudes regarding the effectiveness of the recommended and non-recommended non-surgical treatment modalities and the type of practice. In general, GPs support the recommendations in the SCS. Therefore, we expect

  19. Lessons learned from Fukushima Daiichi nuclear power plant accident: efficient education items of radiation safety for general public.

    Science.gov (United States)

    Ohno, K; Endo, K

    2015-07-01

    The Fukushima Daiichi nuclear power plant (FNP-1) accident, while as tragic as the tsunami, was a man-made disaster created by the ignorance of the effects of radiation and radioactive materials. Therefore, it is important that all specialists in radiation protection in medicine sympathize with the anxiety of the general public regarding the harmful effects of radiation and advise people accordingly. All questions and answers were collected related to inquiries from the general public that were posted to reliable websites, including those of the government and radiation-related organizations, from March 2011 to November 2012. The questions were summarized and classified by similarity of content. (1) The total number of questions is 372. The content was broadly classified into three categories: inquiries for radiation-related knowledge and about health effects and foods. The questions asked to obtain radiation-related knowledge were the most common, accounting for 38 %. Thirty-six percentage of the questions were related to health effects, and 26 % involved foods, whereas 18 % of the questions were related to children and pregnancy. (2) The change over time was investigated in 290 questions for which the time of inquiry was known. Directly after the earthquake, the questions were primarily from people seeking radiation-related knowledge. Later, questions related to health effects increased. The anxiety experienced by residents following the nuclear accident was caused primarily by insufficient knowledge related to radiation, concerns about health effects and uncertainties about food and water safety. The development of educational materials focusing on such content will be important for risk communication with the general public in countries with nuclear power plants. Physicians and medical physicist should possess the ability to respond to questions such as these and should continue with medical examinations and treatments in a safe and appropriate manner.

  20. A local reaction at or near injection site: case definition and guidelines for collection, analysis, and presentation of immunization safety data.

    Science.gov (United States)

    Gidudu, Jane; Kohl, Katrin S; Halperin, Scott; Hammer, Sandra Jo; Heath, Paul T; Hennig, Renald; Hoet, Bernard; Rothstein, Edward; Schuind, Anne; Varricchio, Frederick; Walop, Wikke

    2008-12-09

    The need for developing a case definition and guidelines for a local reaction at or near the injection site, methods for the development of the case definition and guidelines as an adverse event following immunization as well as the rationale for selected decisions about the case definition for a local reaction at or near the injection site are explained in the Preamble section. The case definition is structured in 2 levels of diagnostic certainty: level 1 includes any description of morphological or physiological change at or near the injection site that is described or identified by a healthcare provider. Level 2 is any description of morphological or physiological change at or near injection site that is described by any other person. In Guidelines section, the working group recommends to enable meaningful and standardized data collection, analysis, and presentation of information about a local reaction at or near the injection site. However, implementation of all guidelines might not be possible in all settings. The availability of information may vary depending upon resources, geographic region, and whether the source of information is a prospectively designed clinical trial, a post-marketing surveillance or epidemiologic study, or an individual report of a local reaction at injection site.

  1. The efficacy and safety of multiple doses of vortioxetine for generalized anxiety disorder: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Fu J

    2016-04-01

    Full Text Available Jie Fu,1 Lilei Peng,2 Xiaogang Li1 1Department of Neurology, 2Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, People’s Republic of China Objective: Vortioxetine is a novel antidepressant approved for the treatment of major depressive disorder by the US Food and Drug Administration in September 2013. This meta-analysis assessed the efficacy and safety of different doses of vortioxetine for generalized anxiety disorder of adults.Methods: PubMed, Cochrane Library, PsycINFO, and Clinical Trials databases were searched from 2000 through 2015. The abstracts of the annual meetings of the American Psychiatric Association and previous reviews were searched to identify additional studies. The search was limited to individual randomized controlled trials (RCTs, and there was no language restriction. Four RCTs met the selection criteria. These studies included 1,843 adult patients. Results were expressed as odds ratios (ORs and 95% confidence intervals (CIs. The data were pooled with a random-effects or fixed-effects model.Results: The results showed that multiple doses (2.5, 5, and 10 mg/d of vortioxetine did not significantly improve the generalized anxiety disorder symptoms compared to placebo (OR=1.16, 95% CI=0.84–1.60, Z=0.89, P=0.38; OR=1.41, 95% CI=0.82–2.41, Z=1.25, P=0.21; OR=1.05, 95% CI=0.76–1.46, Z=0.32, P=0.75, respectively. We measured the efficacy of 2.5 mg/d vortioxetine compared to 10 mg/d, and no significant differences were observed. The common adverse effects included nausea and headache. With increased dose, nausea was found to be more frequent in the vortioxetine (5 and 10 mg/d group (OR=2.99, 95% CI=1.31–6.84, Z=2.60, P=0.009; OR=2.80, 95% CI=1.85–4.25, Z=4.85, P<0.00001, respectively, but no significant differences were observed for headache.Conclusion: The results showed no significant improvement in the treatment of generalized anxiety disorder for vortioxetine compared to placebo

  2. Optimism about safety and group-serving interpretations of safety among pedestrians and cyclists in relation to road use in general and under low light conditions.

    Science.gov (United States)

    King, M J; Wood, J M; Lacherez, P F; Marszalek, R P

    2012-01-01

    Drivers are known to be optimistic about their risk of crash involvement, believing that they are less likely to be involved in a crash than other drivers. However, little comparative research has been conducted among other road users. In addition, optimism about crash risk is conceptualised as applying only to an individual's assessment of his or her personal risk of crash involvement. The possibility that the self-serving nature of optimism about safety might be generalised to the group-level as a cyclist or a pedestrian, i.e., becoming group-serving rather than self-serving, has been overlooked in relation to road safety. This study analysed a subset of data collected as part of a larger research project on the visibility of pedestrians, cyclists and road workers, focusing on a set of questionnaire items administered to 406 pedestrians, 838 cyclists and 622 drivers. The items related to safety in various scenarios involving drivers, pedestrians and cyclists, allowing predictions to be derived about group differences in agreement with items based on the assumption that the results would exhibit group-serving bias. Analysis of the responses indicated that specific hypotheses about group-serving interpretations of safety and responsibility were supported in 22 of the 26 comparisons. When the nine comparisons relevant to low lighting conditions were considered separately, seven were found to be supported. The findings of the research have implications for public education and for the likely acceptance of messages which are inconsistent with current assumptions and expectations of pedestrians and cyclists. They also suggest that research into group-serving interpretations of safety, even for temporary roles rather than enduring groups, could be fruitful. Further, there is an implication that gains in safety can be made by better educating road users about the limitations of their visibility and the ramifications of this for their own road safety, particularly in low

  3. Evaluation Of The Safety Integrity Level (SIL Due To The Guidelines Of EN 61508 And With The Use Of Markov Processes

    Directory of Open Access Journals (Sweden)

    Młynarski Stanisław

    2015-11-01

    Full Text Available The methods of evaluation of the Probability of Failure on Demand (PFD of safety systems were presented in the paper, assuming that the safety systems may be represented by the k out of n reliability structures. The results of the calculations obtained according to EN 61508 were compared with another results, this time obtained from the calculations done for these systems assuming that their failure-and-renewal process is a Markov process.

  4. Work Practice Simulation of Complex Human-Automation Systems in Safety Critical Situations: The Brahms Generalized berlingen Model

    Science.gov (United States)

    Clancey, William J.; Linde, Charlotte; Seah, Chin; Shafto, Michael

    2013-01-01

    The transition from the current air traffic system to the next generation air traffic system will require the introduction of new automated systems, including transferring some functions from air traffic controllers to on­-board automation. This report describes a new design verification and validation (V&V) methodology for assessing aviation safety. The approach involves a detailed computer simulation of work practices that includes people interacting with flight-critical systems. The research is part of an effort to develop new modeling and verification methodologies that can assess the safety of flight-critical systems, system configurations, and operational concepts. The 2002 Ueberlingen mid-air collision was chosen for analysis and modeling because one of the main causes of the accident was one crew's response to a conflict between the instructions of the air traffic controller and the instructions of TCAS, an automated Traffic Alert and Collision Avoidance System on-board warning system. It thus furnishes an example of the problem of authority versus autonomy. It provides a starting point for exploring authority/autonomy conflict in the larger system of organization, tools, and practices in which the participants' moment-by-moment actions take place. We have developed a general air traffic system model (not a specific simulation of Überlingen events), called the Brahms Generalized Ueberlingen Model (Brahms-GUeM). Brahms is a multi-agent simulation system that models people, tools, facilities/vehicles, and geography to simulate the current air transportation system as a collection of distributed, interactive subsystems (e.g., airports, air-traffic control towers and personnel, aircraft, automated flight systems and air-traffic tools, instruments, crew). Brahms-GUeM can be configured in different ways, called scenarios, such that anomalous events that contributed to the Überlingen accident can be modeled as functioning according to requirements or in an

  5. [Guidelines for clinical practice].

    Science.gov (United States)

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  6. The development and evaluation of guidelines for the review of advanced human-system interfaces

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M. [Brookhaven National Lab., Upton, NY (US); Wachtel, J. [Nuclear Regulatory Commission, Washington, DC (US). Office of Nuclear Regulatory Research

    1992-12-31

    Advanced control rooms for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes a general approach to advanced human-system interface review, development of human factors guidelines to support NRC safety reviews of advanced systems, and the results of a guideline test and evaluation program.

  7. UMTRA Project environmental, health, and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    1989-02-01

    The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs.

  8. 7 CFR 622.5 - Guidelines.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Guidelines. 622.5 Section 622.5 Agriculture... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued...

  9. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  10. Strategies for the introduction and implementation of a guideline for the treatment of type 2 diabetics by general practitioners (GPs of the Lazio region of Italy (IMPLEMEG study: Protocol for a cluster randomised controlled trial [ISRCTN80116232

    Directory of Open Access Journals (Sweden)

    Perria Carla

    2004-06-01

    Full Text Available Abstract Background Despite broad agreement on the necessity to improve quality of diabetic care through implementation of clinical guidelines, in Italy many people with diabetes still lack adequate care in general practice. In addition there is little evidence to support the choice of implementation strategies, especially in the Lazio region (central Italy, where comparative studies among general practitioners (GPs are uncommon. The primary objective of the study is to assess the effectiveness of different strategies for the implementation of an evidence-based guideline for the management of non-complicated type 2 diabetes mellitus (DM among GPs of the Lazio region. Methods/Design Three-arm cluster-randomised trial (C-RCT. 252 GPs were randomised either to arm 1 (comprising a training module and administration of the guideline, or to arm 2 (administration of guideline without training, or to arm 3 (control arm, continuing current practice. Arm 1 participants attended a two-day course with CME credits. Data collection will be performed using current information systems. Patients' health data was also collected to describe diabetic populations cared for by GP participants. Process outcomes will be measured at the patient level and at the cluster level one year after the intervention. We will assess GPs' adherence to guideline recommendations for diabetes management relative to: 1 pharmacological management of diabetes; 2 pharmacological management of cardiovascular risk factors (hypertension and dislypidaemia; 3 measurement of glycosilated haemoglobin as the principal indicator of glycaemic control; 4 micro- and macrovascular complications assessment tests. Outcomes will be expressed as proportions of patients cared for by GPs who will have prescriptions of drugs, requests for tests and for outpatient appointment visits. To estimate the efficiency of resource use associated with the intervention a cost-effectiveness analysis will be carried out

  11. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part I: introduction and general considerations.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Falco, Frank J E; Singh, Vijay; Benyamin, Ramsin M; Racz, Gabor B; Helm, Standiford; Caraway, David L; Calodney, Aaron K; Snook, Lee T; Smith, Howard S; Gupta, Sanjeeva; Ward, Stephen P; Grider, Jay S; Hirsch, Joshua A

    2013-04-01

    In 2011, the Institute of Medicine (IOM) re-engineered its definition of clinical guidelines as follows: "clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefit and harms of alternative care options." This new definition departs from a 2-decade old definition from a 1990 IOM report that defined guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." The revised definition clearly distinguishes between the term "clinical practice guideline" and other forms of clinical guidance derived from widely disparate development processes, such as consensus statements, expert advice, and appropriate use criteria. The IOM committee acknowledged that for many clinical domains, high quality evidence was lacking or even nonexistent. Even though the guidelines are important decision-making tools, along with expert clinical judgment and patient preference, their value and impact remains variable due to numerous factors. Some of the many factors that impede the development of clinical practice guidelines include bias due to a variety of conflicts of interest, inappropriate and poor methodological quality, poor writing and ambiguous presentation, projecting a view that these are not applicable to individual patients or too restrictive with elimination of clinician autonomy, and overzealous and inappropriate recommendations, either positive, negative, or non-committal. Consequently, a knowledgeable, multidisciplinary panel of experts must develop guidelines based on a systematic review of the existing evidence, as recently recommended by the IOM. Chronic pain is a complex and multifactorial phenomenon associated with significant economic, social, and health outcomes. Interventional pain management is an emerging specialty facing a

  12. German Guidelines.

    Science.gov (United States)

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

    2016-10-01

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

  13. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-01

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

  14. Country Guidelines for the Conduct of Road Safety Management Capacity Reviews and the Specification of Lead Agency Reforms, Investment Strategies and Safe System Projects

    OpenAIRE

    Bliss, Tony; Breen, Jeanne

    2009-01-01

    The World Health Organization (WHO) and the World Bank jointly issued the world report on road traffic injury prevention on world health day 2004, dedicated by the WHO to the improvement of global road safety. The report's publication signaled a growing concern in the global community about the scale of the health losses associated with escalating motorization and a recognition that urgent...

  15. European standardization activities on safety of liquid helium cryostats

    CERN Document Server

    CERN. Geneva

    2016-01-01

    This talk gives a general overview on the challenges of designing safety units for liquid helium cryostats with regard to existing industry standards. It reviews the work of a national working group that published the technical guideline DIN SPEC 4683 in April 2015, which is dedicated to the particular conditions in liquid helium cryostats. Based on both this guideline and equivalent documents from e.g. CEA, CERN, a working group is being formed at the European Committee for Standardization, associated to CEN/TC 268, which will work on a European standard on safety of liquid helium cryostats. The actual status and the schedule of this project are presented.

  16. Safety and tolerability of iobitridol in general and in patients with risk factors: Results in more than 160 000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Martin, E-mail: martin.maurer@charite.de [Charite - University Medicine Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany); Heine, Oliver [Guerbet GmbH, Otto-Vogler-Str. 11, 65843 Sulzbach (Germany); Wolf, Michael [Michael Wolf Information Systems, Viktoriastr. 26, 66346 Puettlingen (Germany); Freyhardt, Patrick; Schnapauff, Dirk; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany)

    2011-11-15

    Objective: To review the safety, the tolerability and the diagnostic effectiveness of iobitridol under daily practice conditions in the general population and at-risk patients in a post-marketing surveillance study. Materials and methods: A total of 160 639 patients (55.1% male, 43.6% female, mean age 58.6 years) were analysed in 555 centers. Patients underwent X-ray examinations using iobitridol (Xenetix, Guerbet, Sulzbach, Germany) as IV contrast medium (mean volume 85.6 ml). 21.8% of all patients had at least one risk factor (e.g., renal impairment), 7.3% were at-risk patients with allergies or who had previously reacted to contrast medium. Antiallergic pretreatment before contrast medium administration was given in 1144 patients (0.7%). Adverse events were documented and the image quality was assessed. Results: A diagnosis was possible in 99.5% of all cases. The image quality was rated good or excellent in 92.2%. The adverse event rate (e.g., nausea, urticaria) observed was 0.6% in all patients, 1.6% in patients with allergies and 6.0% in patients with a previous reaction to contrast medium. Adverse events occurred more often in women than in men (p < 0.001). Pretreatment did not decrease the rate of adverse events. The rate of adverse events was not increased in higher doses of iobitridol, even if administered to high-risk patients. Conclusions: Iobitridol was shown to be a safe and well-tolerated contrast medium with a low incidence of adverse events in patients with and without risk factors resulting in a good or excellent image quality in most patients.

  17. Recommendations to the NRC on human engineering guidelines for nuclear power plant maintainability

    Energy Technology Data Exchange (ETDEWEB)

    Badalamente, R.V.; Fecht, B.A.; Blahnik, D.E.; Eklund, J.D.; Hartley, C.S.

    1986-03-01

    This document contains human engineering guidelines which can enhance the maintainability of nuclear power plants. The guidelines have been derived from general human engineering design principles, criteria, and data. The guidelines may be applied to existing plants as well as to plants under construction. They apply to nuclear power plant systems, equipment and facilities, as well as to maintenance tools and equipment. The guidelines are grouped into seven categories: accessibility and workspace, physical environment, loads and forces, maintenance facilities, maintenance tools and equipment, operating equipment design, and information needs. Each chapter of the document details specific maintainability problems encountered at nuclear power plants, the safety impact of these problems, and the specific maintainability design guidelines whose application can serve to avoid these problems in new or existing plants.

  18. Metadata Guidelines

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document provides guidelines on metadata and metadata requirements for ServCat documents. Information on metadata is followed by an instructional flowchart and...

  19. The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

    Science.gov (United States)

    Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

    2017-04-27

    The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety

  20. Safety Tips: Baseball (For Parents)

    Science.gov (United States)

    ... Tips: Baseball KidsHealth > For Parents > Safety Tips: Baseball Print A A A What's in this article? Why Baseball Safety Is Important Gear Guidelines Breakaway Bases Before Starting the Game During Game Play Excessive Pitching A Few Other ...

  1. Nuclear criticality safety guide

    Energy Technology Data Exchange (ETDEWEB)

    Pruvost, N.L.; Paxton, H.C. [eds.

    1996-09-01

    This technical reference document cites information related to nuclear criticality safety principles, experience, and practice. The document also provides general guidance for criticality safety personnel and regulators.

  2. CERN's new safety policy

    CERN Multimedia

    2014-01-01

    The documents below, published on 29 September 2014 on the HSE website, together replace the document SAPOCO 42 as well as Safety Codes A1, A5, A9, A10, which are no longer in force. As from the publication date of these documents any reference made to the document SAPOCO 42 or to Safety Codes A1, A5, A9 and A10 in contractual documents or CERN rules and regulations shall be deemed to constitute a reference to the corresponding provisions of the documents listed below.   "The CERN Safety Policy" "Safety Regulation SR-SO - Responsibilities and organisational structure in matters of Safety at CERN" "General Safety Instruction GSI-SO-1 - Departmental Safety Officer (DSO)" "General Safety Instruction GSI-SO-2 - Territorial Safety Officer (TSO)" "General Safety Instruction GSI-SO-3 - Safety Linkperson (SLP)" "General Safety Instruction GSI-SO-4 - Large Experiment Group Leader In Matters of Safety (LEXGLI...

  3. Visit safety

    CERN Multimedia

    2012-01-01

    Experiment areas, offices, workshops: it is possible to have co-workers or friends visit these places.     You already know about the official visits service, the VIP office, and professional visits. But do you know about the safety instruction GSI-OHS1, “Visits on the CERN site”? This is a mandatory General Safety Instruction that was created to assist you in ensuring safety for all your visits, whatever their nature—especially those that are non-official. Questions? The HSE Unit will be happy to answer them. Write to safety-general@cern.ch.   The HSE Unit

  4. [Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].

    Science.gov (United States)

    Díaz-Jouanen, Efraín; Abud-Mendoza, Carlos; Garza-Elizondo, Mario Alberto; Medrano-Ramírez, Gabriel; Burgos-Vargas, Rubén; Orozco-Alcalá, José Javier; Pacheco-Tena, César Francisco; Pineda, Carlos; Pozos-Espíndola, Juan Carlos; Ramos-Niembro, Francisco; Robles-San-Román, Manuel; Santana-Sahagún, Jesús Ernesto

    2009-01-01

    Recommendations for the use of Disease-Modifying Antirheumatic Drugs (DMARD) with both conventional and biological agents in Rheumatoid Arthritis (RA) must be based on their safety profile, adverse effects, risks, and advantages. With the purpose of presenting the most updated information about the safety of tumor necrosis factor alpha (TNFalpha) antagonists, in this article we summarize the literature published during the last three years about this sort of biological agents in specific clinical situations, such as risk of developing infections, cancer, cardiovascular diseases, and autoimmunity; as well as their administration to patients who will undergo surgical procedures, pregnant and/or breast-feeding women, and patients who need immunizations. Likewise, in this analysis we offer specific recommendations, based on evidence, for the best anti-TNF-alfa management.

  5. Food Safety for Pregnant and Breastfeeding Women

    Science.gov (United States)

    ... Waste Food Safety Newsroom Dietary Guidelines Communicator’s Guide Food Safety You are here Home / Audience / Adults / Moms/ Moms- ... and raw sprouts. Do not eat these foods. Food safety advice when you are pregnant Follow the food ...

  6. Efficacy and safety of new complementary feeding guidelines with an emphasis on red meat consumption: a randomized trial in Bogota, Colombia.

    Science.gov (United States)

    Olaya, Gilma A; Lawson, Margaret; Fewtrell, Mary S

    2013-10-01

    Iron deficiency and poor linear growth are common in infants from deprived socioeconomic backgrounds and may be associated with inadequate complementary feeding (CF) practices. We tested the hypothesis that new CF guidelines emphasizing meat as a source of iron and zinc would improve linear growth, iron, and zinc status in infants living in poor socioeconomic circumstances in Bogota, Colombia. A total of 85 term infants who were exclusively breastfed for ≥4 mo were randomly assigned at 6 mo of age to a control group [CG (n = 43); current advice] or intervention group (new guidelines group [NGG (n = 42); with counseling to 1) continue breastfeeding, 2) offer red meat ≥3 d/wk, and 3) offer fruit and vegetables daily]). Main outcomes were 1) linear growth from 6 to 12 mo of age; 2) hemoglobin, hematocrit, iron [serum ferritin (SF)], and zinc status at 12 mo of age; and 3) meat intake at 12 mo of age (by using a food-frequency questionnaire). A total of 38 infants/group provided data at 12 mo of age. NGG infants had significantly higher red meat intake [mean ± SD: 5.4 ± 1.8 compared with 3.5 ± 1.7 d/wk at 12 mo of age; P < 0.001), higher hemoglobin and hematocrit at 12 mo of age, and a significantly greater increase in hemoglobin (mean ± SD change: 0.41 ± 0.8 compared with -0.13 ± 1.0; P = 0.01) and hematocrit (1.04 ± 2.2 compared with -0.15 ± 2.4; P = 0.03) from 6 to 12 mo of age than those in CG infants. There were no significant differences in linear growth from 6 to 12 mo of age or in SF or zinc. The new guidelines showed efficacy with higher red meat intake and positive effects on hemoglobin and hematocrit. The intervention was acceptable and affordable for most mothers. These preliminary results suggest that the intervention merits investigation in a larger cohort with longer-term follow-up. This trial was registered at http://isrctn.org as ISRCTN57733004.

  7. Guidelines on Building Regulations 2008

    DEFF Research Database (Denmark)

    Thse guidelines clarify and intepret the provisions of the Building Regulations of 2008 (BR08). The Guidelines, which match BR08 in terms of organisation into Parts, are accompanied by the full text of the regulations and the explanatory notes issued by the Danish Enterprise and Construction...... Authority. The Guidelines refer the reader to sources such as relevant standards, instructions and other background material which provides more detailed information. The Guidelines cover the same ground as BR08, including building control regulations, layout, fitting out, structures, fire safety, indoor...... climate, energy consumotion and services. The Guidelines are aimed at all professionals involved in building projects, particularly building design consultants, contractors and municipal application officers....

  8. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: a cross-sectional study

    NARCIS (Netherlands)

    Smink, A.J.; Bierma-Zeinstra, S.M.; Dekker, J.; Vlieland, T.P.; Bijlsma, J.W.J.; Swierstra, B.A.; Kortland, J.H.; Voorn, T.B.; Ende, C.H.M. van den; Schers, H.J.

    2013-01-01

    BACKGROUND: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in

  9. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: A cross-sectional study

    NARCIS (Netherlands)

    E. Smink (Enna); S.M. Bierma-Zeinstra (Sita); J. Dekker (Joost); T.P.M.V. Vlieland (Thea P. M. Vliet); J.W.J. Bijlsma (Hans); B.A. Swierstra (Bart); J.H. Kortland (Joke); T.B. Voorn (Theo); C.H.M. van den Ende (C. H M); H.J. Schers (Henk)

    2013-01-01

    textabstractBackground: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of

  10. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

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

  11. Drogodependencias en el lugar de trabajo: Pautas generales de intervención desde la medicina del trabajo Illicit drugs in the Workplace: General guidelines of intervention from the Occupational Health

    Directory of Open Access Journals (Sweden)

    Carmen Otero Dorrego

    2011-01-01

    último, facilitará la rehabilitación laboral (Prevención Terciaria favoreciendo la reincorporación laboral del trabajador con garantías de seguridad.Drug abuse is an important problem of public health, as well as a serious labor problem in industrialized countries. The serious labor consequences (smaller yield, increase of the number of accidents, etc. and the possibility of successfully approaching the problem from Occupational Health Services of companies, make the creation of politics and programs of intervention necessary. The overall goal of all these programs is to obtain the personal and labor rehabilitation of the affected workers. Other secondary targets are to improve the indices of absenteeism and accidentability, to establish general guidelines of performance of occupational health doctors to take part in the situations of drug abuse in the work place, as well as to favor the suitable labor restoration of workers who have followed a therapy program. In this article we make a revision of epidemiologic data, labor, personal and social consequences, different norms and international and national recommendations, as well as of specific programs of national and foreign companies in the different sectors from production. Finally, the general guidelines of intervention from Occupational Health Physicians are described. The performances of Occupational Health Physicians in the scope of Primary Prevention will be directed towards the detection of risk factors at work (evaluation of psycho-social risks and facility of access to drugs at work, among others and individual factors (early detection of specially sensible workers, applying correction measures (training courses, job adaptations, etc. Occupational Health Physicians will also make early diagnosis (Secondary Prevention for detox through the National Health System. Finally, they will facilitate labor rehabilitation (Tertiary Prevention favoring labor restoration of the worker with security guarantees.

  12. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

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

  13. Road safety risks in young people attending general practice: A cross-sectional study of road risks and associated health risks.

    Science.gov (United States)

    Martin, Jennifer; Kauer, Sylvia D; Sanci, Lena

    2016-09-01

    Young people have a large burden of death and disease from risky road behaviours. Guidelines recommend injury prevention and harm minimisation counselling; however, little is known about road risks in youth attending primary care. The aim of this study was to examine the type of road risks and associated behaviours in young people attending general practice. A cross-sectional analysis was undertaken on health risk survey data from a sample of 901 patients, aged 14-24 years, attending 40 Victorian general practices in a stratified cluster randomised trial. Frequently occurring road risks included travelling with people under the influence of alcohol or drugs (55%), speeding (43%) and mobile phone use (40%). These behaviours were strongly associated with other health risks, including use of tobacco, alcohol and illicit drugs, and unprotected sex. High proportions of youth attending general practice engage in road risks, making this a potential setting to discuss road risks along with broader health risk prevention activities.

  14. The value of population pharmacokinetics and simulation for postmarketing safety evaluation of dosing guidelines for drugs with a narrow therapeutic index: buflomedil as a case study.

    Science.gov (United States)

    Bourguignon, Laurent; Ducher, Michel; Matanza, David; Bleyzac, Nathalie; Uhart, Mathieu; Odouard, Emmanuel; Maire, Pascal; Goutelle, Sylvain

    2012-04-01

    Population pharmacokinetics and simulation techniques currently play an important role in new drug development. This paper illustrates the potential value of those methods in postmarketing safety assessment, using buflomedil in elderly patients as an example. We retrospectively assessed the risk of buflomedil overdosing associated with the latest dosing recommendations of the French Drug Agency (AFSSAPS). First, buflomedil concentrations measured in 24 elderly patients were analysed with a nonparametric population approach. Then, the pharmacokinetic model was used to perform a 1000-patient Monte Carlo simulation for the two recommended buflomedil dosage regimens. The maximum concentrations calculated after 10 days of therapy were compared with levels observed in reported cases of toxicity to assess the probability of overdosing. A three-compartment model best fit concentration data. Population predictions showed little bias (-0.14 mg/L) and good precision (8.73 mg(2) /L(2)). Overall results of the simulation study showed that the application of the two recommended dosage regimens of buflomedil was associated with overdosing (C(max) > 10 mg/L) and potential toxicity in 2.9% of geriatric patients. In patients with mild renal impairment, who may receive the higher-dosage regimen by therapeutic error, the probability of overdosing was 6.2%. Despite specific dosing recommendations in case of renal impairment, this study shows that the use of buflomedil could be associated with significant risk of overdosing in geriatric patients. Such results might have enhanced decision-making when buflomedil safety was reassessed by AFSSAPS in 2006. The retrospective case of buflomedil illustrates how these methods may be valuable in postmarketing safety evaluation of potentially toxic drugs.

  15. Hand hygiene-meeting the JCAHO safety goal: can compliance with CDC hand hygiene guidelines be improved by a surveillance and educational program?

    Science.gov (United States)

    Benton, Carol

    2007-01-01

    While establishing 2004 department goals, the new JCAHO Safety Goal of improving compliance with CDC hand washing recommendations was an appropriate department initiative for a hospital Wound Care Center. The purpose of the project was to improve physician compliance with hand hygiene. Nursing staff monitored physician hand washing and provided a compliance report to each physician. Informative articles pertaining to hand hygiene were provided to each physician. Follow-up monitoring demonstrated a significant increase in physician compliance with an additional benefit of patients showing interest in hand hygiene. Continuous oversight of hand hygiene may ultimately reduce the incidence of infection transmission.

  16. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    Dietary guidelines are issued regularly in most developed countries. In almost all cases they are concerned solely with the nutritional aspects of food and eating and are based on an understanding of food exclusively as a source of nutrients. In recent years, however, a growing number of proposals...... in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in relation...... and the role of expert cultures for the elaboration and communication of messages about health and sustainability. Finally, the article briefly points to some answers to the complexity of issues surrounding the creation of dietary guidelines...

  17. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

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

  18. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

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

  19. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

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

  20. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

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

  1. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

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

  2. Safety Note

    CERN Multimedia

    SC Secretariat

    2004-01-01

    Please note that the Safety Note no 29 (NS 29) entitled 'Fire Prevention for Insulating Core (Sandwich) Panel Structures for Inside Use Guidelines for Selection, Installation and Use' is available on the web at the following url: https://edms.cern.ch/document/475438/LAST_RELEASED Paper copies can also be obtained from the SC Unit secretariat, e-mail : sc.secretariat@cern.ch SC Secretariat

  3. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

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

  4. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

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

  5. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

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

  6. 10 CFR 960.5-2 - Technical guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.5-2 Section 960.5-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-2 Technical guidelines. The technical guidelines in this subpart...

  7. 10 CFR 960.4-2 - Technical guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.4-2 Section 960.4-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4-2 Technical guidelines. The technical guidelines in this...

  8. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  9. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

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

  10. Spreading the word of the concept 'inherent safety' in a general industrial setting in the Dutch province of Zeeland

    NARCIS (Netherlands)

    Jongen, M.J.M.; Dijkman, A.; Zwanikken, S.; Zwetsloot, G.I.J.M.; Gort, J.

    2007-01-01

    Recent accidents in The Netherlands in different kinds of industries, like fire works storage, catering and energy industry, triggered the Dutch government to start a national program to enhance the enforcement of industrial safety at the regional and municipal level. Stimulated by this program the

  11. Child Care: State Efforts To Enforce Safety and Health Requirements. United States General Accounting Office Report to Congressional Requesters.

    Science.gov (United States)

    Fagnoni, Cynthia M.

    Although states must certify that they have requirements to protect the health and safety of children in child care in order to receive Child Care and Development Block Grant funds, neither the scope nor stringency of these requirements has been stipulated. At the request of Congressional members, this report identifies the most critical…

  12. Spreading the word of the concept 'inherent safety' in a general industrial setting in the Dutch province of Zeeland

    NARCIS (Netherlands)

    Jongen, M.J.M.; Dijkman, A.; Zwanikken, S.; Zwetsloot, G.I.J.M.; Gort, J.

    2007-01-01

    Recent accidents in The Netherlands in different kinds of industries, like fire works storage, catering and energy industry, triggered the Dutch government to start a national program to enhance the enforcement of industrial safety at the regional and municipal level. Stimulated by this program the

  13. Curriculum Guidelines for Pathology for Dental Hygienists.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    Guidelines for structuring a pathology curriculum for dental hygienists include: definition of the field and its subfields; relationships with other fields; primary educational goals, prerequisites, core content, specific behavioral objectives; and suggestions for sequencing, faculty, facilities, and occupational safety. (MSE)

  14. Measure Guideline: Guide to Attic Air Sealing

    Energy Technology Data Exchange (ETDEWEB)

    Lstiburek, J.

    2014-09-01

    The Guide to Attic Air Sealing was completed in 2010 and although not in the standard Measure Guideline format, is intended to be a Measure Guideline on Attic Air Sealing. The guide was reviewed during two industry stakeholders meetings held on December 18th, 2009 and January 15th, 2010, and modified based on the comments received. Please do not make comments on the Building America format of this document. The purpose of the Guide to Attic Air Sealing is to provide information and recommendations for the preparation work necessary prior to adding attic insulation. Even though the purpose of this guide is to save energy - health, safety and durability should not be compromised by energy efficiency. Accordingly, combustion safety and ventilation for indoor air quality are addressed first. Durability and attic ventilation then follow. Finally, to maximize energy savings, air sealing is completed prior to insulating. The guide is intended for home remodelers, builders, insulation contractors, mechanical contractors, general contractors who have previously done remodeling and homeowners as a guide to the work that needs to be done.

  15. [Guideline "Cancer rehabilitation"].

    Science.gov (United States)

    van den Berg, Jan-Paul; Velthuis, Miranda J; Gijsen, Brigitte C M; Lindeman, Eline; van der Pol, Marjolein A; Hillen, Harry F P

    2011-01-01

    Initiated by IKNL (Integraal Kankercentrum Nederland), a multidisciplinary guideline for cancer rehabilitation for adult oncology patients has been developed. The guideline describes the rehabilitation care of adult patients with cancer, during and after treatment. The guideline focuses on (a) prevalence of complaints either resulting from cancer or the treatment, (b) detection of these complaints and indicated referral, (c) the intake procedure before cancer rehabilitation, (d) intervention and evaluation within cancer rehabilitation and (e) the importance of patient empowerment. The guideline is directed at all professionals giving care to patients with cancer. It concerns those (such as medical specialists, general practitioners and nurses) who are responsible for detecting cancer-related complaints and for referral to cancer rehabilitation, as well as health care professionals involved in cancer rehabilitation care (such as consultants in rehabilitation medicine, physiotherapists and psychologists). The main goal of the guideline is that every cancer patient or ex-cancer patient with (residual) complaints resulting from cancer or its treatment receives timely and appropriate cancer rehabilitation.

  16. Investment policy, guidelines help providers control risk.

    Science.gov (United States)

    Seidner, A G

    1989-03-01

    Because the financial markets are volatile, every healthcare organization should establish its own investment policy and guidelines. An investment policy reflects the views of a hospital's board of trustees, and helps the trustees avoid conflict of interest situations. Investment guidelines spell out management's approach to three critical investing components: safety of principal, liquidity, and yield.

  17. Guideline recommendations on the use of allergen immunotherapy in house dust mite allergy: Time for a change?

    Science.gov (United States)

    Calderón, Moisés A; Bousquet, Jean; Canonica, G Walter; Cardell, Lars-Olaf; Fernandez de Rojas, Dolores Hernandez; Kleine-Tebbe, Jörg; Demoly, Pascal

    2017-07-01

    Guidelines on the treatment of asthma, allergic rhinitis (AR), and allergen immunotherapy (AIT) lack recommendations for house dust mite (HDM) allergy. An expert panel reviewed current guidelines in the light of new data to assess whether guidelines could be improved. Most guidelines and key position papers did not provide specific recommendations on treatment of allergic asthma (AA) caused by HDM allergy, although some included AIT as a treatment option for AA in general. Around half of the guidelines stated that AIT with HDM extract was an effective treatment for AR, with several indicating sublingual immunotherapy as an option. This heterogeneity is caused by quality issues affecting studies of AIT with perennial allergens in patients with AA and AR, including use of different diagnosis and severity criteria, lack of consistent scoring or grading systems for primary and safety outcomes, and lack of consensus on treatment parameters. There is a need for well-designed clinical trials to serve as a basis for guideline recommendations. Although results from recent studies strengthen the evidence base for the efficacy and safety of sublingual immunotherapy in patients with HDM-induced AA and AR, their effect on subsequent guideline updates will depend on the methodology and evidence model used by each guideline. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Jogging Guidelines.

    Science.gov (United States)

    President's Council on Physical Fitness and Sports, Washington, DC.

    Jogging guidelines are set forth under the following headings: a) What Is Jogging; c) Why One Should Jog; c) How To Begin; d) What To Wear (with the emphasis on proper shoes); e) When and Where To Jog; and f) How To Jog. A 16-week basic program, outlined for inactive adults, recommends for each week the number of days to exercise, the distance,…

  19. 40 CFR 766.12 - Testing guidelines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Testing guidelines. 766.12 Section 766... DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.12 Testing guidelines. Analytical test methods must be developed using methods equivalent to those described or reviewed in Guidelines for...

  20. Item-Writing Guidelines for Physics

    Science.gov (United States)

    Regan, Tom

    2015-01-01

    A teacher learning how to write test questions (test items) will almost certainly encounter item-writing guidelines--lists of item-writing do's and don'ts. Item-writing guidelines usually are presented as applicable across all assessment settings. Table I shows some guidelines that I believe to be generally applicable and two will be briefly…

  1. Cadmium phytoavailability to rice (Oryza sativa L.) grown in representative Chinese soils. A model to improve soil environmental quality guidelines for food safety.

    Science.gov (United States)

    Rafiq, Muhammad T; Aziz, Rukhsanda; Yang, Xiaoe; Xiao, Wendan; Rafiq, Muhammad K; Ali, Basharat; Li, Tingqiang

    2014-05-01

    Food chain contamination by cadmium (Cd) is globally a serious health concern resulting in chronic abnormalities. Rice is a major staple food of the majority world population, therefore, it is imperative to understand the relationship between the bioavailability of Cd in soils and its accumulation in rice grain. Objectives of this study were to establish environment quality standards for seven different textured soils based on human dietary toxicity, total Cd content in soils and bioavailable portion of Cd in soil. Cadmium concentrations in polished rice grain were best related to total Cd content in Mollisols and Udic Ferrisols with threshold levels of 0.77 and 0.32mgkg(-1), respectively. Contrastingly, Mehlich-3-extractable Cd thresholds were more suitable for Calcaric Regosols, Stagnic Anthrosols, Ustic Cambosols, Typic Haplustalfs and Periudic Argosols with thresholds values of 0.36, 0.22, 0.17, 0.08 and 0.03mgkg(-1), respectively. Stepwise multiple regression analysis indicated that phytoavailability of Cd to rice grain was strongly correlated with Mehlich-3-extractable Cd and soil pH. The empirical model developed in this study explains the combined effects of soil properties and extractable soil Cd content on the phytoavailability of Cd to polished rice grain. This study indicates that accumulation of Cd in rice is influenced greatly by soil type, which should be considered in assessment of soil safety for Cd contamination in rice. This investigation concluded that the selection of proper soil type for food crop production can help us to avoid the toxicity of Cd in our daily diet.

  2. [Diagnosis and treatment of community-acquired urinary tract infections in adults: what has changed. Comments on the 2008 guidelines of the French Health Products Safety Agency (AFSSAPS)].

    Science.gov (United States)

    Caron, François

    2010-01-01

    This article comments on the new recommendations for the diagnosis and treatment of adult patients with community-acquired urinary tract infections (UTIs), issued in 2008 by the French Health Products Safety Agency (AFSSAPS). The terms uncomplicated and complicated UTIs have been retained ; complicated UTIs are those with risk factor for complication (rather than with established complications). In women, age (>or= 65 years) is no longer considered itself a risk factor for complications. In men, cystitis must be treated as prostatitis. The bacterial levels defining UTIs have been revised, but levels below the threshold cannot be used to rule out UTI in the presence of symptoms. For uncomplicated cystitis, only fosfomycin-trometamol is recommended as a first-line treatment, essentially because of its ecological advantages (resistance uncommon, no cross resistance with other antibiotic classes, specific class, sparing others). For recurrent cystitis, prophylactic antibiotic treatment must be limited to cases when other preventive measures are impossible. For complicated cystitis, the principle is to delay antibiotic therapy until the resistance profile results are available, when possible (because of the high risk of resistance). Delay must be avoided during pregnancy, however, because of maternal-fetal risks. The strategy for uncomplicated pyelonephritis has been simplified : no plain abdominal radiography, antibiotic therapy shortened to 10-14 days (even 7 days for regimen or relay including fluoroquinolone), and no routine verification by urine culture. For prostatitis, PSA testing is not recommended during the acute phase of prostatitis, and a 14-day antibiotic regimen is enough for the easiest-to-treat infections.

  3. Drug treatment of hypertension in pregnancy: a critical review of adult guideline recommendations.

    Science.gov (United States)

    Al Khaja, Khalid A J; Sequeira, Reginald P; Alkhaja, Alwaleed K; Damanhori, Awatif H H

    2014-03-01

    This review evaluates the guideline recommendations for the management of hypertension in pregnancy as presented by 25 national/international guidelines developed for the management of arterial hypertension in adults. There is a general consensus that oral α-methyldopa and parenteral labetalol are the drugs of choice for nonsevere and severe hypertension in pregnancy, respectively. Long-acting nifedipine is recommended by various guidelines as an alternative for first-line and second-line therapy in nonsevere and severe hypertension. The safety of β-blockers, atenolol in particular, in early and late stages of pregnancy is unresolved; their use is contraindicated according to several guidelines. Diuretic-associated harmful effects on maternal and fetal outcomes are controversial: their use is discouraged in pregnancy. It is important to develop specific guidelines for treating hypertension in special groups such as adult females of childbearing age and sexually active female adolescents to minimize the risk of adverse effects of drugs on the fetus. In several guidelines, the antihypertensive classes, recommended drug(s), intended drug formulation, and route of administration are not explicit. These omissions should be addressed in future guideline revisions in order to enhance the guidelines' utility and credibility in clinical practice.

  4. The design of the SAFE or SORRY? study : A cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events

    NARCIS (Netherlands)

    Gaal, Betsie van; Schoonhoven, Lisette; Hulscher, Marlies; Mintjes, Joke; Borm, George F; Koopmans, Raymond TCM; Achterberg, Theo van

    2009-01-01

    Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs), which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides general barriers t

  5. Diretrizes para implantação de sistemas de segurança e saúde do trabalho em empresas produtoras de baterias automotivas Guidelines to implement occupational health and safety systems in automotive batteries manufacturers

    Directory of Open Access Journals (Sweden)

    Otávio José de Oliveira

    2010-01-01

    way. The main objective of this paper is to present guidelines based on theoretical basis and on the results of case studies to implement Occupational Health and Safety Management Systems in automotive battery manufacturers. A qualitative case study research was carried out in two battery automotive manufacturing companies located in the city of Bauru, state of São Paulo. The data were collected through semi-structured interviews, analysis of documents, and observation in loco. Guidelines related to the following elements were proposed for the implementation of this kind of system : top administration, organizational strategy, organizational culture, Occupational Health and Safety Department (OHSD, Occupational Safety and Health technicians, human resources, training, multidisciplinary teams, internal communication, resistance to changes, performance indicators, management tools for problem solution, projects management, rewards and incentives, and system integration.

  6. Generalizing on best practices in image processing: a model for promoting research integrity: Commentary on: Avoiding twisted pixels: ethical guidelines for the appropriate use and manipulation of scientific digital images.

    Science.gov (United States)

    Benos, Dale J; Vollmer, Sara H

    2010-12-01

    Modifying images for scientific publication is now quick and easy due to changes in technology. This has created a need for new image processing guidelines and attitudes, such as those offered to the research community by Doug Cromey (Cromey 2010). We suggest that related changes in technology have simplified the task of detecting misconduct for journal editors as well as researchers, and that this simplification has caused a shift in the responsibility for reporting misconduct. We also argue that the concept of best practices in image processing can serve as a general model for education in best practices in research.

  7. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. Advanced human-system interface design review guideline. Evaluation procedures and guidelines for human factors engineering reviews

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.; Brown, W.S. [Brookhaven National Lab., Upton, NY (United States); Baker, C.C.; Welch, D.L.; Granda, T.M.; Vingelis, P.J. [Carlow International Inc., Falls Church, VA (United States)

    1994-07-01

    Advanced control rooms will use advanced human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator`s overall role in the system, the method of information presentation, and the ways in which operators interact with the system. The U.S. Nuclear Regulatory Commission (NRC) reviews the HSI aspects of control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported to protect public health and safety. The principal guidance available to the NRC, however, was developed more than ten years ago, well before these technological changes. Accordingly, the human factors guidance needs to be updated to serve as the basis for NRC review of these advanced designs. The purpose of this project was to develop a general approach to advanced HSI review and the human factors guidelines to support. NRC safety reviews of advanced systems. This two-volume report provides the results of the project. Volume I describes the development of the Advanced HSI Design Review Guideline (DRG) including (1) its theoretical and technical foundation, (2) a general model for the review of advanced HSIs, (3) guideline development in both hard-copy and computer-based versions, and (4) the tests and evaluations performed to develop and validate the DRG. Volume I also includes a discussion of the gaps in available guidance and a methodology for addressing them. Volume 2 provides the guidelines to be used for advanced HSI review and the procedures for their use.

  9. Overview of safety pharmacology.

    Science.gov (United States)

    Goineau, Sonia; Lemaire, Martine; Froget, Guillaume

    2013-12-02

    Safety pharmacology entails the assessment of the potential risks of novel pharmaceuticals for human use. As detailed in the ICH S7A guidelines, safety pharmacology for drug discovery involves a core battery of studies on three vital systems: central nervous (CNS), cardiovascular (CV), and respiratory. Primary CNS studies are aimed at defining compound effects on general behavior, locomotion, neuromuscular coordination, seizure threshold, and vigilance. The primary CV test battery includes an evaluation of proarrhythmic risk using in vitro tests (hERG channel and Purkinje fiber assays) and in vivo measurements in conscious animals via telemetry. Comprehensive cardiac risk assessment also includes full hemodynamic evaluation in a large, anesthetized animal. Basic respiratory function can be examined in conscious animals using whole-body plethysmography. This allows for an assessment of whether the sensitivity to respiratory-depressant effects can be enhanced by exposure to increased CO2 . Other safety pharmacology topics detailed in this unit are the timing of such studies, ethical and animal welfare issues, and statistical evaluation.

  10. Author Guidelines

    OpenAIRE

    Istadi Istadi

    2011-01-01

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

  11. Safety Resources.

    Science.gov (United States)

    Hoot, James L.; Bartkowiak, Elaine T.

    1994-01-01

    Lists 72 organizations and programs that deal with child safety, grouped by the following categories: (1) general; (2) general violence; (3) gun violence; (4) media violence; (5) drugs and alcohol; (6) child abuse and at-risk children; (7) parenting programs; (8) community service programs; (9) leadership programs; (10) peer counseling; (11)…

  12. Nutritional Guidelines and Fermented Food Frameworks

    Science.gov (United States)

    Bell, Victoria; Ferrão, Jorge; Fernandes, Tito

    2017-01-01

    This review examines different nutritional guidelines, some case studies, and provides insights and discrepancies, in the regulatory framework of Food Safety Management of some of the world’s economies. There are thousands of fermented foods and beverages, although the intention was not to review them but check their traditional and cultural value, and if they are still lacking to be classed as a category on different national food guides. For understanding the inconsistencies in claims of concerning fermented foods among various regulatory systems, each legal system should be considered unique. Fermented foods and beverages have long been a part of the human diet, and with further supplementation of probiotic microbes, in some cases, they offer nutritional and health attributes worthy of recommendation of regular consumption. Despite the impact of fermented foods and beverages on gastro-intestinal wellbeing and diseases, their many health benefits or recommended consumption has not been widely translated to global inclusion in world food guidelines. In general, the approach of the legal systems is broadly consistent and their structures may be presented under different formats. African traditional fermented products are briefly mentioned enhancing some recorded adverse effects. Knowing the general benefits of traditional and supplemented fermented foods, they should be a daily item on most national food guides. PMID:28783111

  13. Managing work-related psychological complaints by general practitioners, in coordination with occupational physicians: A pilot Study - Developing and testing a guideline

    NARCIS (Netherlands)

    Buijs, P.C.; Dijk, F.J.H. van; Evers, M.; Klink, J.J.L. van de; Anema, H.

    2007-01-01

    Increasingly, workers have psychological work-related complaints, endangering their work ability and causing considerable economic losses. Many employees consult their general practitioner (GP). He, however, often pays insufficient attention to work-relatedness or to coordination with occupational p

  14. Engineer Ethics Education that Treated Safety Problem to Promote Development of General Human Competence and Independent Engineer

    Science.gov (United States)

    Hotta, Genji

    The human race came to expect the engineer‧s international activity by an international extension of the risk. The engineer should provide with “Overall ability” and “Independent ability” to answer the demand of the society. The engineer ethics education is effective to the acquisition of the ability that the society demands. Because the engineer ethics education teaches the engineer to develop “Ethics action as the individual” to “Ethics activity as the enterprise” . In the point of development of the comprehensive capacity, it can be said that the engineer ethics education is training that supports the action power that accomplishes the social responsibility. However, it is easy to make the engineer ethics education a polite fiction. Then, we propose to take the safety problem to the ethics education for the prevention of making to the polite fiction of the education.

  15. 49 CFR 350.339 - What are tolerance guidelines?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false What are tolerance guidelines? 350.339 Section 350... MOTOR CARRIER SAFETY ASSISTANCE PROGRAM Funding § 350.339 What are tolerance guidelines? Tolerance guidelines set forth the limited deviations from the FMCSRs allowed in your State's laws and...

  16. New Safety rules

    CERN Multimedia

    Safety Commission

    2008-01-01

    The revision of CERN Safety rules is in progress and the following new Safety rules have been issued on 15-04-2008: Safety Procedure SP-R1 Establishing, Updating and Publishing CERN Safety rules: http://cern.ch/safety-rules/SP-R1.htm; Safety Regulation SR-S Smoking at CERN: http://cern.ch/safety-rules/SR-S.htm; Safety Regulation SR-M Mechanical Equipment: http://cern.ch/safety-rules/SR-M.htm; General Safety Instruction GSI-M1 Standard Lifting Equipment: http://cern.ch/safety-rules/GSI-M1.htm; General Safety Instruction GSI-M2 Standard Pressure Equipment: http://cern.ch/safety-rules/GSI-M2.htm; General Safety Instruction GSI-M3 Special Mechanical Equipment: http://cern.ch/safety-rules/GSI-M3.htm. These documents apply to all persons under the Director General’s authority. All Safety rules are available at the web page: http://www.cern.ch/safety-rules The Safety Commission

  17. A Comparison of the Effectiveness of Interactive Laser Disc and Classroom Video Tape for Safety Instruction of General Motors Workers.

    Science.gov (United States)

    Bosco, James; Wagner, Jerry

    1988-01-01

    Describes evaluation that assessed the effectiveness of the Interactive Laser Disc System (ILDS) Training Program in comparison with classroom instruction with videotape for training of General Motors workers. Topics discussed include achievement test, attitude scales, opinion surveys, user preference questionnaires, interviews, and variables that…

  18. Immunisation Guidelines for Ireland (2008)

    OpenAIRE

    Department of Health

    2008-01-01

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

  19. Wildland firefighter safety zones: A review of past science and summary of future needs

    Science.gov (United States)

    B. W. Butler

    2014-01-01

    Current wildland firefighter safety zone guidelines are based on studies that assume flat terrain, radiant heating, finite flame width, constant flame temperature and high flame emissivity. Firefighter entrapments and injuries occur across a broad range of vegetation, terrain and atmospheric conditions generally when they are within two flame heights of the fire....

  20. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.

    Science.gov (United States)

    Turner, Gill; Clegg, Andrew

    2014-11-01

    Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility. A more proactive, integrated, person-centred and community-based response to frailty is required. The British Geriatrics Society Fit for Frailty guideline is consensus best practice guidance for the management of frailty in community and outpatient settings. The BGS recommends that all encounters between health and social care staff and older people in community and outpatient settings should include an assessment for frailty. A gait speed 10s; and a score of ≥3 on the PRISMA 7 questionnaire can indicate frailty. The common clinical presentations of frailty (falls, delirium, sudden immobility) can also be used to indicate the possible presence of frailty. The BGS recommends an holistic medical review based on the principles of comprehensive geriatric assessment (CGA) for all older people identified with frailty. This will: diagnose medical illnesses to optimise treatment; apply evidence-based medication review checklists (e.g. STOPP/START criteria); include discussion with older people and carers to define the impact of illness; work with the older person to create an individualised care and support plan. The BGS does not recommend population screening for frailty using currently available instruments. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

    Directory of Open Access Journals (Sweden)

    Dash A

    2016-02-01

    Full Text Available Amitabh Dash,1 Sangeeta Ravat,2 Avathvadi Venkatesan Srinivasan,3 Ashutosh Shetty,4 Vivek Kumar,5 Renu Achtani,6 Vivek Narain Mathur,7 Boby Varkey Maramattom,8 Veeresh Bajpai,9 Nanjappa C Manjunath,10 Randhi Venkata Narayana,11 Suyog Mehta12 1Eisai Co. Ltd., 2Department of Neurology, Seth GS Medical College & KEM Hospital, Mumbai, 3Department of Neurology, Trinity Acute Care Hospital, Chennai, 4Department of Neurology, Criticare Multispeciality Hospital & Research Centre, Mumbai, 5Department of Neurology, Metro Multispeciality Hospital, Noida, 6Department of Neurology, Mata Chanan Devi Hospital, New Delhi, 7Department of Neurology, Vivekananda Hospital, Hyderabad, 8Department of Neurology, Lourdes Hospital, Kochi, 9Department of Neurology, Sai Neurology Clinic, Lucknow, 10Department of Neurology, Brain and Nerve Care, Bangalore, 11Department of Neurology, Seven Hills Hospital, Visakhapatnam, 12Department of Pharmacology & Therapeutics,Government Medical College, Solapur, India Abstract: A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24 weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20

  2. NASA Aerospace Flight Battery Program: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries; Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries; Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop). Volume 1, Part 1

    Science.gov (United States)

    Manzo, Michelle A.; Brewer, Jeffrey C.; Bugga, Ratnakumar V.; Darcy, Eric C.; Jeevarajan, Judith A.; McKissock, Barbara I.; Schmitz, Paul C.

    2010-01-01

    This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 1 - Volume I: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries, Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries, and Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop).

  3. Human factors design review guidelines for advanced nuclear control room technologies

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.; Brown, W. (Brookhaven National Lab., Upton, NY (United States)); Granda, T.; Baker, C. (Carlow Associates, Inc., Fairfax, VA (United States))

    1991-01-01

    Advanced control rooms (ACRs) for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale, general approach, and initial development of an NRC Advanced Control Room Design Review Guideline. 20 refs., 1 fig.

  4. Facilities Guidelines for Fine Arts Programs.

    Science.gov (United States)

    Maryland State Dept. of Education, Baltimore.

    This manual of facility guidelines examines the planning process and design features and considerations for public school fine arts programs in Maryland. Planning concepts and trends are highlighted followed by planning guidelines for dance, music, theater, visual arts, general education, and performance spaces. General design considerations…

  5. 40 CFR 799.11 - Availability of test guidelines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Availability of test guidelines. 799.11... General Provisions § 799.11 Availability of test guidelines. (a) The TSCA and FIFRA guidelines for the...-487-4650). (b) The OECD guidelines for the various study plans are available from the...

  6. 10 CFR 960.5-1 - System guidelines.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false System guidelines. 960.5-1 Section 960.5-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-1 System guidelines. (a) Qualifying conditions—(1)...

  7. An Evaluation of Shared Mental Models and Mutual Trust on General Medical Units: Implications for Collaboration, Teamwork, and Patient Safety.

    Science.gov (United States)

    McComb, Sara A; Lemaster, Matthew; Henneman, Elizabeth A; Hinchey, Kevin T

    2015-02-24

    This study examines nurse-physician teamwork and collaboration, a critical component in the delivery of safe patient care, on general medical units. To that end, we assess shared mental models and mutual trust, 2 coordinating mechanisms that help facilitate teamwork, among nurses and physicians working on general medical units. Data were collected from 37 nurses and 42 physicians at an urban teaching medical center in the Northeastern United States. Shared mental model questionnaire items were iteratively developed with experts' input to ensure content validity. Mutual trust items were adapted from an existing scale; items were reliable. Data were analyzed using χ and independent 2-tailed t tests. Physicians and nurses reported significant differences in their perceptions of the professional responsible for a variety of roles (e.g., advocating for the patient [P = 0.0007], identifying a near miss/error [P = 0.003]). Medication reconciliation is only role for which nurses perceive less responsibility than physicians perceive nurses have. Regarding mutual trust, both groups reported significantly more trust within their own professions; both groups reported similar levels of trust in physicians, with physicians reporting significantly less trust in their nursing colleagues than nurses perceive (P collaboration, more work is needed. To that end, we propose increasing knowledge about their respective roles, providing opportunities for nurse and physician collaboration through rounding or committee work and enhancing the preparedness and professionalism of interactions.

  8. Safety training and safe operating procedures written for PBFA (Particle Beam Fusion Accelerator) II and applicable to other pulsed power facilities

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, G.L.; Goldstein, S.A.

    1986-12-01

    To ensure that work in advancing pulsed power technology is performed with an acceptably low risk, pulsed power research facilities at Sandia National Laboratories must satisfy general safety guidelines established by the Department of Energy, policies and formats of the Environment, Safety, and Health (ES and H) Department, and detailed procedures formulated by the Pulsed Power Sciences Directorate. The approach to safety training and to writing safe operating procedures, and the procedures presented here are specific to the Particle Beam Fusion Accelerator II (PBFA II) Facility but are applicable as guidelines to other research and development facilities which have similar hazards.

  9. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Wattjes, Mike P; Rovira, Àlex; Miller, David

    2015-01-01

    for the prediction of long-term disability. With the introduction of a new generation of immunomodulatory and/or immunosuppressive drugs for the treatment of MS, MRI also makes an important contribution to the monitoring of treatment, and can be used to determine baseline tissue damage and detect subsequent repair....... This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...... present recommendations on how and when to use MRI for disease monitoring, and discuss some promising MRI approaches that may be introduced into clinical practice in the near future....

  10. Inspection and evaluation guidelines for light water reactor internals

    Energy Technology Data Exchange (ETDEWEB)

    Iizuka, N. [Tokyo Electric Power Co., Inc. (Japan); Taniguchi, K. [Kansai Electric Power Co., Inc., Osaka (Japan); Yoshinaga, T. [Japan Atomic Power Co., Tokyo (Japan)

    2002-12-01

    On February, 2000, in the Engineering Society of Thermal and Nuclear Power Generation, the 'Investigation Group on Inspection and Evaluation Guidelines for Nuclear Reactor Internals' was established. This group was started at moments of some damage cases on reactor internals on BWRs and PWRs in Japan and foreign countries and of finding out cracks based on a number of SCC (stress corrosion cracking) at Inconel alloy weldings of a shroud support of BWR internals in Tsuruga Nuclear Power Station Unit-1 of the Japan Nuclear Power Generation Co., Ltd. on December, 1999. Under these conditions, this group made some guidelines for rational inspection with clear technical foundation, and so on as well as arrangements on structural functions, importance at safety, and so on of the reactor internals, promoted some investigations aiming at wide general proposal on how to carry out future internal inspections on LWR in Japan, and completed almost all of the investigations on March, 2002. Here were described basic indications of the guideline development and summaries of the developed guideline. (G.K.)

  11. Comparing Online and In-Person Delivery Formats of the OSHA 10-Hour General Industry Health and Safety Training for Young Workers.

    Science.gov (United States)

    Shendell, Derek G; Milich, Lindsey J; Apostolico, Alexsandra A; Patti, Alexa A; Kelly, Siobhan

    2017-05-01

    Seven school districts or comprehensive high schools were enrolled in online OSHA 10-hour General Industry or Construction health and safety training via CareerSafe to determine the feasibility of online training for students, given limited resources for in-person trainings. A two-campus school district was analyzed comparing OSHA 10 for General Industry across in-person, supervisor-level teachers as authorized trainers, and online course formats. The online training courses were completed by 86 of 91 students, while another 53 of 57 students completed in-person training. Both groups completed identical OSHA-approved quizzes for "Introduction to OSHA," the initial 2-h module consistently provided in OSHA 10 courses across topics and formats. Results indicated teacher supervision was critical, and girls had higher online course completion rates, overall quiz scores, and never failed. Though both cohorts passed, in-person had significantly higher scores than online; both struggled with two questions. Online OSHA 10 for General Industry can be an efficient learning tool for students when limited resources prevent widespread availability of in-person courses.

  12. Sector-specific issues and reporting methodologies supporting the General Guidelines for the voluntary reporting of greenhouse gases under Section 1605(b) of the Energy Policy Act of 1992. Volume 2: Part 4, Transportation sector; Part 5, Forestry sector; Part 6, Agricultural sector

    Energy Technology Data Exchange (ETDEWEB)

    1994-10-01

    This volume, the second of two such volumes, contains sector-specific guidance in support of the General Guidelines for the voluntary reporting of greenhouse gas emissions and carbon sequestration. This voluntary reporting program was authorized by Congress in Section 1605(b) of the Energy Policy Act of 1992. The General Guidelines, bound separately from this volume, provide the overall rationale for the program, discuss in general how to analyze emissions and emission reduction/carbon sequestration projects, and address programmatic issues such as minimum reporting requirements, time parameters, international projects, confidentiality, and certification. Together, the General Guidelines and the guidance in these supporting documents will provide concepts and approaches needed to prepare the reporting forms. This second volume of sector-specific guidance covers the transportation sector, the forestry sector, and the agricultural sector.

  13. Guidelines for Description

    NARCIS (Netherlands)

    Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

    2013-01-01

    The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

  14. Author Guidelines

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    General Information Frontiers of Materials Science (FOMS) is a peer- reviewed international journal jointly published by Higher Education Press and Springer. It focuses on the latest pioneering studies in all aspects of materials science. Categories of contribution are Review/Mini-Review Articles, Research Articles,

  15. China's Work Safety Report

    Institute of Scientific and Technical Information of China (English)

    Liang Jiakun

    2005-01-01

    @@ General Situation of China's Work Safety in 2004 In 2004, the national work safety situation remained stable as a whole and gained momentum to improve. The totality of accidents held the line and began to drop. The safety conditions in industrial,mining, and commercial/trading enterprises improved. Progress was made in ensuring work safety in the relevant industries and fields. The safety situation in most provinces (autonomous regions, municipalities directly under the Central Government) kept stable.

  16. Advanced control room evaluation: General approach and rationale

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.M. (Brookhaven National Lab., Upton, NY (USA)); Wachtel, J. (Nuclear Regulatory Commission, Washington, DC (USA))

    1991-01-01

    Advanced control rooms (ACRs) for future nuclear power plants (NPPs) are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale and general approach to the development of a human factors review guideline for ACRs. The factors influencing the guideline development are discussed, including the review environment, the types of advanced technologies being addressed, the human factors issues associated with advanced technology, and the current state-of-the-art of human factors guidelines for advanced human-system interfaces (HSIs). The proposed approach to ACR review would track the design and implementation process through the application of review guidelines reflecting four review modules: planning, design process analysis, human factors engineering review, and dynamic performance evaluation. 21 refs.

  17. Method and details of on-site application materials inspection of food production license according to GB 14881-2013 and general guidelines%结合GB 14881-2013、食品生产许可审查通则谈食品生产许可现场对申请资料审核的内容和方法

    Institute of Scientific and Technical Information of China (English)

    鲁燕骅; 陈柄旭; 杨丽仙

    2015-01-01

    To improve the food safety inspection, it is urgent and necessary to have a deep understanding of the related food production regulations and standards, unify the executions at various levels and improve the execution quality of the site inspectors. The similarities and differences among related standards and documents were summarized so that it would be easier for the inspectors and auditors to understand GB 14881 and inspection's general guideline according to their work. Based on the general guidelines for food production license inspection (version 2010) as well as the related regulations in GB 14881-2013 and authors' professional experiences, the details and methods for auditing the application materials were analyzed and summarized, including 13 aspects, such as organization structure, responsibility and requirements of staff, technical documents, purchase and verification, process management, critical control point, product protection, and test management,etc. This article intended to be a technical reference for future on-site verification and the implementation of routine monitoring.%深入理解食品生产相关法令法规和标准,逐步统一各级执行者的认识,提高一线监管的专业水平,是食品安全监管工作发展的当前迫切需求和今后必经之路。为了逐步整合同类标准和文件之间的异同,便于监管人员和审核人员从实际工作需求角度去理解GB 14881和审查通则的要求,本文以食品生产许可审查通则(2010版)为基本框架,结合GB 14881-2013的相关内容以及笔者以往的审核经验,对申请材料审核部分各条款核查的内容和方法进行细化、分析和归纳,包括组织领导、人员职责和要求、技术性文件、采购及验证、过程管理、关键质控、产品防护、检验管理等13个方面的内容,可作为食品生产许可现场核查和日常监管的具体工作实施的技术参考材料。

  18. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

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

  19. Work Hard to Ensure Food,Drugs Safety for the People——An interview with Shao Mingli,director-general of the State Food and Drug Administration (SFDA)

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ EDITOR'S NOTE:Following is an interview given by Shao Mingli,director-general of China's State Food and Drug Administration to our reporter on what is being done to ensure food and drug safety in China.As everybody knows,food and drug safety is vital to people's lives.Question:To start with,would you give us an account of your agency's official functions?

  20. Pregnancy screening of adolescents and women before radiologic testing: does radiology need a national guideline?

    Science.gov (United States)

    Applegate, Kimberly

    2007-08-01

    Ionizing radiation has known teratogenic and cancer risks to fetuses. Policies for radiation exposure of pregnant patients during imaging tests in radiology departments vary widely and may or may not be in fully written form. No national guideline exists for how individual radiologists or radiology departments should protect fetuses from ionizing radiation exposure. With the rapid increase in the use of radiologic testing in general, particularly computed tomography, more adolescents and women undergo computed tomographic imaging and may unintentionally expose their fetuses. A national discussion within radiology organizations is needed to understand the advantages and disadvantages in the development of a national guideline for screening women of childbearing age for pregnancy before any procedures using ionizing radiation are performed. Given the increased public concern and increased use of radiologic testing, such a national guideline would improve consumer satisfaction and safety.

  1. Methodological guidelines for developing accident modification functions

    DEFF Research Database (Denmark)

    Elvik, Rune

    2015-01-01

    This paper proposes methodological guidelines for developing accident modification functions. An accident modification function is a mathematical function describing systematic variation in the effects of road safety measures. The paper describes ten guidelines. An example is given of how to use...... limitations in developing accident modification functions are the small number of good evaluation studies and the often huge variation in estimates of effect. It is therefore still not possible to develop accident modification functions for very many road safety measures. © 2015 Elsevier Ltd. All rights...

  2. Safety system status monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

    1984-03-01

    The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide.

  3. Safety at CERN

    CERN Multimedia

    2009-01-01

    Safety is an integral part of our working lives, and should be in our minds whatever job we do at CERN. Ultimately, safety is the responsibility of the Director General – your safety is my concern. That’s why I have this week appointed a new Safety Policy Committee (SAPOCO) that reflects the new Organizational structure of CERN. CERN’s Staff Rules and Regulations clearly lay out in chapter 3 the scope of safety at CERN as well as my responsibilities and yours in safety matters. At CERN, safety is considered in the broadest sense, encompassing occupational Health and Safety, environmental protection, and the safety of equipment and installations. It is my responsibility to put appropriate measures in place to ensure that these conditions are met. And it is the responsibility of us all to ensure that we are fully conversant with safety provisions applicable in our areas of work and that we comply with them. The appointment of a n...

  4. 12 CFR 618.8015 - Policy guidelines.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Policy guidelines. 618.8015 Section 618.8015 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618.8015 Policy guidelines. (a) The board of directors of each System bank or association...

  5. 25 CFR 163.81 - Assessment guidelines.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Assessment guidelines. 163.81 Section 163.81 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GENERAL FORESTRY REGULATIONS Program Assessment § 163.81 Assessment guidelines. Assessments shall be national in scope and shall include: (a)...

  6. Clinical Practice Guidelines for paroxysmal supraventricular tachycardia.

    Directory of Open Access Journals (Sweden)

    Brandy Viera Valdés

    2009-03-01

    Full Text Available Clinical Practice Guidelines for paroxysmal supraventricular tachycardia. These are arrhythmias in which structures placed above the bifurcation of the bundle of His are involved; characterized by tachycardia with abrupt starting and ending. We comment its classification, common characteristics, general treatment and specific conduct for its different variables. It includes assessment guidelines focused on the most important aspects to be accomplished.

  7. General al guidelines for the prescription of exercise in patients with cardiovascular diseases Pautas generales para la prescripción de la actividad física en pacientes con enfermedades cardiovasculares

    Directory of Open Access Journals (Sweden)

    Mauricio Rico Sierra

    2003-03-01

    Full Text Available This his is a review about the general rules for prescription of physical activity in patients with cardiovascular diseases. The accepted benefits of physical activity are emphasized and a brief description is made concerning the functional capacity of the individual by means of the effort test; also the equipments and protocols used with that aim are described. The classification of individuals and of their risk in physical activities is included, according to recommendations of the American Heart Association and the New York Heart Association. Finally, physical activities are described, with emphasis on intensity, duration, frequency and recommended type of exercise. Prescription of exercise for patients with the most prevalent cardiovascular diseases in Colombia is also included. Se hace una revisión sobre las paut ut utas as gener generales ales para la prescripción de la actividad física en pacientes con enfermedades cadiovasculares. Inicialmente se resaltan los beneficios comprobados de la actividad física y se hace una descripción breve sobre la evaluación de la capacidad funcional de un individuo mediante la prueba de esfuerzo, y de los equipos y los diferentes protocolos utilizados para ello. Luego se aborda la clasificación de los individuos y del riesgo que para ellos representan las actividades físicas, según recomendaciones de la Asociación Americana del Corazón y la asociación Neoyorquina del Corazón (AHA y NYHA, por sus siglas en inglés. Posteriormente se incluye la prescripción de las actividades físicas, haciendo énfasis en la intensidad, la duración, la frecuencia y el tipo de ejercicios recomendado. Por último, se hace referencia a la prescripción de las actividades físicas en pacientes con las enfermedades de mayor prevalencia en nuestro medio.

  8. 75 FR 73946 - Worker Safety and Health Program: Safety Conscious Work Environment

    Science.gov (United States)

    2010-11-30

    ... Part 851 Worker Safety and Health Program: Safety Conscious Work Environment AGENCY: Office of the... ``Safety-Conscious Work Environment'' guidelines as a model. DOE published this petition and a request for... ``Safety-Conscious Work Environment'' by regulation be redundant, but it would also fail to add...

  9. Revitalizing Nuclear Safety Research.

    Science.gov (United States)

    National Academy of Sciences - National Research Council, Washington, DC.

    This report covers the general issues involved in nuclear safety research and points out the areas needing detailed consideration. Topics included are: (1) "Principles of Nuclear Safety Research" (examining who should fund, who should conduct, and who should set the agenda for nuclear safety research); (2) "Elements of a Future…

  10. Modeling Guidelines for Code Generation in the Railway Signaling Context

    Science.gov (United States)

    Ferrari, Alessio; Bacherini, Stefano; Fantechi, Alessandro; Zingoni, Niccolo

    2009-01-01

    Modeling guidelines constitute one of the fundamental cornerstones for Model Based Development. Their relevance is essential when dealing with code generation in the safety-critical domain. This article presents the experience of a railway signaling systems manufacturer on this issue. Introduction of Model-Based Development (MBD) and code generation in the industrial safety-critical sector created a crucial paradigm shift in the development process of dependable systems. While traditional software development focuses on the code, with MBD practices the focus shifts to model abstractions. The change has fundamental implications for safety-critical systems, which still need to guarantee a high degree of confidence also at code level. Usage of the Simulink/Stateflow platform for modeling, which is a de facto standard in control software development, does not ensure by itself production of high-quality dependable code. This issue has been addressed by companies through the definition of modeling rules imposing restrictions on the usage of design tools components, in order to enable production of qualified code. The MAAB Control Algorithm Modeling Guidelines (MathWorks Automotive Advisory Board)[3] is a well established set of publicly available rules for modeling with Simulink/Stateflow. This set of recommendations has been developed by a group of OEMs and suppliers of the automotive sector with the objective of enforcing and easing the usage of the MathWorks tools within the automotive industry. The guidelines have been published in 2001 and afterwords revisited in 2007 in order to integrate some additional rules developed by the Japanese division of MAAB [5]. The scope of the current edition of the guidelines ranges from model maintainability and readability to code generation issues. The rules are conceived as a reference baseline and therefore they need to be tailored to comply with the characteristics of each industrial context. Customization of these

  11. Military Handbook: General Guidelines for Electronic Equipment

    Science.gov (United States)

    2007-11-02

    for MIL-B-7838 Bolt, Internal Wrenching, 160 KSI FTU MIL-R-7885 Rivets; Blind, Structural, Pull-Stem and Chemically Expanded KIL-R- 8814 Rivets, Blind...Nonstructural blind rivets should conform to NIL-R- 8814 . c. Blind, nonstructurat, retained mandrel type rivets should conform to MIL-R-24243. 4.2.2...6 MIL-R- 8814 ...................... 12 MIL-W-4088 ..................... 44 MIL-B-8831 ...................... 12 MIL-M-4820

  12. Vitamin D supplementation guidelines.

    Science.gov (United States)

    Pludowski, Pawel; Holick, Michael F; Grant, William B; Konstantynowicz, Jerzy; Mascarenhas, Mario R; Haq, Afrozul; Povoroznyuk, Vladyslav; Balatska, Nataliya; Barbosa, Ana Paula; Karonova, Tatiana; Rudenka, Ema; Misiorowski, Waldemar; Zakharova, Irina; Rudenka, Alena; Łukaszkiewicz, Jacek; Marcinowska-Suchowierska, Ewa; Łaszcz, Natalia; Abramowicz, Pawel; Bhattoa, Harjit P; Wimalawansa, Sunil J

    2017-02-12

    Research carried out during the past two-decades extended the understanding of actions of vitamin D, from regulating calcium and phosphate absorption and bone metabolism to many pleiotropic actions in organs and tissues in the body. Most observational and ecological studies report association of higher serum 25-hydroxyvitamin D [25(OH)D] concentrations with improved outcomes for several chronic, communicable and non-communicable diseases. Consequently, numerous agencies and scientific organizations have developed recommendations for vitamin D supplementation and guidance on optimal serum 25(OH)D concentrations. The bone-centric guidelines recommend a target 25(OH)D concentration of 20ng/mL (50nmol/L), and age-dependent daily vitamin D doses of 400-800IU. The guidelines focused on pleiotropic effects of vitamin D recommend a target 25(OH)D concentration of 30ng/mL (75nmol/L), and age-, body weight-, disease-status, and ethnicity dependent vitamin D doses ranging between 400 and 2000IU/day. The wise and balanced choice of the recommendations to follow depends on one's individual health outcome concerns, age, body weight, latitude of residence, dietary and cultural habits, making the regional or nationwide guidelines more applicable in clinical practice. While natural sources of vitamin D can raise 25(OH)D concentrations, relative to dietary preferences and latitude of residence, in the context of general population, these sources are regarded ineffective to maintain the year-round 25(OH)D concentrations in the range of 30-50ng/mL (75-125nmol/L). Vitamin D self-administration related adverse effects, such as hypercalcemia and hypercalciuria are rare, and usually result from taking extremely high doses of vitamin D for a prolonged time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Nuclear safety policy working group recommendations on nuclear propulsion safety for the space exploration initiative

    Science.gov (United States)

    Marshall, Albert C.; Lee, James H.; Mcculloch, William H.; Sawyer, J. Charles, Jr.; Bari, Robert A.; Cullingford, Hatice S.; Hardy, Alva C.; Niederauer, George F.; Remp, Kerry; Rice, John W.

    1993-01-01

    An interagency Nuclear Safety Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program. These recommendations, which are contained in this report, should facilitate the implementation of mission planning and conceptual design studies. The NSPWG has recommended a top-level policy to provide the guiding principles for the development and implementation of the SEI nuclear propulsion safety program. In addition, the NSPWG has reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. These recommendations should be useful for the development of the program's top-level requirements for safety functions (referred to as Safety Functional Requirements). The safety requirements and guidelines address the following topics: reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations.

  14. Discussion on safety management of nuclear power engineering in general contracting mode%总承包模式下核电工程安全管理相关问题探讨

    Institute of Scientific and Technical Information of China (English)

    赵显; 刘勃

    2014-01-01

    The characteristics of safety management on nuclear power engineering in general contracting mode, which were different from the common construction projects, were analyzed.Then the main problems in current safety management of nuclear power engineering construction were put forward, such as lagging of relevant laws and regulations, the contradiction between expansion of nuclear power construction project and lack of human resources, the labor subcontracting system and safety problems brought by its working personnel, and passive regulation of safety production costs etc.These problems would directly impact the existing work safety defense line, and bring unprecedented challenge to safety management work of general contractor.So the suggestions and countermeasures were put forward, including that the relevant government departments should publish the relevant laws and regula-tions about general contracting of project as soon as possible, the general contractor should fully integrate on-site safety management resources, strengthen the safety management on subcontractors, strengthen safety training of the labor service personnel, and explore the management mode of work safety costs.%首先分析了总承包模式下核电工程建设不同于一般建设工程安全管理的特点,提出目前工作中存在的主要问题,包括相关法律法规的滞后、核电建设工程扩张与人力资源不足之间的矛盾、劳务分包体制及其作业人员引起的相关问题以及安全生产费用监管被动等,这些都直接冲击现有的安全生产防线,并给总承包单位安全管理工作带来前所未有的挑战。为此,提出以下建议和对策措施:有关部门尽快出台总承包工程相关法律法规;总承包单位应充分整合现场安全管理资源,加大对分包单位安全管理力度,加强劳务作业人员安全培训,探索安全生产费用管理模式等。

  15. The development and evaluation of human factors guidelines for the review of advanced human-system interfaces

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.

    1992-09-01

    Advanced control rooms for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are approximately supported in order to protect public health and safety. This paper describes the rationale, general approach, and initial development of an NRC Advanced Control Room Design Review Guideline.

  16. The development and evaluation of human factors guidelines for the review of advanced human-system interfaces

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.M.

    1992-01-01

    Advanced control rooms for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are approximately supported in order to protect public health and safety. This paper describes the rationale, general approach, and initial development of an NRC Advanced Control Room Design Review Guideline.

  17. Influence of music and its genres on respiratory rate and pupil diameter variations in cats under general anaesthesia: contribution to promoting patient safety.

    Science.gov (United States)

    Mira, Filipa; Costa, Alexandra; Mendes, Eva; Azevedo, Pedro; Carreira, L Miguel

    2016-02-01

    The aims of the study were to recognise if there is any auditory sensory stimuli processing in cats under general anaesthesia, and to evaluate changes in respiratory rate (RR) and pupillary diameter (PD) in anaesthetised patients exposed to different music genres, while relating this to the depth of anaesthesia. A sample of 12 cats submitted for elective ovariohysterectomy was exposed to 2 min excerpts of three different music genres (classical [CM], pop [PM] and heavy metal [HM]) at three points during surgery (T1 = coeliotomy; T2 = ligature placement and transection of the ovarian pedicle; T3 = ligature placement and transection of the uterine body). A multiparametric medical monitor was used to measure the RR, and a digital calliper was used for PD measurement. Music was delivered through headphones, which fully covered the patient's ears. P values   music induces RR and PD variations modulated by the genre of music and is associated with autonomic nervous system activity. The use of music in the surgical theatre may contribute to allowing a reduced anaesthetic dose, minimising undesirable side effects and thus promoting patient safety. © ISFM and AAFP 2015.

  18. Guidelines for overcoming hospital managerial challenges: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Crema M

    2013-10-01

    Full Text Available Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Purpose: The need to respond to accreditation institutes' and patients' requirements and to align health care results with increased medical knowledge is focusing greater attention on quality in health care. Different tools and techniques have been adopted to measure and manage quality, but clinical errors are still too numerous, suggesting that traditional quality improvement systems are unable to deal appropriately with hospital challenges. The purpose of this paper is to grasp the current tools, practices, and guidelines adopted in health care to improve quality and patient safety and create a base for future research on this young subject. Methods: A systematic literature review was carried out. A search of academic databases, including papers that focus not only on lean management, but also on clinical errors and risk reduction, yielded 47 papers. The general characteristics of the selected papers were analyzed, and a content analysis was conducted. Results: A variety of managerial techniques, tools, and practices are being adopted in health care, and traditional methodologies have to be integrated with the latest ones in order to reduce errors and ensure high quality and patient safety. As it has been demonstrated, these tools are useful not only for achieving efficiency objectives, but also for providing higher quality and patient safety. Critical indications and guidelines for successful implementation of new health managerial methodologies are provided and synthesized in an operative scheme useful for extending and deepening knowledge of these issues with further studies. Conclusion: This research contributes to introducing a new theme in health care literature regarding the development of successful projects with both clinical risk management and health lean management objectives, and should address solutions for improving health

  19. Postdoctoral program guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina; Liu, Yanli; Ferreira, Summer Rhodes; Biedermann, Laura Butler; Cruz-Campa, Jose Luis; Hall, Lisa Michelle; Liu, Xiaohua H.; Ekoto, Isaac

    2012-04-01

    We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up to five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.

  20. Development of clinical practice guidelines.

    Science.gov (United States)

    Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

    2014-01-01

    Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

  1. EAU guidelines on urinary incontinence.

    Science.gov (United States)

    Thüroff, Joachim W; Abrams, Paul; Andersson, Karl-Erik; Artibani, Walter; Chapple, Christopher R; Drake, Marcus J; Hampel, Christian; Neisius, Andreas; Schröder, Annette; Tubaro, Andrea

    2011-03-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe), more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  2. [EAU Guidelines on Urinary Incontinence].

    Science.gov (United States)

    Thüroff, J W; Abrams, P; Andersson, K-E; Artibani, W; Chapple, C R; Drake, M J; Hampel, C; Neisius, A; Schröder, A; Tubaro, A

    2011-01-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe),more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  3. Occupational safety motivation

    DEFF Research Database (Denmark)

    Pedersen, Louise; Kines, Pete

    2010-01-01

    . At the same time many motivation questionnaire items are seldom founded on theory and/or do not account for the theories’ ontological and epistemological differences, e.g. of how knowledge, attitude and action are related. Present questionnaire items tap into occupational safety motivation in asking whether...... or not respondents ‘are’ motivated and whether they feel that safety is important or worthwhile. Another important aspect is ‘what’ motivates workers to comply to and participate in safety. The aim of this article is to introduce a new theory-based occupational safety motivation scale which is validated......Background: Motivation is one of the most important factors for safety behaviour and for implementing change in general. However, theoretical and psychometric studies of safety performance have traditionally treated safety motivation, safety compliance and safety participation unidimensionally...

  4. Occupational safety motivation

    DEFF Research Database (Denmark)

    Pedersen, Louise; Kines, Pete

    2010-01-01

    . At the same time many motivation questionnaire items are seldom founded on theory and/or do not account for the theories’ ontological and epistemological differences, e.g. of how knowledge, attitude and action are related. Present questionnaire items tap into occupational safety motivation in asking whether...... or not respondents ‘are’ motivated and whether they feel that safety is important or worthwhile. Another important aspect is ‘what’ motivates workers to comply to and participate in safety. The aim of this article is to introduce a new theory-based occupational safety motivation scale which is validated......Background: Motivation is one of the most important factors for safety behaviour and for implementing change in general. However, theoretical and psychometric studies of safety performance have traditionally treated safety motivation, safety compliance and safety participation unidimensionally...

  5. Development of human factors design review guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea)

    1997-10-01

    The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: 25. Human Factors Engineering Program Review Model and 26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation, which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we will update the guidelines by reviewing the literature related to alarm design published after 1994. (author). 12 refs., 5 figs., 2 tabs.

  6. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  7. Regional Guidelines for management of patients absent Without Leave (AWOL)

    OpenAIRE

    Public Health Agency

    2015-01-01

    The overarching purpose of these guidelines is to promote the safety and protection of service users and others in the event of a service user going missing or Absent Without Leave (AWOL). The guidelines provide a framework for all staff when it is determined that a service user is absent without leave.

  8. Emergency Response Guideline Development

    Energy Technology Data Exchange (ETDEWEB)

    Gary D. Storrick

    2007-09-30

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled “Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor” focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design – specifically, the lack of a detailed secondary system design – precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design™ philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I&C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions.

  9. Barrieren der Leitlinienumsetzung und Fortbildungsbedarf von Hausärzten zur Herzinsuffizienz: eine qualitative Studie [Barriers to guideline implementation and educational needs of general practitioners regarding heart failure: a qualitative study

    Directory of Open Access Journals (Sweden)

    Peters-Klimm, Frank

    2012-05-01

    Full Text Available [english] Objectives: A clinical practice guideline (CPG contains specifically developed recommendations that can serve physicians as a decision aid in evidence-based practice. The implementation of heart failure (HF CPGs represents a challenge in general practice. As part of the development of a tailored curriculum, aim of this study was to identify barriers of guideline adherence and needs for medical education (CME in HF care.Methods: We conducted a modified focus group with elements of a workshop of three hours duration. Thirteen GPs collected and discussed together and parallel in smaller groups barriers of guideline implementation. Afterwards they performed a needs assessment for a tailored CME curriculum for chronic HF. The content of the discussions was analysed qualitatively according to Mayring and categorised thematically.Results: Barriers of guideline adherence were found in the following areas: doctor: procedural knowledge (knowledge gaps, communicative and organisational skills (e.g. time management and attitude (dissatisfaction with time-money-relation. Patients: individual case-related problems (multimorbidity, psychiatric comorbidity, expectations and beliefs. Doctor and patient: Adherence and barriers of communication. Main measures for improvement of care concerned the areas of the identified barriers of guideline adherence with the focus on application-oriented training of the abovementioned procedural knowledge and skills, but also the supply of tools (like patient information leaflets and patient education. Conclusion: For a CME-curriculum for HF tailored to the needs of GPs, a comprehensive educational approach seems necessary. It should be broad-based and include elements of knowledge and skills to be addressed and trained case-related. Additional elements should include support in the implementation of organisational processes in the practice and patient education.[german] Zielsetzung: Leitlinien zur Herzinsuffizienz (HI

  10. Guideline for safe and eco-friendly biomass gasification

    Energy Technology Data Exchange (ETDEWEB)

    Vos, J.; Knoef, H. (BTG biomass technology group, Enschede (Netherlands)); Hauth, M. (Graz Univ. of Technology. Institute of Thermal Engineering, Graz (Austria)) (and others)

    2009-11-15

    The objective of the Gasification Guide project is to accelerate the market penetration of small-scale biomass gasification systems (< 5 MW fuel power) by the development of a Guideline and Software Tool to facilitate risk assessment of HSE aspects. The Guideline may also be applied in retrofitting or converting old thermal plants in the Eastern European countries - with rich biomass recourses - to new gasification plants. The objective of this document is to guide key target groups identifying potential hazards and make a proper risk assessment. The software tool is an additional aid in the risk assessment. This guideline is intended to be a training tool and a resource for workers and employers to safely design, fabricate, construct, operate and maintain small-scale biomass gasification facilities. The Guideline is applicable with the following constraints: 1) The maximum scale of the gasification plant was agreed to be about 1 MW{sub e}. The reason is that large companies do have normally their safety rules in place; 2) This means in principle only fixed bed gasifier designs. However, most parts are also valid to other designs and even other thermal conversion processes; 3) The use of contaminated biomass is beyond the scope of this Guideline. The Guideline contains five major chapters; Chapter 2 briefly describes the gasification technology in general. Chapter 3 gives an overview of major legal framework issues on plant permission and operation. The legal frame is changing and the description is based on the situation by the end of 2007. Chapter 4 explains the theory behind the risk assessment method and risk reduction measures. Chapter 5 is the heart of the Guideline and gives practical examples of good design, operation and maintenance principles. The practical examples and feedback have been received throughout the project and the description is based on mid-2009. Chapter 6 describes the best techniques currently available for emission abatement which are

  11. A national guideline for palliative sedation in the Netherlands

    NARCIS (Netherlands)

    Verkerk, Marian; van Wijlick, Eric; Legemaate, Johan; de Graeff, Alexander

    2007-01-01

    The first national guideline on palliative sedation in The Netherlands has been adopted by the General Board of the Royal Dutch Medical Association. By law, the physician is obliged to take this guideline into consideration. In this paper, we present the main principles of the guideline. Palliative

  12. A national guideline for palliative sedation in the Netherlands

    NARCIS (Netherlands)

    Verkerk, Marian; van Wijlick, Eric; Legemaate, Johan; de Graeff, Alexander

    2007-01-01

    The first national guideline on palliative sedation in The Netherlands has been adopted by the General Board of the Royal Dutch Medical Association. By law, the physician is obliged to take this guideline into consideration. In this paper, we present the main principles of the guideline. Palliative

  13. Vaccine Safety

    Science.gov (United States)

    ... Vaccine Safety Shingles (Herpes Zoster) Vaccine Safety Smallpox Vaccine Safety Common Concerns Adjuvants Autism CDC Statement: 2004 Pediatrics Paper on MMR and Autism Fainting (Syncope) Febrile ...

  14. Clinical Practice Guidelines and Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

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

  15. Improved safety at CERN

    CERN Multimedia

    2006-01-01

    As announced in Weekly Bulletin No. 43/2006, a new approach to the implementation of Safety at CERN has been decided, which required taking some managerial decisions. The guidelines of the new approach are described in the document 'New approach to Safety implementation at CERN', which also summarizes the main managerial decisions I have taken to strengthen compliance with the CERN Safety policy and Rules. To this end I have also reviewed the mandates of the Safety Commission and the Safety Policy Committee (SAPOCO). Some details of the document 'Safety Policy at CERN' (also known as SAPOCO42) have been modified accordingly; its essential principles, unchanged, remain the basis for the safety policy of the Organisation. I would also like to inform you that I have appointed Dr M. Bona as the new Head of the Safety Commission until 31.12.2008, and that I will proceed soon to the appointment of the members of the new Safety Policy Committee. All members of the personnel are deemed to have taken note of the d...

  16. EAU guidelines on chronic pelvic pain.

    Science.gov (United States)

    Fall, Magnus; Baranowski, Andrew P; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J; Oberpenning, Frank; de C Williams, Amanda C

    2010-01-01

    These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. To revise guidelines for the diagnosis, therapy, and follow-up of CPP patients. Guidelines were compiled by a working group and based on a systematic review of current literature using the PubMed database, with important papers reviewed for the 2003 EAU guidelines as a background. A panel of experts weighted the references. The full text of the guidelines is available through the EAU Central Office and the EAU Web site (www.uroweb.org). This article is a short version of the full guidelines text and summarises the main conclusions from the guidelines on the management of CPP. A guidelines text is presented including chapters on chronic prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynaecologic practice, neurogenic dysfunctions, the role of the pelvic floor and pudendal nerve, psychological factors, general treatment of CPP, nerve blocks, and neuromodulation. These guidelines have been drawn up to provide support in the management of the large and difficult group of patients suffering from CPP.

  17. Cryogenic safety organisation at CERN

    CERN Document Server

    CERN. Geneva

    2016-01-01

    With Safety being a top priority of CERN’s general policy, the Organisation defines and implements a Policy that sets out the general principles governing Safety at CERN. To the end of the attainment of said Safety objectives, the organic units (owners/users of the equipment) are assigned the responsibility for the implementation of the CERN Safety Policy at all levels of the organization, whereas the Health and Safety and Environmental Protection Unit (HSE) has the role of providing assistance for the implementation of the Safety Policy, and a monitoring role related to the implementation of continuous improvement of Safety, compliance with the Safety Rules and the handling of emergency situations. This talk will elaborate on the roles, responsibilities and organisational structure of the different stakeholders within the Organization with regards to Safety, and in particular to cryogenic safety. The roles of actors of particular importance such as the Cryogenic Safety Officers (CSOs) and the Cryogenic Sa...

  18. Challenges and guidelines for clinical trial of herbal drugs

    Directory of Open Access Journals (Sweden)

    Abida Parveen

    2015-01-01

    Full Text Available World Health Organization (WHO has defined herbal medicines as finished labeled medicinal product that contain an active ingredient, aerial, or underground parts of the plant or other plant material or combinations. According to a report of WHO, about 80% of the world population is reported to rely on traditional medicine for their primary health care needs. Even in the developed countries, complementary or alternative medicine is gaining popularity. A report of a global survey on national policy on traditional medicine and regulation of herbal medicines indicated that about 50 countries including China, Japan, and Germany already have their national policy and laws on regulations of traditional medicines. Herbal drugs possess a long history of its use and better patient tolerance. These are cheaper and easily available in countries like India due to rich agro culture conditions. However, reckless utilization of resources threatens the sustainability of several plant species. Traditional medicines are governed by the Drugs and Cosmetics Act of 1940 and the Drugs and Cosmetics Rules of 1945. In 1959, the Government of India amended the Drugs and Cosmetics Act to include drugs that are derived from traditional Indian medicine. In 1993, the guidelines for the safety and efficacy of herbal medicines developed by an expert committee directed that the procedures laid down by the office of the Drug Controller General of India for allopathic drugs should be followed for all traditional and herbal products to enter into clinical trials for any therapeutic condition. However, there are certain loop holes in the clinical trials of herbal drugs as the lack of stringent bylaws and regulations. Hence, a deep insight of important challenges and major regulatory guidelines for clinical trial of herbal drugs and botanicals is discussed in the present communication. There is lack of scientific evidence to evaluate safety and efficacy of herbal drugs. The quality

  19. Hurricane Safety

    Science.gov (United States)

    ... English Hurricane Safety Checklist - Arabic Hurricane Safety Checklist - Chinese Hurricane Safety Checklist - French Hurricane Safety Checklist - Haitian ... Cross serves in the US, its territories and military installations around the world. Please try again. Your ...

  20. Model-based Derivation of the Safety Operating Limits of a Semi-batch Reactor for the Catalytic Acetoacetylation of Pyrrole Using a Generalized Sensitivity Criterion

    OpenAIRE

    Maria, G; A Dan; Stefan, D.-N.

    2010-01-01

    The safe operation of a semi-batch catalytic reactor remains a sensitive issue when highly exothermic side reactions may occur, and various elements such as controllability, stability, safety, and economic aspects have to be considered in the process development. Nominal operating conditions are set to avoid excessive thermal sensitivity to variations in the process parameters. Several shortcuts or model-based methods are used to estimate the safety limits and runaway boundaries for the op...

  1. Neighborhood safety factors associated with older adults' health-related outcomes: A systematic literature review.

    Science.gov (United States)

    Won, Jaewoong; Lee, Chanam; Forjuoh, Samuel N; Ory, Marcia G

    2016-09-01

    Neighborhood safety is important for older adults' health and wellbeing, but there has not been a synthesis in the literature of what is currently known about this construct. This systematic literature review, following the PRISMA guidelines, focuses on identifying neighborhood safety factors associated with health-related outcomes and behaviors of older adults in the U.S. A search was conducted in 2014 via Academic Search Complete, CINAHL, Embase, MEDLINE, SportDis, and Transportation Databases. Based on our inclusion and exclusion criteria, we identified thirty-two articles for review. Sixteen studies examined health outcomes such as health status, mental health, physical function, morbidity/mortality, and obesity; the other sixteen studies focused on health behaviors, such as physical activity and walking. Four domains of neighborhood safety were identified: overall/general neighborhood safety; crime-related safety; traffic-related safety; and proxies for safety (e.g., vandalism, graffiti). Overall/general neighborhood safety appeared most relevant to mental health and physical function. Traffic-related safety was most pertinent to physical activity, while crime-related safety was more consistently associated with mental health and walking. While all safety variables were significantly associated with mental health, no significant associations were found for obesity. We also found that specific measures or constructs of safety were not applied consistently across the examined studies, making it difficult to compare the results. This review identified several important gaps in the existing studies dealing with neighborhood safety-health relationships among older adults. Further studies are needed that examine the different roles of multidimensional neighborhood safety in promoting the community health, not only in the U.S., but globally. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. The changing Chinese SEA indicator guidelines

    DEFF Research Database (Denmark)

    Gao, Jingjing; Christensen, Per; Kørnøv, Lone

    2014-01-01

    In the last decades China has introduced a set of indicators to guide their Strategic Environmental Assessment (SEA) practice. The most recent indicator system, proposed in 2009, is based on sector-specific guidelines and it found its justification in past negative experiences with more general...... guidelines (from 2003), which were mostly inspired by, or copied from, international experiences. Based on interviews with practitioners, researchers and administrators, we map and analyse the change in the national guidelines. This analysis is based on a description of the indicators that makes it possible...... to discern different aggregation levels of indicators and then trace the changes occurring under two sets of guidelines. The analysis also reveals the reasons and rationales behind the changes found in the guidelines. This analysis is inspired by implementation theory and a description of some of the more...

  3. Safety analysis for `Fugen`

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The improvement of safety in nuclear power stations is an important proposition. Therefore also as to the safety evaluation, it is important to comprehensively and systematically execute it by referring to the operational experience and the new knowledge which is important for the safety throughout the period of use as well as before the construction and the start of operation of nuclear power stations. In this report, the results when the safety analysis for ``Fugen`` was carried out by referring to the newest technical knowledge are described. As the result, it was able to be confirmed that the safety of ``Fugen`` has been secured by the inherent safety and the facilities which were designed for securing the safety. The basic way of thinking on the safety analysis including the guidelines to be conformed to is mentioned. As to the abnormal transient change in operation and accidents, their definition, the events to be evaluated and the standards for judgement are reported. The matters which were taken in consideration at the time of the analysis are shown. The computation programs used for the analysis were REACT, HEATUP, LAYMON, FATRAC, SENHOR, LOTRAC, FLOOD and CONPOL. The analyses of the abnormal transient change in operation and accidents are reported on the causes, countermeasures, protective functions and results. (K.I.)

  4. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

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

  5. Human Resources Development and Technical Cooperation - pursue safer operation. Directorate General of Mines Safety Training Program Australia - India, 1997-2001

    Energy Technology Data Exchange (ETDEWEB)

    Rowan, G. [CSIRO (Australia)

    2002-09-01

    This paper details the project, which was performed under the Memorandum of Understanding 'Agreement on Development Cooperation between India and Australia' signed in 1990. In its initial phase the objective was to review the existing procedures and practices in mine safety in India and to update these based on contemporary practices in a country employing more advanced mining technology - Australia. Other objectives were to expose Indian Mines Inspectors to mining conditions and practices in Australia to mining conditions and practices in Australia, and to train a number of inspectors in managing mine safety using techniques which render operators responsible for the health and safety of mineworkers in individual mines. The project summary section of this paper details the initial and expanded objectives of the project as well as the achieved outcomes. It further details several key findings and recommendations for organizations considering entering into similar projects. 1 fig., 6 tabs., 1 annex.

  6. User systems guidelines for software projects

    Energy Technology Data Exchange (ETDEWEB)

    Abrahamson, L. (ed.)

    1986-04-01

    This manual presents guidelines for software standards which were developed so that software project-development teams and management involved in approving the software could have a generalized view of all phases in the software production procedure and the steps involved in completing each phase. Guidelines are presented for six phases of software development: project definition, building a user interface, designing software, writing code, testing code, and preparing software documentation. The discussions for each phase include examples illustrating the recommended guidelines. 45 refs. (DWL)

  7. Safety objectives for 2014

    CERN Multimedia

    HSE Unit

    2014-01-01

    This is the third year in which the CERN Management has presented annual safety objectives for the Organization, the “HSE Objectives”.   The HSE objectives for 2014, which were announced by the Director-General at his traditional New Year’s address to the staff and were presented at the first Enlarged Directorate meeting of the year, have been drawn up and agreed in close collaboration between the DSOs, the HSE Unit and the DG himself. From safety in the workplace to radiation and environmental protection, the document emphasises that “Safety is a priority for CERN” and that safety policy is a key element in how the Organization is run. And, like all policies, it generates objectives that “serve as a general framework for action”. The HSE objectives are broken down into the following fields: occupational health and safety on sites and in the workplace, radiation protection, radiation safety, environmental protection, emerge...

  8. After Guidelines, What?

    Directory of Open Access Journals (Sweden)

    Dennis M Bowie

    2004-01-01

    Full Text Available In a recent survey, Canadian Thoracic Society (CTS members indicated that they feel our association should be involved in the production of guidelines (1. There is evidence in the literature that suggests guidelines can have some effect in changing behaviour, although this is variable and modest at best. Certainly, the production of guidelines is not without costs, particularly in time spent by experts in reviewing the literature and producing them. For good reasons, delays frequently occur in their production, often leading to recommendations that may be outdated. People sometimes forget that one of the most important reasons for producing guidelines is to identify questions that require future research.

  9. [Guidelines for the management of human resources].

    Science.gov (United States)

    Charbonnier, E; Vaubourdolle, M; Pernet, P; Gerrier, F

    2013-06-01

    The management of human resources is a major issue for laboratory accreditation, since it allows to show the proofs of competency assessment, a basis to ensure the confidence. In this paper, the main processes involved are described: the general process for the management of human resources and the authorization for personnel process. Guidelines for document control are also proposed. At least, examples are given to facilitate the implementation of these guidelines in a medical laboratory.

  10. Clinical Practice Guidelines for Cerebral Abscess Treatment

    Directory of Open Access Journals (Sweden)

    Danny Barrueta Reyes

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Cerebral Abscess Treatment. It has been defined as a festering process caused by any germ and placed inside the cerebral parenchyma; this is a diagnostic and therapeutic challenge for surgeons and general doctors since the clinical and radiological manifestations are often imprecise. This document describes its etiological agents, clinical presentation, diagnosis and treatment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  11. Research on dynamics mechanism and mode of general aviation safety management system self-organizing evolvement%通用航空安全体系自组织演化动力学机制与模式研究

    Institute of Scientific and Technical Information of China (English)

    许红军; 田俊改

    2012-01-01

    建立符合通用航空发展规律的通用航空安全管理理论体系,是通用航空发展的前提.本文以通用航空发展特点为基础,应用自组织理论对通用航空发展的组织特性进行了分析,研究了通用航空安全体系自组织生成模式的前提条件和动因,剖析了通用航空安全体系自组织演化的内外部动力因素,以及其相互作用方式和过程,从而解构出通用航空安全体系自组织演化的动力学机制—涨落机制、创新机制、选择机制和学习机制,在此基础上,构建了通用航空安全体系自组织演化动力学模型.最后,结合实际对我国通用航空安全管理体系建设提出了相应的建议.%To establish a comprehensive and effective safety management system is a prerequisite for sustainable development of general aviation. In this paper,based on self-organizing theory, the organization characters of general aviation were analyzed. Then, the prerequisite for general aviation safety management system evolvement was studied and the exterior and interior dynamics factors which drive the self-organizing evolvement of general aviation safety management system were analyzed, as well as their interaction mechanism and process, thereby the dynamics mechanism of the general aviation safety management system evolvement were deconstructed which included fluctuating mechanism, invocation mechanism, choosing mechanism and learning mechanism. Finally, some suggestions were put forward to develop the general aviation safety management system.

  12. Safety aspects of nuclear waste disposal in space

    Science.gov (United States)

    Rice, E. E.; Edgecombe, D. S.; Compton, P. R.

    1981-01-01

    Safety issues involved in the disposal of nuclear wastes in space as a complement to mined geologic repositories are examined as part of an assessment of the feasibility of nuclear waste disposal in space. General safety guidelines for space disposal developed in the areas of radiation exposure and shielding, containment, accident environments, criticality, post-accident recovery, monitoring systems and isolation are presented for a nuclear waste disposal in space mission employing conventional space technology such as the Space Shuttle. The current reference concept under consideration by NASA and DOE is then examined in detail, with attention given to the waste source and mix, the waste form, waste processing and payload fabrication, shipping casks and ground transport vehicles, launch site operations and facilities, Shuttle-derived launch vehicle, orbit transfer vehicle, orbital operations and space destination, and the system safety aspects of the concept are discussed for each component. It is pointed out that future work remains in the development of an improved basis for the safety guidelines and the determination of the possible benefits and costs of the space disposal option for nuclear wastes.

  13. Survey on nurses’ attitude to safety culture of hospital patients in general hospitals of Nantong city%南通市综合医院护士的病人安全文化态度调查

    Institute of Scientific and Technical Information of China (English)

    徐旭娟; 单君; 吴娟

    2015-01-01

    Objective:To investigate status quo of clinical nursings’ attitude to safety culture of hospital pa‐tients ,to provide the reference for targeted safety education for clinical nursing .Methods:A total of 1 953 nurses (working time >3 months) who had practice certificates in 5 general hospitals of Nantong received the survey by using the patient safety culture assessment questionnaire w hich w as constructed by Chen Fanglei ect .Re‐sults:The clinical nurses’ attitude to the patients safety culture was overall positive .There were statistically sig‐nificant differences in the scores of attitude to patient safety culture between different ages ,the level of the hos‐pital ,the title ,the time of nursing work of nurses and whether they has received a safety culture training or not (P<0 .05) .Conclusion:Hospitals should strengthen the safety culture education of low seniority nurses ,Second grade hospital needs to further improve their working conditions and take corresponding measures to improve nurses’ cognition level of patient safety culture ,to ensure the safety of patients .%[目的]调查南通市临床护理人员对医院病人安全文化态度现状,为针对性地对临床护理人员进行安全教育提供参考。[方法]采用病人安全文化测评问卷对南通市5所综合性医院具有执业证书的1953名护士(工作时间>3个月)进行问卷调查。[结果]南通市临床护士对病人安全文化态度总体比较积极。不同年龄、就职医院等级、职称、从事护理工作时间及是否接受过安全文化培训护士对病人安全文化态度总分比较差异有统计学意义(P<0.05)。[结论]医院应加强对低年资护士的安全文化教育,二级医院需要进一步改善工作条件,采取相应措施提高护士安全文化认知水平,保障病人安全。

  14. Guidelines for resident teaching experiences.

    Science.gov (United States)

    Havrda, Dawn E; Engle, Janet P; Anderson, Keri C; Ray, Shaunta' M; Haines, Seena L; Kane-Gill, Sandra L; Ballard, Stephanie L; Crannage, Andrew J; Rochester, Charmaine D; Parman, Malinda G

    2013-07-01

    Postgraduate year one (PGY1) and postgraduate year two (PGY2) residencies serve to develop pharmacists into skillful clinicians who provide advanced patient-centered care in various general and specialized areas of pharmacy practice. Pharmacy residencies are a minimum requirement for many clinical pharmacy positions, as well as for positions in academia. The role of clinical pharmacists typically includes teaching, regardless of whether they pursue an academic appointment. Common teaching duties of pharmacist-clinicians include giving continuing education or other invited presentations, providing education to colleagues regarding clinical initiatives, precepting pharmacy students (early and advanced experiences) and residents, and educating other health care professionals. Although ASHP provides accreditation standards for PGY1 and PGY2 residencies, the standards pertaining to teaching or education training are vague. Through the years, teaching certificate programs that develop residents' teaching skills and better prepare residents for a diverse pharmacy job market have increased in popularity; moreover, teaching certificate programs serve as an attractive recruitment tool. However, the consistency of requirements for teaching certificate programs is lacking, and standardization is needed. The Task Force on Residencies developed two sets of guidelines to define teaching experiences within residencies. The first guideline defines the minimum standards for teaching experiences in any residency-training program. The second guideline is for programs offering a teaching certificate program to provide standardization, ensuring similar outcomes and quality on program completion. One of the main differences between the guidelines is the recommendation that residency programs offering a teaching certificate program be affiliated with an academic institution to provide the pedagogy and variety of teaching experiences for the resident. Residency program directors should

  15. 上海市浦东新区公立综合性医院病人安全氛围评价%Evaluation on patient safety climate in public general hospitals in Pudong New Area of Shanghai

    Institute of Scientific and Technical Information of China (English)

    蔡美玉; 顾建钧; 贺晓燕; 俞步青; 孙昕; 周萍; 廖兴斌; 薛迪

    2015-01-01

    目的:评价上海市浦东新区区属公立综合性医院的病人安全氛围。方法:采用病人安全氛围测评量表,对浦东新区7家综合性医院1353位员工进行问卷调查。结果:员工对医院病人安全氛围总体评价良好,但对不害怕受羞辱、不害怕受责备、未见不良结果维度的评价较低,管理者和受过质控培训的员工评价较高。结论:医院应加强医院病人安全文化的建设,避免医疗差错重复发生。%Objective:The study aims to evaluate the patient safety climate in public general hospitals in Pudong New Area of Shanghai. Methods:Questionnaire survey of 1 353 employees in seven public general hospitals of Pudong New Area was conducted. An assessment tool for patient safety climate was used. Results:Overall,the perception of employees on patient safety climate was positive,but the perceptions of employees on“not fear of shame”,“not fear of blame”and“no adverse outcomes”dimensions were negative. In addition,the hospital managers and the employees who had got training on quality control had more positive perception on patient safety climate. Conclusion:Hospitals should construct patient safety culture to avoid repeated medical errors.

  16. Driver support systems and traffic safety : theoretical considerations. On behalf of the Directorate-General of Public Works and Water Management, Transport Research Centre AVV.

    NARCIS (Netherlands)

    Kuiken, M.J. & Heijer, T.

    1996-01-01

    This report provides an overview of possible approaches, when considering driver support and traffic safety. The assessment of driver support systems should address potential problems in relation to the environment, the driver, and the driving task. Assessment procedures should focus on potential er

  17. The effect of orthodontic referral guidelines: A randomised controlled trial

    OpenAIRE

    Conboy, Frances; O'Brien, K.

    2000-01-01

    Objective To develop and evaluate the effectiveness of referral guidelines for the referral of orthodontic patients to consultant and specialist practijioner orthodontists. Design Single centre randomised controlled trial with random allocation of referral guidelines for orthodontic treatment to general dental practitioners. Setting Hospital orthodontic departments and specialist orthodontic practices in Manchester and Stockport. Subjects General dental practitioners and the patients they ref...

  18. How meaningful are risk determinations in the absence of a complete dataset? Making the case for publishing standardized test guideline and ‘no effect’ studies for evaluating the safety of nanoparticulates versus spurious ‘high effect’ results from single investigative studies

    Science.gov (United States)

    Warheit, David B.; Donner, E. Maria

    2015-06-01

    A recent review article critically assessed the effectiveness of published research articles in nanotoxicology to meaningfully address health and safety issues for workers and consumers. The main conclusions were that, based on a number of flaws in study designs, the potential risk from exposures to nanomaterials is highly exaggerated, and that no ‘nano-specific’ adverse effects, different from exposures to bulk particles, have been convincingly demonstrated. In this brief editorial we focus on a related tangential issue which potentially compromises the integrity of basic risk science. We note that some single investigation studies report specious toxicity findings, which make the conclusions more alarming and attractive and publication worthy. In contrast, the standardized, carefully conducted, ‘guideline study results’ are often ignored because they can frequently report no adverse effects; and as a consequence are not considered as novel findings for publication purposes, and therefore they are never considered as newsworthy in the popular press. Yet it is the Organization for Economic Cooperation and Development (OECD) type test guideline studies that are the most reliable for conducting risk assessments. To contrast these styles and approaches, we present the results of a single study which reports high toxicological effects in rats following low-dose, short-term oral exposures to nanoscale titanium dioxide particles concomitant with selective investigative analyses. Alternatively, the findings of OECD test guideline 408, standardized guideline oral toxicity studies conducted for 90 days at much higher doses (1000 mg kg-1) in male and female rats demonstrated no adverse effects following a very thorough and complete clinical chemical, as well as histopathological evaluation of all of the relevant organs in the body. This discrepancy in study findings is not reconciled by the fact that several biokinetic studies in rats and humans demonstrate little or

  19. Subjective safety in traffic.

    NARCIS (Netherlands)

    2012-01-01

    The term ‘subjective safety in traffic’ refers to people feeling unsafe in traffic or, more generally, to anxiety regarding being unsafe in traffic for oneself and/or others. Subjective safety in traffic can lead to road users limiting their mobility and social activities, which is one of the

  20. Subjective safety in traffic.

    NARCIS (Netherlands)

    2012-01-01

    The term ‘subjective safety in traffic’ refers to people feeling unsafe in traffic or, more generally, to anxiety regarding being unsafe in traffic for oneself and/or others. Subjective safety in traffic can lead to road users limiting their mobility and social activities, which is one of the reason

  1. The impact of the instrumentation and control systems in the safety of a nuclear plant: a general vision; El impacto de los sistemas de instrumentacion y control en la seguridad de una planta nuclear: una vision general

    Energy Technology Data Exchange (ETDEWEB)

    Celis del Angel, L.; Rivero, T., E-mail: lina.celis@inin.gob.mx [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2011-11-15

    One of the fundamental components so much for the sure operation, like in emergency cases or accident are the equipment s and instrumentation and control systems. The nuclear industry has had some accidents where the instrumentation and control have played and important part: a wrong design, instrumentation lack, faulty systems of safety, etc. At the present time the necessity to modernize the instrumentation and control in a nuclear power plant is before the challenge of finding innovative forms to improve the competitiveness and readiness, reducing operation costs without put ing in risk the safety and reliability of the nuclear power plant. Most of the nuclear power plants require actualizing their instrumentation and control systems, here the digital systems represent a great alternative, improving the performance and the safety, increasing the readiness and reducing the maintenance s. However they require of strict tests that allow assuring their application in critical systems. It is also necessary, the development of modernization programs that allow the programmed substitution of the systems without affecting the readiness of the nuclear power plants. During this whole modernization process will be necessary to put special attention in the cyber-safety because the attacks every time they are more elaborated. Therefore will be necessary to go toward the modernization of the instrumentation and control with the challenge of making without detriment some in the safety of the normal operation and with response reliability in emergency conditions or accident that which represents an effort that should not be postponed in the case of the nuclear power plant of Laguna Verde. (Author)

  2. [Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

    Science.gov (United States)

    Planjar-Prvan, Miljenka; Granić, Davorka

    2005-01-01

    The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

  3. Engineering Technology Curriculum Guidelines

    Science.gov (United States)

    Gershon, J. J.

    1977-01-01

    Summarizes curriculum guidelines for the following engineering technologies: chemical, industrial, mining, petroleum, nuclear, civil, mechanical, electrical, automotive, and manufacturing. In a few years, these Engineering Council for Professional Development committee guidelines are intended to become the criteria by which programs will be judged…

  4. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-01

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

  5. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-01

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

  6. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

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

  7. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

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

  8. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

    2015-01-01

    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  9. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

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

  10. NASA Aerospace Flight Battery Program: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries; Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries; Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop). Volume 2, Part 1

    Science.gov (United States)

    Manzo, Michelle A.; Brewer, Jeffrey C.; Bugga, Ratnakumar V.; Darcy, Eric C.; Jeevarajan, Judith A.; McKissock, Barbara I.; Schmitz, Paul C.

    2010-01-01

    This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This report contains the Appendices to the findings from the first year of the program's operations.

  11. An Evaluation Methodology Development and Application Process for Severe Accident Safety Issue Resolution

    Directory of Open Access Journals (Sweden)

    Robert P. Martin

    2012-01-01

    Full Text Available A general evaluation methodology development and application process (EMDAP paradigm is described for the resolution of severe accident safety issues. For the broader objective of complete and comprehensive design validation, severe accident safety issues are resolved by demonstrating comprehensive severe-accident-related engineering through applicable testing programs, process studies demonstrating certain deterministic elements, probabilistic risk assessment, and severe accident management guidelines. The basic framework described in this paper extends the top-down, bottom-up strategy described in the U.S Nuclear Regulatory Commission Regulatory Guide 1.203 to severe accident evaluations addressing U.S. NRC expectation for plant design certification applications.

  12. Current safety practices in nano-research laboratories in China.

    Science.gov (United States)

    Zhang, Can; Zhang, Jing; Wang, Guoyu

    2014-06-01

    China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

  13. 21 CFR 104.5 - General principles.

    Science.gov (United States)

    2010-04-01

    ... requirements of the nutritional quality guideline established for its class of food may state “This product... meeting the requirements of the applicable nutritional quality guideline, shall comply with the following... CONSUMPTION NUTRITIONAL QUALITY GUIDELINES FOR FOODS General Provisions § 104.5 General principles. (a) A...

  14. Undertreatment of urinary incontinence in general practice.

    NARCIS (Netherlands)

    Penning-van Beest, F.J.A.; Sturkenboom, M.C.; Bemelmans, B.L.H.; Herings, R.M.C.

    2005-01-01

    BACKGROUND: In the urinary incontinence guidelines that are issued by the Dutch College of General Practitioners, treatment guidelines are related to the type of incontinence. It is unknown whether treatment of urinary incontinence in general practice complies with these guidelines. OBJECTIVE: To de

  15. Contemporary views of dental practitioners' on patient safety.

    Science.gov (United States)

    Bailey, E

    2015-12-01

    There is little known about general dental practitioners' (GDPs) views on patient safety in dentistry; we believe this to be the first paper describing their opinions and ideas for maintaining or improving safe practices. Focus groups were used to gather the views of 12 GDPs (who also hold university teaching contracts) on the following topics: Defining patient safety, the important issues in patient safety, safeguards and tools for maintaining safe care, never events and research priorities. Thematic analysis was performed on the verbatim transcripts. Key themes from the practitioners included: Medical history (polypharmacy and co-morbidities), competence and skill level, the use of safeguards and tools to ensure safety, the importance of effective communication (including working with a chaperone) and the role of reflective practice. Suggestions for improvement included: effective sharing of information with other healthcare professionals, easy access to guidelines and educational tools, adoption of practice protocols, team working and the use of universal charting systems to limit ambiguity. GDPs are well versed in the concept of patient safety and are keen to implement evidence based tools and/or interventions designed to improve safety for their patients.

  16. The safety experience of New Zealand adventure tourism operators.

    Science.gov (United States)

    Bentley, Tim A; Page, Stephen; Walker, Linda

    2004-01-01

    This survey examined parameters of the New Zealand adventure tourism industry client injury risk. The research also sought to establish priorities for intervention to reduce adventure tourism risk, and identify client injury control measures currently in place (or absent) in the New Zealand adventure tourism industry, with a view to establishing guidelines for the development of effective adventure tourism safety management systems. This 2003 survey builds upon an exploratory study of New Zealand adventure tourism safety conducted by us during 1999. A postal questionnaire was used to survey all identifiable New Zealand adventure tourism operators. The questionnaire asked respondents about their recorded client injury experience, perceptions of client injury risk factors, safety management practices, and barriers to safety. Some 27 adventure tourism activities were represented among the responding sample (n=96). The highest client injury risk was reported in the snow sports, bungee jumping and horse riding sectors, although serious underreporting of minor injuries was evident across the industry. Slips, trips and falls (STF) were the major client injury mechanisms, and a range of risk factors for client injuries were identified. Safety management measures were inconsistently applied across the industry. The industry should consider the implications of poor injury reporting standards and safety management practices generally. Specifically, the industry should consider risk management that focuses on minor (e.g., STF) as well as catastrophic events.

  17. Pediatric safety pin ingestion.

    Science.gov (United States)

    Sarihan, H; Kaklikkaya, I; Ozcan, F

    1998-08-01

    Fifteen consecutive children with ingested safety pins were evaluated retrospectively. Eight patients were males and seven were girls. The mean age of the patients was 5.4 years ranging from 7 months to 16 years. Two of 15 patients were mentally retarded Seven safety pins ingestion were noted by parents, three older children applied with safety pin swallowing. Three infants referred with hypersalivation and swallowing difficulty. One of two mentally retarded patients had recurrent aspiration pneumonia, the other had neck abscess. These patients' lesions were detected incidentally by thoracic X-ray. Nine safety pins were at the level of the cricopharyngeus, one at the level of the aortic arch and five at the esophagogastric junction. A right esophagoscopy was used for extraction of safety pins under general anesthesia and endotracheal intubation were used. Before esophagoscopy control plain X-ray was obtained for location of safety pin. Nine safety pins were extracted by esophagoscopy. Three safety pins spontaneously and three during anesthesia induction passed through the esophagus falling down the stomach. Five of these six safety pins were spontaneously extracted without complication. However one open safety pin lodged at the duodenum and laparotomy was required. In this article, etiology and management of safety pin ingestion in children are discussed.

  18. Workshop presentation: research guidelines for Construction Management

    Directory of Open Access Journals (Sweden)

    Marco Alvise Bragadin

    2013-10-01

    Full Text Available Nowadays the European economic system challenges the construction sector to take part to industrial recovery of western countries. In co-operation with the Construction Production research group of the Tampere University of of research about construction management tools and methods were detected. Research guidelines: 1 Construction management: tools and methods to manage construction projects 2 environmental impact of construction projects 3 construction management and safety 4 project procurement 5 construction management for major public works & complex projects

  19. Workshop presentation: research guidelines for Construction Management

    OpenAIRE

    Marco Alvise Bragadin

    2013-01-01

    Nowadays the European economic system challenges the construction sector to take part to industrial recovery of western countries. In co-operation with the Construction Production research group of the Tampere University of of research about construction management tools and methods were detected. Research guidelines: 1) Construction management: tools and methods to manage construction projects 2) environmental impact of construction projects 3) construction management and safety 4) project p...

  20. Food safety concerns of fast food consumers in urban Ghana.

    Science.gov (United States)

    Omari, Rose; Frempong, Godfred

    2016-03-01

    In Ghana, out-of-home ready-to-eat foods including fast food generally have been associated with food safety problems. Notwithstanding, fast food production and consumption are increasing in Ghana and therefore this study sought to determine the food safety issues of importance to consumers and the extent to which they worry about them. First, through three focus group discussions on consumers' personal opinions about food safety issues, some emergent themes were obtained, which were used to construct an open-ended questionnaire administered face-to-face to 425 respondents systematically sampled from 20 fast food restaurants in Accra. Findings showed that most fast food consumers were concerned about food hazards such as pesticide residue in vegetables, excessive use of artificial flavour enhancers and colouring substances, bacterial contamination, migrated harmful substances from plastic packages, and general unhygienic conditions under which food is prepared and sold. Consumers also raised concerns about foodborne diseases such as cholera, typhoid, food poisoning, diarrhoea, bird flu and swine flu. The logistic regression model showed that being male increased the likelihood of worrying about general food safety issues and excessive use of flavour enhancers than in females while being youthful increased the likelihood of being worried about typhoid fever than in older consumers. These findings imply that consumers in urban Ghana are aware and concerned about current trends of food safety and foodborne disease challenges in the country. Therefore, efforts targeted at improving food safety and reducing incidences of foodborne diseases should not only focus on public awareness creation but should also design more comprehensive programmes to ensure the making of food safety rules and guidelines and enforcing compliance to facilitate availability and consumers' choice of safe foods.

  1. Safety culture

    Energy Technology Data Exchange (ETDEWEB)

    Keen, L.J. [Canadian Nuclear Safety Commission, Ottawa, Ontario (Canada)

    2003-07-01

    Safety culture has become a topic of increasing interest for industry and regulators as issues are raised on safety problems around the world. The keys to safety culture are organizational effectiveness, effective communications, organizational learning, and a culture that encourages the identification and resolution of safety issues. The necessity of a strong safety culture places an onus on all of us to continually question whether the safety measures already in place are sufficient, and are being applied. (author)

  2. Guidelines for Posting Soil Contamination Areas

    Energy Technology Data Exchange (ETDEWEB)

    Mcnaughton, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Eisele, William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-02-01

    All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.

  3. Safety assessment for a KBS-3H spent nuclear fuel repository at Olkiluoto. Complementary evaluations of safety

    Energy Technology Data Exchange (ETDEWEB)

    Neall, Fiona; Pastina, Barbara; Snellman, Margit; Smith, Paul; Gribi, P.; Johnson, Lawrence

    2008-12-15

    The KBS-3H design is a variant of the more general KBS-3 method for the geological disposal of spent nuclear fuel in Finland and Sweden. In the KBS-3H design, multiple assemblies containing spent fuel are emplaced horizontally in parallel, approximately 300 m long, slightly inclined deposition drifts. The copper canisters, each with a surrounding layer of bentonite clay, are placed in perforated steel shells prior to deposition in the drifts; the assembly is called the 'supercontainer'. The other KBS-3 variant is the KBS-3V design, in which the copper canisters are emplaced vertically in individual deposition holes surrounded by bentonite clay but without steel supercontainer shells. SKB and Posiva have conducted a Research, Development and Demonstration programme over the period 2002-2007 with the overall aim of establishing whether KBS-3H represents a feasible alternative to KBS-3V. As part of this programme, the long-term safety of a KBS-3H repository has been assessed in the KBS-3H safety studies. In order to focus the safety studies, the Olkiluoto site in the municipality of Eurajoki, which is the proposed site for a spent fuel repository in Finland, was used as a hypothetical site for a KBS-3H repository. The present report is part of a portfolio of reports discussing the long-term safety of the KBS-3H repository. The overall outcome of the KBS-3H safety studies is documented in the summary report, 'Safety assessment for a KBS-3H repository for spent nuclear fuel at Olkiluoto'. The purpose and scope of the KBS-3H complementary evaluations of safety report is provided in Posiva's Safety Case Plan, which is based on Regulatory Guide YVL 8.4 and on international guidelines on complementary lines of argument to long-term safety that are considered an important element of a post-closure safety case for geological repositories. Complementary evaluations of safety require the use of evaluations, evidence and qualitative supporting arguments

  4. Pharmacovigilance as a tool for safety and monitoring: a review of general issues and the specific challenges with end-stage renal failure patients

    Directory of Open Access Journals (Sweden)

    Jacob D

    2013-04-01

    Full Text Available Dalia Jacob,1 Belén Marrón,2 Jay Ehrlich,1 Peter A Rutherford3 1Baxter Healthcare Corporation, Deerfield, IL, USA; 2Baxter Healthcare Corporation, Madrid, Spain; 3Baxter Healthcare SA, Zurich, Switzerland Abstract: Pharmacovigilance is instrumental in helping to ensure patient safety for both newly released drugs and those that are well established in the market. However, while pharmacovigilance procedures are strictly regulated in the clinical trial setting, post-marketing adverse event reporting is not well implemented or enforced. As such, the underreporting of adverse events, in relation to drugs that are on the market, is estimated to be in the region of 90%. The identification of drug safety issues in patients with complex diseases and extensive comorbidities is therefore particularly challenging. Dialysis patients – those with end-stage renal disease and often other comorbidities such as diabetes, hypertension, and cardiovascular disease – are a population with significant treatment challenges. Patients receive dialysis using complex medical devices (eg, a peritoneal dialysis home cycler and also receive a range of pharmaceutical agents as part of dialysis itself (eg, peritoneal dialysis solutions. Many of the pharmaceutical agents used to treat these patients have been developed in populations without these complications and, therefore, an extensive knowledge of potential problems and contraindications in the dialysis population is lacking. It is important that the nephrology community understands the concept of pharmacovigilance – the pharmacologic science relating to the detection, assessment, understanding, and prevention of adverse effects, particularly long-term and short-term side effects, of medicines. Health care professionals (HCPs and providers, pharmaceutical companies, global regulatory agencies, and the patients themselves all play unique and critical roles in this process. This review defines the science of

  5. Tank farm health and safety plan. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Mickle, G.D.

    1995-03-29

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, {open_quotes}Health and Safety Programs for Hazardous Waste Operations;{close_quotes} 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved.

  6. Microsurgical techniques for experimental kidney transplantation and general guidelines to establish studies about transplantation immunology Técnicas microcirúrgicas para transplante renal experimental e condutas para estabelecer experimentos sobre imunologia do transplante

    OpenAIRE

    Paulo Ney Aguiar Martins; Alexander Filatenkov

    2003-01-01

    Experimental models of organ transplantation played a crucial role to establish the principles of transplantation immunology. The renal transplantation in rodents became the most used model to study the mechanisms of allograft rejection. To perform it, it is necessary to master the microsurgery techniques and the research group should cooperate with other specialists in the field. In this article we review the surgical techniques employed in rats, and we draw guidelines to establish studies a...

  7. Safety advice sheets

    CERN Multimedia

    HSE Unit

    2013-01-01

    You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to general-safety-visits.service@cern.ch.

  8. [Guidelines for the management of dyslipidemia].

    Science.gov (United States)

    Díaz Rodríguez, Ángel

    2014-09-01

    The AHA/ACC 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) in adults contains major differences with the previous ESC/EAS 2011 guidelines and the remaining international guidelines, which has generated major controversies. The AHA/ACC document has developed a new model for estimating cardiovascular risk for primary prevention which is not comparable with the SCORE recommended in the European guidelines. This guideline does not establish a fixed target for low-density lipoprotein cholesterol (LDLc). Instead, it identifies 4 major statin benefit groups at risk for the development ASCVD, who should receive low-, moderate-, and high-intensity statin therapy to reduce LCLc. In contrast, the European guidelines maintain LDLc as the main treatment target and non-high-density lipoprotein cholesterol as a secondary treatment target. The document recommends calculating cardiovascular risk for the overall treatment of patients with dyslipidemia according to 4 risk levels (low, moderate, high, and very high), establishes LDLc treatment targets, and recommends a statin-based therapeutic strategy and other, lipid-lowering strategies, aimed at achieving these targets. The American guidelines cannot be extrapolated to the European population. Target-based treatment, as recommended in the EAS/ESC guidelines, is the best strategy for Europe. In Spain, the Primary Care Guidelines of the Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of Primary Care Physicians (SEMERGEN) are based on the European recommendations. Finally, the Spanish Society of Arteriosclerosis (SEA), SEMERGEN, semFYC and the Spanish Society of General Medicine (SEMG) are reaching a consensus on the approach and management of patients with atherogenic dyslipidemia in primary care.

  9. Nurses'perception of patient safety culture in 3A - grade general hospitals in Beijing%北京市三级甲等医院护士对病人安全文化的认知

    Institute of Scientific and Technical Information of China (English)

    田欢欢; 刘华平; 赵瑾; 赵芹芹; 焦静

    2011-01-01

    Objective To investigate nurses'perception of patient safety culture in 3A - grade general hospitals in Beijing. Method A total of 709 nurses from six 3A - grade general hospitals in Beijing were investigated by Safety Attitude Questionnaire (SAQ). Results The score of patient safety culture was ( 74.70 ± 14.29). The descending order of dimension scores was safe atmosphere, atmosphere of team cooperation, cognition to stress, work status,job satisfaction and feeling for management. The scores among nurses in different departments and with different professional titles had significant differences ( P < 0. 01 ).Conclusion The overall status of nurses'perception of patient safety culture in six in 3A - grade general hospitals in Beijing is in the positive level. However,two dimensions of patient safety culture, feeling for management and job satisfaction, should be further improved.%目的 了解北京市三级甲等综合医院病人安全文化现状.方法 采用安全文化问卷,对北京市6所三级甲等综合医院共709名护士进行调查.结果 护士认同的病人安全文化总分为(74.70±14.29)分,各维度得分从高到低依次是安全氛围、团队合作氛围、对压力的认知、工作状况、工作满意度及对管理的感受;不同科室及职务的护士认同的病人安全文化总分比较差异具有统计学意义(P<0.01).结论 北京市6所三级甲等综合医院护士认同的病人安全文化偏正向,但对管理的感受及工作满意度两个维度有待进一步提高.

  10. Fire safety of timber structures

    OpenAIRE

    Štupnik, Igor

    2016-01-01

    The aim of this graduation thesis is to show procedures for calculating the fire safety of timber structures. Presented are proposals of improvements of calculations according to standard EN 1995-1-2, based on fire tests and described in European technical guideline. The practical calculations are shown on examples of timber structures of Kindergarten Preddvor.

  11. Handbook for Public Playground Safety.

    Science.gov (United States)

    Consumer Product Safety Commission, Washington, DC.

    Guidelines for playground equipment safety are presented in this handbook. It first provides an overview of common playground injuries and definitions. The layout and design of playgrounds, such as choosing a site, locating equipment, and separating equipment by age level, is addressed next. The remaining sections describe the installation and…

  12. Commentary on recent therapeutic guidelines for osteoarthritis.

    Science.gov (United States)

    Cutolo, Maurizio; Berenbaum, Francis; Hochberg, Marc; Punzi, Leonardo; Reginster, Jean-Yves

    2015-06-01

    Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. A symposium of European and US OA experts was held within the framework of the Annual European Congress of Rheumatology to discuss and compare guidelines and recommendations for the treatment of knee OA and to reach a consensus for management, particularly for areas in which there is no clear consensus: non-pharmacological therapy; efficacy and safety of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); intra-articular (i.a.) hyaluronates (HA); and the role of chondroitin sulfate (CS) and/or glucosamine sulfate (GS). All guidelines reviewed agree that knee OA is a progressive disease of the joint whose management requires non-pharmacological and pharmacological approaches. Discrepancies between guidelines are few and mostly reflect heterogeneity of expert panels involved, geographical differences in the availability of pharmacotherapies, and heterogeneity of the studies included. Panels chosen for guideline development should include experts with real clinical experience in drug use and patient management. Implementation of agreed guidelines can be thwarted by drug availability and reimbursement plans, resulting in optimal OA treatment being jeopardized, HA and symptomatic slow-acting drugs for osteoarthritis (SySADOAs) being clear examples of drugs whose availability and prescription can greatly vary geographically. In addition, primary care providers, often responsible for OA management (at least in early disease), may not adhere to clinical care guidelines, particularly for non-pharmacological OA treatment. Harmonization of the recommendations for knee OA treatment is challenging but feasible, as shown by the step-by-step therapeutic algorithm developed by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). More easily disseminated and

  13. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  14. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  15. Hepatitis B in China: from Guideline to Practice

    Institute of Scientific and Technical Information of China (English)

    Ji-dong JIA

    2008-01-01

    Chronic hepatitis B infection is a very important health problem in China, which is carrying an enormous economic and social burdens. The major routs of chronic hepatitis B infection in China are mother-infant vertical transmission and early childhood horizontal transmission. After more than 10 years implementation of universal vaccination against hepatitis B in newborns and safety injection in health care settings, the prevalence of HBsAg in general population has decreased from 9.75% to around 7%. In China, patients with hepatitis are cared by either hepatologists or physicians of infectious diseases. The Chinese Society of Hepatology, and Chinese Society of Infectious Diseases jointly issued an evidence-based guideline on the prevention and treatment of chronic hepatitis B in 2005. This guideline concisely describes the virology, epidemiology, natural history and prevention, as well as diagnosis and management of chronic hepatitis B. It also highlights the importance of active viral replication in disease progression in chronic HBV infection and explicitly states the necessity of antiviral therapy in patient care. The cornerstone of anti-hepatitis B therapy is optimal use of interferons or nucleos(t)ide analogs in those patients with active viral replication and elevated serum transaminase levels. Through an independent continue medical educational agency, a panel of selected speakers were trained to give well-formatted talks on the key points of the guideline in over 60 major cities across China. This educational campaign among health care providers has greatly improved the awareness and the stand of care for antiviral therapy.

  16. European vehicle passive safety network

    NARCIS (Netherlands)

    Wismans, J.S.H.M.; Janssen, E.G.

    1999-01-01

    The general objective of the European Vehicle Passive Safety Network is to contribute to the reduction of the number of road traffic victims in Europe by passive safety measures. The aim of the road safety policy of the European Commission is to reduce the annual total of fatalities to 18000 in 2010

  17. Epetra developers coding guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael Allen; Sexton, Paul Michael

    2003-12-01

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

  18. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    -sectional telephone survey. SETTING: All municipal health centres in Finland. SUBJECTS: Health centres where both the head physician and the senior nursing officer responded. MAIN OUTCOME MEASURES: Agreement in views of the senior executives on the adoption of clinical practices as recommended in the Hypertension......OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p

  19. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

    Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

  20. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

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