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

NARCIS (Netherlands)

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

2014-01-01

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

Methodological quality of guidelines in gastroenterology.

Science.gov (United States)

Malheiro, Rui; de Monteiro-Soares, Matilde; Hassan, Cesare; Dinis-Ribeiro, Mário

2014-06-01

Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy. Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 - 7 for each item; higher scores mean better quality). A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria. The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners. © Georg Thieme Verlag KG Stuttgart · New York.

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

Science.gov (United States)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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

Science.gov (United States)

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

2015-12-01

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

Adolescent Health, Global Guidelines Versus Local Realities: The Sub-Saharan Africa Experience.

Science.gov (United States)

Dube, Kudakwashe; Van der Putten, Marc; Vajanapoom, Nitaya

2013-12-03

As the field of adolescent sexual and reproductive health (ASRH) evolves, further discussion and documentation of national policy and aspects of its implementation is needed to ensure effectiveness of interventions. Further research is required to foster beneficial shifts in policy advocacy, including resource allocation, and in the prioritization of adolescent programs in health and education systems, in communities and in workplaces. Adolescents are exposed to diverse interventions across all the countries under discussion; however there exist obstacles to realization of ASRH goals. In some countries, there exist a conflict of interest between national laws and global policy guidelines on ASRH; moreover national laws and policies are ambiguous and inconsistent. In addition, there have been strong negligence of vulnerable groups such as HIV positive adolescents, pregnant street youth; young sex workers; orphans; adolescents in conflict areas; adolescent refugees; adolescent girls working in the informal sectors and very young adolescents, likewise many adolescents in rural areas remain largely underserved. Furthermore there are consistently less disaggregated data available on adolescents' key indicators for comparative purposes signifying considerable knowledge gaps. There are multiple obstacles to the realization of ASRH and need for research combining both qualitative and quantitative approaches to determine the extent to which factors are either conducive or impeding to consistency between global guidelines, national ASRH policies, and actual policy implementation.

Adolescent health, global guidelines versus local realities: the Sub-Saharan Africa experience

Directory of Open Access Journals (Sweden)

Nitaya Vajanapoom

2013-12-01

Full Text Available As the field of adolescent sexual and reproductive health (ASRH evolves, further discussion and documentation of national policy and aspects of its implementation is needed to ensure effectiveness of interventions. Further research is required to foster beneficial shifts in policy advocacy, including resource allocation, and in the prioritization of adolescent programs in health and education systems, in communities and in workplaces. Adolescents are exposed to diverse interventions across all the countries under discussion; however there exist obstacles to realization of ASRH goals. In some countries, there exist a conflict of interest between national laws and global policy guidelines on ASRH; moreover national laws and policies are ambiguous and inconsistent. In addition, there have been strong negligence of vulnerable groups such as HIV positive adolescents, pregnant street youth; young sex workers; orphans; adolescents in conflict areas; adolescent refugees; adolescent girls working in the informal sectors and very young adolescents, likewise many adolescents in rural areas remain largely underserved. Furthermore there are consistently less disaggregated data available on adolescents’ key indicators for comparative purposes signifying considerable knowledge gaps. There are multiple obstacles to the realization of ASRH and need for research combining both qualitative and quantitative approaches to determine the extent to which factors are either conducive or impeding to consistency between global guidelines, national ASRH policies, and actual policy implementation.

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

Directory of Open Access Journals (Sweden)

Carmel Jacobs

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

Factors influencing adherence to guidelines in general practice

NARCIS (Netherlands)

Stewart, RE; Vroegop, S; van der Werf, GT; Meyboom-de Jong, B; Kamps, G.

2003-01-01

Objectives: To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines. Methods: In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n = 269,067) in 190

Assessment of EPRI water chemistry guidelines for new nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

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

2010-07-01

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

Assessment of EPRI water chemistry guidelines for new nuclear power plants

International Nuclear Information System (INIS)

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

2010-01-01

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

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

International Nuclear Information System (INIS)

Gilmore, W.E.

1985-07-01

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

Guidelines and procedures for the International Code Assessment and Applications Program

International Nuclear Information System (INIS)

1987-04-01

This document presents the guidelines and procedures by which the International Code Assessment and Applications Program (ICAP) will be conducted. The document summarizes the management structure of the program and the relationships between and responsibilities of the United States Nuclear Regulatory Commission (USNRC) and the international participants. The procedures for code maintenance and necessary documentation are described. Guidelines for the performance and documentation of code assessment studies are presented. An overview of an effort to quantify code uncertainty, which the ICAP supports, is included

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

Science.gov (United States)

2012-07-31

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

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

NARCIS (Netherlands)

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

2001-01-01

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

GAR Global Risk Assessment

Science.gov (United States)

Maskrey, Andrew; Safaie, Sahar

2015-04-01

Disaster risk management strategies, policies and actions need to be based on evidence of current disaster loss and risk patterns, past trends and future projections, and underlying risk factors. Faced with competing demands for resources, at any level it is only possible to priorities a range of disaster risk management strategies and investments with adequate understanding of realised losses, current and future risk levels and impacts on economic growth and social wellbeing as well as cost and impact of the strategy. The mapping and understanding of the global risk landscape has been greatly enhanced by the latest iteration of the GAR Global Risk Assessment and the objective of this submission is to present the GAR global risk assessment which contributed to Global Assessment Report (GAR) 2015. This initiative which has been led by UNISDR, was conducted by a consortium of technical institutions from around the world and has covered earthquake, cyclone, riverine flood, and tsunami probabilistic risk for all countries of the world. In addition, the risks associated with volcanic ash in the Asia-Pacific region, drought in various countries in sub-Saharan Africa and climate change in a number of countries have been calculated. The presentation will share thee results as well as the experience including the challenges faced in technical elements as well as the process and recommendations for the future of such endeavour.

Reliability of assessment of adherence to an antimicrobial treatment guideline

NARCIS (Netherlands)

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

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

Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

Science.gov (United States)

White, Susan W.; Smith, Laura A.; Schry, Amie R.

2014-01-01

Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

Guidelines for the on-site assessment of historic timber structures

NARCIS (Netherlands)

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

2014-01-01

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

Guidelines and recommendations for regional approaches to disarmament within the context of global security

International Nuclear Information System (INIS)

Mason, P.

1994-01-01

Guidelines and recommendations for regional approaches to disarmament within the context of global security provide both a conceptual framework within which to pursue arms control in South Asia and a variety of concrete mechanisms or tools to carry out the task. However, they cannot operate independently of a broader process of political accommodation, which might be named as 'cooperative security building'. That process, however embryonic, is under way across Asia Pacific region

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

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Han; Kim, J. B.; Lee, H. Y.; Park, C. G.; Joo, Y. S.; Koo, G. H.; Kim, S. H

2007-02-15

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

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

Science.gov (United States)

Chabeli, M M

2002-08-01

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

Transcultural Endocrinology: Adapting Type-2 Diabetes Guidelines on a Global Scale.

Science.gov (United States)

Nieto-Martínez, Ramfis; González-Rivas, Juan P; Florez, Hermes; Mechanick, Jeffrey I

2016-12-01

Type-2 diabetes (T2D) needs to be prevented and treated effectively to reduce its burden and consequences. White papers, such as evidence-based clinical practice guidelines (CPG) and their more portable versions, clinical practice algorithms and clinical checklists, may improve clinical decision-making and diabetes outcomes. However, CPG are underused and poorly validated. Protocols that translate and implement these CPG are needed. This review presents the global dimension of T2D, details the importance of white papers in the transculturalization process, compares relevant international CPG, analyzes cultural variables, and summarizes translation strategies that can improve care. Specific protocols and algorithmic tools are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Systematic review on tuberculosis transmission on aircraft and update of the European Centre for Disease Prevention and Control risk assessment guidelines for tuberculosis transmitted on aircraft (RAGIDA-TB).

Science.gov (United States)

Kotila, Saara M; Payne Hallström, Lara; Jansen, Niesje; Helbling, Peter; Abubakar, Ibrahim

2016-01-01

As a setting for potential tuberculosis (TB) transmission and contact tracing, aircraft pose specific challenges. Evidence-based guidelines are needed to support the related-risk assessment and contact-tracing efforts. In this study evidence of TB transmission on aircraft was identified to update the Risk Assessment Guidelines for TB Transmitted on Aircraft (RAGIDA-TB) of the European Centre for Disease Prevention and Control (ECDC). Electronic searches were undertaken from Medline (Pubmed), Embase and Cochrane Library until 19 July 2013. Eligible records were identified by a two-stage screening process and data on flight and index case characteristics as well as contact tracing strategies extracted. The systematic literature review retrieved 21 records. Ten of these records were available only after the previous version of the RAGIDA guidelines (2009) and World Health Organization guidelines on TB and air travel (2008) were published. Seven of the 21 records presented some evidence of possible in-flight transmission, but only one record provided substantial evidence of TB transmission on an aircraft. The data indicate that overall risk of TB transmission on aircraft is very low. The updated ECDC guidelines for TB transmission on aircraft have global implications due to inevitable need for international collaboration in contract tracing and risk assessment.

RELAP5 assessment: conclusions and user guidelines

International Nuclear Information System (INIS)

Kmetyk, L.N.

1984-10-01

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

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

Science.gov (United States)

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

2015-03-01

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

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

Science.gov (United States)

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

2016-03-01

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

OSART Independent Safety Culture Assessment (ISCA) Guidelines

International Nuclear Information System (INIS)

2016-01-01

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

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

Science.gov (United States)

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

2015-04-01

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

Guidelines for Providing Accommodations Using CASAS Assessment for Learners with Disabilities

Science.gov (United States)

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

2005-01-01

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

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

Science.gov (United States)

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

2018-02-27

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

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

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joo Eon

2009-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-10-15

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

European clinical guidelines for Tourette Syndrome and other tic disorders. Part I : assessment

NARCIS (Netherlands)

Cath, Danielle C.; Hedderly, Tammy; Ludolph, Andrea G.; Stern, Jeremy S.; Murphy, Tara; Hartmann, Andreas; Czernecki, Virginie; Robertson, Mary May; Martino, Davide; Munchau, A.; Rizzo, R.

A working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines of Tourette Syndrome (TS). The available literature including national guidelines was thoroughly screened and extensively discussed in the expert group of ESSTS

World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base.

Science.gov (United States)

Simons, F Estelle R; Ardusso, Ledit R F; Dimov, Vesselin; Ebisawa, Motohiro; El-Gamal, Yehia M; Lockey, Richard F; Sanchez-Borges, Mario; Senna, Gian Enrico; Sheikh, Aziz; Thong, Bernard Y; Worm, Margitta

2013-01-01

The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis are a widely disseminated and used resource for information about anaphylaxis. They focus on patients at risk, triggers, clinical diagnosis, treatment in health care settings, self-treatment in the community, and prevention of recurrences. Their unique strengths include a global perspective informed by prior research on the global availability of essentials for anaphylaxis assessment and management and a global agenda for anaphylaxis research. Additionally, detailed colored illustrations are linked to key concepts in the text [Simons et al.: J Allergy Clin Immunol 2011;127:593.e1-e22]. The recommendations in the original WAO Anaphylaxis Guidelines for management of anaphylaxis in health care settings and community settings were based on evidence published in peer-reviewed, indexed medical journals to the end of 2010. These recommendations remain unchanged and clinically relevant. An update of the evidence base was published in 2012 [Simons et al.: Curr Opin Allergy Clin Immunol 2012;12:389-399]. In 2012 and early 2013, major advances were reported in the following areas: further characterization of patient phenotypes; development of in vitro tests (for some allergens) that help distinguish clinical risk of anaphylaxis from asymptomatic sensitization; epinephrine (adrenaline) research, including studies of a new epinephrine auto-injector for use in community settings, and randomized controlled trials of immunotherapy to prevent food-induced anaphylaxis. Despite these advances, the need for additional prospective studies, including randomized controlled trials of interventions in anaphylaxis is increasingly apparent. This 2013 Update highlights publications from 2012 and 2013 that further contribute to the evidence base for the recommendations made in the original WAO Anaphylaxis Guidelines. Ideally, it should be used in conjunction with these Guidelines and with the 2012

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

International Nuclear Information System (INIS)

2002-01-01

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

The evolution of global disaster risk assessments: from hazard to global change

Science.gov (United States)

Peduzzi, Pascal

2013-04-01

The perception of disaster risk as a dynamic process interlinked with global change is a fairly recent concept. It gradually emerged as an evolution from new scientific theories, currents of thinking and lessons learned from large disasters since the 1970s. The interest was further heighten, in the mid-1980s, by the Chernobyl nuclear accident and the discovery of the ozone layer hole, both bringing awareness that dangerous hazards can generate global impacts. The creation of the UN International Decade for Natural Disaster Reduction (IDNDR) and the publication of the first IPCC report in 1990 reinforced the interest for global risk assessment. First global risk models including hazard, exposure and vulnerability components were available since mid-2000s. Since then increased computation power and more refined datasets resolution, led to more numerous and sophisticated global risk models. This article presents a recent history of global disaster risk models, the current status of researches for the Global Assessment Report on Disaster Risk Reduction (GAR 2013) and future challenges and limitations for the development of next generation global disaster risk models.

The Adaptation Gap Report. Towards Global Assessment

DEFF Research Database (Denmark)

2017-01-01

The Paris Agreement, adopted in 2015, established the global goal on adaptation of enhancing adaptive capacity, strengthening resilience and reducing vulnerability to climate change, with a view to contributing to sustainable development and ensuring an adequate adaptation response in the context...... Change (UNFCCC) to prepare for the implementation of the Paris Agreement. In contrast to previous Adaptation Gap Reports, the 2017 report focuses on issues relating to frameworks, comprising concepts, methodologies and data, rather than on assessing a particular dimension of the adaptation gap. Future...... extensive external review. The Paris Agreement’s global goal on adaptation provides a new starting point and impetus for assessing progress on adaptation at the global level, but additional information is required for assessing such progress. The global goal on adaptation provides a collective vision...

Systematic Review of the Methodology Quality in Lung Cancer Screening Guidelines

Directory of Open Access Journals (Sweden)

Jiang LI

2016-10-01

Full Text Available Background and objective Lung cancer is the most common malignancy and screening can decrease the mortality. High quality screening guideline is necessary and important for effective work. Our study is to review and evaluate the basic characteristics and methodology quality of the current global lung cancer screening guidelines so as to provide useful information for domestic study in the future. Methods Electronic searches were done in English and Chinese databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, CBM, Wanfang, and some cancer official websites. Articles were screened according to the predefined inclusion and exclusion criteria by two researchers. The quality of guidelines was assessed by AGREE II. Results At last, a total of 11 guidelines with methodology were included. The guidelines were issued mainly by USA (81%. Canada and China developed one, respectively. As for quality, the average score in the “Scale and objective” of all guidelines was 80, the average score in the “Participants” was 52, the average score in the “rigorism” was 50, the average score in the “clarity” was 76, the average score in the “application” was 43 and the average score in the “independence” was 59. The highest average score was found in 2013 and 2015. Canada guideline had higher quality in six domains. 7 guidelines were evaluated as A level. Conclusion The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries with heavy burden. Multi-country contribution to one guideline was another trend. Evidence-based methodology was accepted globally in the guideline development.

Global estimations of the inventory and mitigation potential of methane emissions from rice cultivation conducted using the 2006 Intergovernmental Panel on Climate Change Guidelines

Science.gov (United States)

Yan, Xiaoyuan; Akiyama, Hiroko; Yagi, Kazuyuki; Akimoto, Hajime

2009-06-01

The Intergovernmental Panel on Climate Change (IPCC) regularly publishes guidelines for national greenhouse gas inventories and methane emission (CH4) from rice paddies has been an important component of these guidelines. While there have been many estimates of global CH4 emissions from rice fields, none of them have been obtained using the IPCC guidelines. Therefore, we used the Tier 1 method described in the 2006 IPCC guidelines to estimate the global CH4 emissions from rice fields. To accomplish this, we used country-specific statistical data regarding rice harvest areas and expert estimates of relevant agricultural activities. The estimated global emission for 2000 was 25.6 Tg a-1, which is at the lower end of earlier estimates and close to the total emission summarized by individual national communications. Monte Carlo simulation revealed a 95% uncertainty range of 14.8-41.7 Tg a-1; however, the estimation uncertainty was found to depend on the reliability of the information available regarding the amount of organic amendments and the area of rice fields that were under continuous flooding. We estimated that if all of the continuously flooded rice fields were drained at least once during the growing season, the CH4 emissions would be reduced by 4.1 Tg a-1. Furthermore, we estimated that applying rice straw off season wherever and whenever possible would result in a further reduction in emissions of 4.1 Tg a-1 globally. Finally, if both of these mitigation options were adopted, the global CH4 emission from rice paddies could be reduced by 7.6 Tg a-1. Although draining continuously flooded rice fields may lead to an increase in nitrous oxide (N2O) emission, the global warming potential resulting from this increase is negligible when compared to the reduction in global warming potential that would result from the CH4 reduction associated with draining the fields.

Proposal for the development of ICNIRP guidelines on limits for optical radiation exposure

Energy Technology Data Exchange (ETDEWEB)

Siekmann, H. [Berufsgenossenschaftliches Institut fuer Arbeitsschutz - FIA, Sankt Augustin (Germany); Reidenbach, H.D. [Fachhochschule Koeln (Germany)

2004-07-01

Guidelines on limits of exposure to incoherent ultraviolet radiation, to incoherent visible and infrared radiation and to laser radiation have been published by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). These guidelines are accepted globally and form the basis for risk assessment procedures for optical radiation in many countries. With the appearance of new scientific cognition the ICNIRP guidelines will be revised from time to time. A revision may also concern more formal aspects. Some proposals for the development of the ICNIRP limit value recommendations for optical radiation exposures follow. (orig.)

Regulatory assessment of proposed accessibility guidelines for pedestrians in the public right-of-way

Science.gov (United States)

2011-06-30

This report assesses the potential costs and benefits of proposed accessibility guidelines issued by the Access Board for pedestrian facilities in the public right-of-way. The report also analyzes the potential impacts of the proposed guidelines on s...

Development of international guidelines for RAM shipment security

Energy Technology Data Exchange (ETDEWEB)

Luna, R.E.

2004-07-01

In October of 2003 a weeklong IAEA Technical Meeting developed a set of guidelines for providing security to consignments of radioactive materials in transport. These guidelines will be published shortly in an IAEA TECDOC. The guidelines produced reflect consideration of many influences and concerns that currently revolve around the potential for terrorist use of radioactive material for malevolent ends. The influences discussed here include: public perception of hazard and concern that new requirements will further limit global shipping capability, international efforts to control sealed sources, national efforts to increment protection on selected materials, the basis for exemption of materials, concern for cost impacts of overly broad requirements, questions on how to adjust requirements for a national threat assessment, and issues relating to consistency within the international community on security needs.

Development of international guidelines for RAM shipment security

International Nuclear Information System (INIS)

Luna, R.E.

2004-01-01

In October of 2003 a weeklong IAEA Technical Meeting developed a set of guidelines for providing security to consignments of radioactive materials in transport. These guidelines will be published shortly in an IAEA TECDOC. The guidelines produced reflect consideration of many influences and concerns that currently revolve around the potential for terrorist use of radioactive material for malevolent ends. The influences discussed here include: public perception of hazard and concern that new requirements will further limit global shipping capability, international efforts to control sealed sources, national efforts to increment protection on selected materials, the basis for exemption of materials, concern for cost impacts of overly broad requirements, questions on how to adjust requirements for a national threat assessment, and issues relating to consistency within the international community on security needs

Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

Science.gov (United States)

Marson, Daniel

2016-09-01

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

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

International Nuclear Information System (INIS)

1996-01-01

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

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

International Nuclear Information System (INIS)

Anon.

1982-01-01

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

EPA`s program for risk assessment guidelines: Quantification issues

Energy Technology Data Exchange (ETDEWEB)

Dourson, M.L. [Environmental Protection Agency, Washington, DC (United States)

1990-12-31

The quantitative procedures associated with noncancer risk assessment include reference dose (RfD), benchmark dose, and severity modeling. The RfD, which is part of the EPA risk assessment guidelines, is an estimation of a level that is likely to be without any health risk to sensitive individuals. The RfD requires two major judgments: the first is choice of a critical effect(s) and its No Observed Adverse Effect Level (NOAEL); the second judgment is choice of an uncertainty factor. This paper discusses major assumptions and limitations of the RfD model.

Assessment of EPRI water chemistry guidelines for new nuclear power plants

International Nuclear Information System (INIS)

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

2012-09-01

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

Global Mercury Assessment 2013

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

mercury pollution. This summary report and the accompanying. Technical Background Report for the Global. Mercury Assessment 2013 are developed in response to Decision 25/5, paragraph ... The use of different pollution control technologies in different ...... vegetation, snow, freshwater, and seawater. One of the largest ...

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

International Nuclear Information System (INIS)

1992-01-01

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

U.S. Global Change Research Program National Climate Assessment Global Change Information System

Science.gov (United States)

Tilmes, Curt

2012-01-01

The program: a) Coordinates Federal research to better understand and prepare the nation for global change. b) Priori4zes and supports cutting edge scientific work in global change. c) Assesses the state of scientific knowledge and the Nation s readiness to respond to global change. d) Communicates research findings to inform, educate, and engage the global community.

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

Science.gov (United States)

Cornell, Dewey; Allen, Korrie

2011-01-01

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

Transparent Global Seismic Hazard and Risk Assessment

Science.gov (United States)

Smolka, Anselm; Schneider, John; Pinho, Rui; Crowley, Helen

2013-04-01

Vulnerability to earthquakes is increasing, yet advanced reliable risk assessment tools and data are inaccessible to most, despite being a critical basis for managing risk. Also, there are few, if any, global standards that allow us to compare risk between various locations. The Global Earthquake Model (GEM) is a unique collaborative effort that aims to provide organizations and individuals with tools and resources for transparent assessment of earthquake risk anywhere in the world. By pooling data, knowledge and people, GEM acts as an international forum for collaboration and exchange, and leverages the knowledge of leading experts for the benefit of society. Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, open tools and models for seismic hazard and risk assessment. Guided by the needs and experiences of governments, companies and citizens at large, they work in continuous interaction with the wider community. A continuously expanding public-private partnership constitutes the GEM Foundation, which drives the collaborative GEM effort. An integrated and holistic approach to risk is key to GEM's risk assessment platform, OpenQuake, that integrates all above-mentioned contributions and will become available towards the end of 2014. Stakeholders worldwide will be able to calculate, visualise and investigate earthquake risk, capture new data and to share their findings for joint learning. Homogenized information on hazard can be combined with data on exposure (buildings, population) and data on their vulnerability, for loss assessment around the globe. Furthermore, for a true integrated view of seismic risk, users can add social vulnerability and resilience indices to maps and estimate the costs and benefits

A framework for global river flood risk assessments

NARCIS (Netherlands)

Winsemius, H.C.; van Beek, L.P.H.|info:eu-repo/dai/nl/14749799X; Jongman, B.; Ward, P.J.; Bouwman, A.

2013-01-01

There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and

Assessment of clinical guidelines for continuation treatment in major depression.

Science.gov (United States)

Nuijten, M J

2001-01-01

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

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

NARCIS (Netherlands)

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

2011-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-09-15

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

Assessing the decennial, reassessing the global

DEFF Research Database (Denmark)

Manners, Ian James

2013-01-01

in global politics by rethinking the nature of power and actorness in a globalizing, multilateralizing and multipolarizing era. To do this, the article assesses the past decade in terms of normative power engagement, internationalization and comparison. The article then argues that rethinking power...... and actorness involves reassessing global theory and pouvoir normatif in action. The article concludes by setting out three ways of developing the NPA in its second decade: macro-approach, meso-characterization and micro-analysis. Following the suggestion of Emanuel Adler, Barry Buzan and Tim Dunne, the article...

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

Science.gov (United States)

2003-02-01

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

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

Science.gov (United States)

Pielert, James H.; Mathey, Robert G.

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

A framework for global river flood risk assessments

Science.gov (United States)

Winsemius, H. C.; Van Beek, L. P. H.; Jongman, B.; Ward, P. J.; Bouwman, A.

2013-05-01

There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and socio-economic changes. The framework's goal is to establish flood hazard and impact estimates at a high enough resolution to allow for their combination into a risk estimate, which can be used for strategic global flood risk assessments. The framework estimates hazard at a resolution of ~ 1 km2 using global forcing datasets of the current (or in scenario mode, future) climate, a global hydrological model, a global flood-routing model, and more importantly, an inundation downscaling routine. The second component of the framework combines hazard with flood impact models at the same resolution (e.g. damage, affected GDP, and affected population) to establish indicators for flood risk (e.g. annual expected damage, affected GDP, and affected population). The framework has been applied using the global hydrological model PCR-GLOBWB, which includes an optional global flood routing model DynRout, combined with scenarios from the Integrated Model to Assess the Global Environment (IMAGE). We performed downscaling of the hazard probability distributions to 1 km2 resolution with a new downscaling algorithm, applied on Bangladesh as a first case study application area. We demonstrate the risk assessment approach in Bangladesh based on GDP per capita data, population, and land use maps for 2010 and 2050. Validation of the hazard estimates has been performed using the Dartmouth Flood Observatory database. This was done by comparing a high return period flood with the maximum observed extent, as well as by comparing a time series of a single event with Dartmouth imagery of the event. Validation of modelled damage estimates was performed using observed damage estimates from the EM

A framework for global river flood risk assessments

Directory of Open Access Journals (Sweden)

H. C. Winsemius

2013-05-01

Full Text Available There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and socio-economic changes. The framework's goal is to establish flood hazard and impact estimates at a high enough resolution to allow for their combination into a risk estimate, which can be used for strategic global flood risk assessments. The framework estimates hazard at a resolution of ~ 1 km2 using global forcing datasets of the current (or in scenario mode, future climate, a global hydrological model, a global flood-routing model, and more importantly, an inundation downscaling routine. The second component of the framework combines hazard with flood impact models at the same resolution (e.g. damage, affected GDP, and affected population to establish indicators for flood risk (e.g. annual expected damage, affected GDP, and affected population. The framework has been applied using the global hydrological model PCR-GLOBWB, which includes an optional global flood routing model DynRout, combined with scenarios from the Integrated Model to Assess the Global Environment (IMAGE. We performed downscaling of the hazard probability distributions to 1 km2 resolution with a new downscaling algorithm, applied on Bangladesh as a first case study application area. We demonstrate the risk assessment approach in Bangladesh based on GDP per capita data, population, and land use maps for 2010 and 2050. Validation of the hazard estimates has been performed using the Dartmouth Flood Observatory database. This was done by comparing a high return period flood with the maximum observed extent, as well as by comparing a time series of a single event with Dartmouth imagery of the event. Validation of modelled damage estimates was performed using observed damage estimates from

Testing post-editing guidelines

DEFF Research Database (Denmark)

Flanagan, Marian; Christensen, Tina Paulsen

2014-01-01

guidelines to use in translator training programmes. Recently, the first set of publicly available industry-focused PE guidelines (for ‘good enough’ and ‘publishable’ quality) were developed by Translation Automation User Society (TAUS) in partnership with the Centre for Global Intelligent Content (CNGL......), which can be used as a basis on which to instruct post-editors in professional environments. This paper reports on a qualitative study that investigates how trainee translators on an MA course, which is aimed at preparing the trainees for the translation industry, interpret these PE guidelines...... for publishable quality. The findings suggest trainees have difficulties interpreting the guidelines, primarily due to trainee competency gaps, but also due to the wording of the guidelines. Based on our findings we propose training measures to address these competency gaps. Furthermore, we provide post...

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Harvesting forest biomass for energy in Minnesota: An assessment of guidelines, costs and logistics

Science.gov (United States)

Saleh, Dalia El Sayed Abbas Mohamed

The emerging market for renewable energy in Minnesota has generated a growing interest in utilizing more forest biomass for energy. However, this growing interest is paralleled with limited knowledge of the environmental impacts and cost effectiveness of utilizing this resource. To address environmental and economic viability concerns, this dissertation has addressed three areas related to biomass harvest: First, existing biomass harvesting guidelines and sustainability considerations are examined. Second, the potential contribution of biomass energy production to reduce the costs of hazardous fuel reduction treatments in these trials is assessed. Third, the logistics of biomass production trials are analyzed. Findings show that: (1) Existing forest related guidelines are not sufficient to allow large-scale production of biomass energy from forest residue sustainably. Biomass energy guidelines need to be based on scientific assessments of how repeated and large scale biomass production is going to affect soil, water and habitat values, in an integrated and individual manner over time. Furthermore, such guidelines would need to recommend production logistics (planning, implementation, and coordination of operations) necessary for a potential supply with the least site and environmental impacts. (2) The costs of biomass production trials were assessed and compared with conventional treatment costs. In these trials, conventional mechanical treatment costs were lower than biomass energy production costs less income from biomass sale. However, a sensitivity analysis indicated that costs reductions are possible under certain site, prescriptions and distance conditions. (3) Semi-structured interviews with forest machine operators indicate that existing fuel reduction prescriptions need to be more realistic in making recommendations that can overcome operational barriers (technical and physical) and planning and coordination concerns (guidelines and communications

Guideline for load and resistance assessment of existing european railway bridges

OpenAIRE

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

2008-01-01

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

Linking global scenarios to national assessments: Experiences from the Resources Planning Act (RPA) Assessment

Science.gov (United States)

Linda L. Langner; Peter J. Ince

2012-01-01

The Resources Planning Act (RPA) Assessment provides a nationally consistent analysis of the status and trends of the Nation's renewable forest resources. A global scenario approach was taken for the 2010 RPA Assessment to provide a shared world view of potential futures. The RPA Assessment scenarios were linked to the global scenarios and climate projections used...

True North: Building Imaginary Worlds with the Revised Canadian (CADTH Guidelines for Health Technology Assessment

Directory of Open Access Journals (Sweden)

Paul C Langley

2017-05-01

Full Text Available In March 2017 the Canadian Agency for Drugs and Technologies in Health (CADTH released the 4th edition of their Guidelines for the Economic Evaluation of Health Technologies: Canada. These guidelines, which were first published and revised for a 3rd edition in 2006 are intended to help decision makers, health systems leaders and policy makers make well-informed decisions. They are designed, apparently, to support best practice in conducting health technology assessments in Canada. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the CADTH standards capable of generating claims for competing products that are credible, evaluable and replicable? The review argues that the standards proposed by CADTH do not meet the standards expected in normal science. Technical sophistication in building reference case imaginary worlds is not a substitute for claims that are experimentally evaluable or capable of assessment through systematic observation. There is no way of judging whether imaginary claims are right or even if they are wrong. CADTH is not alone in setting standards that fail to meet the standards of normal science. Recent commentaries on formulary submission guidelines in a number of other countries, to include Ireland, the Netherlands, France, Australia, the UK and New Zealand conclude that they are subject to the same criticism. If the CADTH guidelines were never intended to support feedback to health system decision makers, then this should be made clear. If not, then consideration should be given to withdrawing the guidelines to ensure they conform to these standards. Hopefully, future versions of the CADTH guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback and not the building of imaginary worlds.   Type:  Commentary

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

Science.gov (United States)

Verma, Sunil; Jackisch, Christian

2011-02-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Retraction Note to: “Global Assessment in the World Bank Education Strategy 2020”

Directory of Open Access Journals (Sweden)

Christopher S. Collins

2016-10-01

Full Text Available This article published in Volume 2, Issue 1, pages 29-41 (DOI 10.5195/ehe.2011.41 has been retracted at the request of the editors. The editors became aware of the issue on 21 March 2016 and quickly began investigating the situation. Several locations in the article contain plagiarized texts from various authors, either with inadequate or no attribution. Specifically, these include: excerpts from Marilee J. Bresciani’s 2006 book Outcomes-Based Academic and Co-Curricular Program Review: A Compilation of Institutional Practices appearing on page 30; excerpts from Tom Schuller and Stéphan Vincent-Lancrin’s chapter in the 2009 book International Organizations and Higher Education Policy: Thinking Globally, Acting Locally? appearing on page 31; excerpts from the Organisation for Economic Co-operation and Development (OECD website “UNESCO, OECD guidelines for quality provision in cross-border higher education” appearing on page 31; excerpts from David H. Kamens and Connie L. McNeely’s 2010 article, “Globalization and the Growth of International Education Testing and National Assessment” published in the Comparative Education Review appearing on page 31, and; excerpts from E. J. K. McKellar’s conference paper “Change our assessment practices? Why should we? The theory behind assessment practices” appearing on pages 32-33. The author apologizes to the journal and to its readers for the errors noted above.

Initiatives for regional dialogue consideration of regional disarmament guidelines

International Nuclear Information System (INIS)

Marschik, R.

1994-01-01

The General Assembly of the United Nations adopted guidelines and recommendations for regional approaches to disarmament within the context of global security. The guidelines contain 52 principles on: relationship between regional disarmament, arm limitation and global security; general guidelines and recommendations for regional disarmament efforts; possible ways and means to assist and implement these efforts; possible role of the United Nations in aiding these efforts. Experiences gained in Europe and Near East are analysed in the framework of the situation in Northeast, South and Southeast Asia

Global assessments of the state of the marine environment: Contemporary initiatives

International Nuclear Information System (INIS)

Bewers, J.M.; Boelens, R.G.V.

1999-01-01

A large number of assessments of regional marine areas have been conducted in recent years for a variety of purposes. Periodic reviews of the state of the marine environment have been undertaken by the United Nations Joint Group of Experts on the Scientific Aspects of Marine Environmental Protection (GESAMP). The most recent of these global assessments was published in 1990. The international adoption of a Global Programme of Action for the Protection of the Marine Environment from Land-Based Activities in 1995 has led to additional demand for regional assessments and a global review. The regional assessments are either completed or in train largely through mechanisms associated with the UNEP Regional Seas Programme. The global assessment has been assigned to GESAMP and incorporated into its plans for the preparation of a new global review to be completed in the year 2002. The Intergovernmental Oceanographic Commission, (IOC) the Scientific Committee for Oceanic Research (SCOR) and the Scientific Committee on Problems of the Environment (SCOPE) are collaborating in a review of ocean science. The Global Environment Facility (GEF) recently approved funding for a 'Global International Waters Assessment' (GIWA) partly as a means of determining priorities within its International Waters Portfolio. This paper outlines the nature of, and contemporary activities within, these various assessments. (author)

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

International Nuclear Information System (INIS)

2003-01-01

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

Building Chronic Kidney Disease Clinical Practice Guidelines Using the openEHR Guideline Definition Language.

Science.gov (United States)

Lin, Ching-Heng; Lo, Ying-Chih; Hung, Pei-Yuan; Liou, Der-Ming

2016-12-07

As a result of the disease's high prevalence, chronic kidney disease (CKD) has become a global public health problem. A clinical decision support system that integrates with computer-interpretable guidelines (CIGs) should improve clinical outcomes and help to ensure patient safety. The openEHR guideline definition language (GDL) is a formal language used to represent CIGs. This study explores the feasibility of using a GDL approach for CKD; it also attempts to identify any potential gaps between the ideal concept and reality. Using the Kidney Disease Improving Global Outcomes (KDIGO) anemia guideline as material, we designed a development workflow in order to establish a series of GDL guidelines. Focus group discussions were conducted in order to identify important issues related to GDL implementation. Ten GDL guidelines and 37 archetypes were established using the KDIGO guideline document. For the focus group discussions, 16 clinicians and 22 IT experts were recruited and their perceptions, opinions and attitudes towards the GDL approach were explored. Both groups provided positive feedback regarding the GDL approach, but raised various concerns about GDL implementation. Based on the findings of this study, we identified some potential gaps that might exist during implementation between the GDL concept and reality. Three directions remain to be investigated in the future. Two of them are related to the openEHR GDL approach. Firstly, there is a need for the editing tool to be made more sophisticated. Secondly, there needs to be integration of the present approach into non openEHR-based hospital information systems. The last direction focuses on the applicability of guidelines and involves developing a method to resolve any conflicts that occur with insurance payment regulations.

Cancer related fatigue: implementing guidelines for optimal management.

Science.gov (United States)

Pearson, Elizabeth J M; Morris, Meg E; McKinstry, Carol E

2017-07-18

Cancer-related fatigue (CRF) is a key concern for people living with cancer and can impair physical functioning and activities of daily living. Evidence-based guidelines for CRF are available, yet inconsistently implemented globally. This study aimed to identify barriers and enablers to applying a cancer fatigue guideline and to derive implementation strategies. A mixed-method study explored the feasibility of implementing the CRF guideline developed by the Canadian Association for Psychosocial Oncology (CAPO). Health professionals, managers and consumers from different practice settings participated in a modified Delphi study with two survey rounds. A reference group informed the design of the study including the surveys. The first round focused on guideline characteristics, compatibility with current practice and experience, and behaviour change. The second survey built upon and triangulated the first round. Forty-five health practitioners and managers, and 68 cancer survivors completed the surveys. More than 75% of participants endorsed the CAPO cancer related fatigue guidelines. Some respondents perceived a lack of resources for accessible and expert fatigue management services. Further barriers to guideline implementation included complexity, limited practical details for some elements, and lack of clinical tools such as assessment tools or patient education materials. Recommendations to enhance guideline applicability centred around four main themes: (1) balancing the level of detail in the CAPO guideline with ease of use, (2) defining roles of different professional disciplines in CRF management, (3) how best to integrate CRF management into policy and practice, (4) how best to ensure a consumer-focused approach to CRF management. Translating current knowledge on optimal management of CRF into clinical practice can be enhanced by the adoption of valid guidelines. This study indicates that it is feasible to adopt the CAPO guidelines. Clinical application may

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

NARCIS (Netherlands)

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

2003-01-01

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

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

Science.gov (United States)

Chaikledkaew, Usa; Kittrongsiri, Kankamon

2014-05-01

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

Summary of the technical guidelines used in the project: The economics of greenhouse gas limitations

International Nuclear Information System (INIS)

Halsnaes, Kirsten

1998-01-01

This document is a summary version of the technical guidelines for climate change mitigation assessment developed as a part of the Global Environment Facility (GEF) project The Economics of Greenhouse Gas Limitations; Technical guidelines (UNEP 1998). The objectives of this project have been to support the development of a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au)

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

International Nuclear Information System (INIS)

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

2004-01-01

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

Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

Science.gov (United States)

Peter, W F; Jansen, M J; Hurkmans, E J; Bloo, H; Dekker, J; Dilling, R G; Hilberdink, W; Kersten-Smit, C; de Rooij, M; Veenhof, C; Vermeulen, H M; de Vos, R J; Schoones, J W; Vliet Vlieland, T P

2011-01-01

An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 17 experts from different professional backgrounds. A second draft was field-tested by 45 physiotherapists. In total 11 topics were selected. For the initial assessment, three recommendations were formulated, pertaining to history taking, red flags, and formulating treatment goals. Concerning treatment, 7 recommendations were formulated; (supervised) exercise therapy, education and self management interventions, a combination of exercise and manual therapy, postoperative exercise therapy and taping of the patella were recommended. Balneotherapy and hydrotherapy in HKOA, and thermotherapy, TENS, and Continuous Passive Motion in knee OA were neither recommended nor discouraged. Massage therapy, ultrasound, electrotherapy, electromagnetic field, Low Level Laser Therapy, preoperative physiotherapy and education could not be recommended. For the evaluation of treatment goals the following measurement instruments were recommended: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index, Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score, 6-minute walktest, Timed Up and Go test, Patient Specific Complaint list, Visual Analoge Scale for pain, Intermittent and Constant OsteoArthritis Pain Questionnaire, goniometry, Medical Research Council for strength, handheld

Guidelines for Preparing Psychological Specialists: An Entry-Level Course on Intellectual Assessment

Science.gov (United States)

Oakland, Thomas; Wechsler, Solange Muglia

2016-01-01

This article provides guidelines for an entry-level course that prepares psychology students and practitioners to acquire entry-level skills, abilities, knowledge, and attitudes important to the individual assessment of intellectual abilities of children and youth. The article reviews prominent international, regional, and national policies,…

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

Science.gov (United States)

1995-01-01

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

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

International Nuclear Information System (INIS)

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

1992-01-01

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

Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

Science.gov (United States)

Hale, Kelli; Capra, Sandra; Bauer, Judy

2016-12-01

To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Children's Global Assessment Scale (CGAS) and Global Assessment of Psychosocial Disability (GAPD) in clinical practice--substance and reliability as judged by intraclass correlations

DEFF Research Database (Denmark)

Dyrborg, J; Larsen, F W; Nielsen, S

2000-01-01

Studies on the inter-rater reliability on the Children's Global Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD) involving different subgroups of 145 outpatients from 4 to 16 years of age showed fair to substantial intraclass correlations of 0.59 to 0.90. Raters...

Setting Priorities in Global Child Health Research Investments: Guidelines for Implementation of the CHNRI Method

Science.gov (United States)

Rudan, Igor; Gibson, Jennifer L.; Ameratunga, Shanthi; El Arifeen, Shams; Bhutta, Zulfiqar A.; Black, Maureen; Black, Robert E.; Brown, Kenneth H.; Campbell, Harry; Carneiro, Ilona; Chan, Kit Yee; Chandramohan, Daniel; Chopra, Mickey; Cousens, Simon; Darmstadt, Gary L.; Gardner, Julie Meeks; Hess, Sonja Y.; Hyder, Adnan A.; Kapiriri, Lydia; Kosek, Margaret; Lanata, Claudio F.; Lansang, Mary Ann; Lawn, Joy; Tomlinson, Mark; Tsai, Alexander C.; Webster, Jayne

2008-01-01

This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the process; (ii) specifying the context and risk management preferences; (iii) discussing criteria for setting health research priorities; (iv) choosing a limited set of the most useful and important criteria; (v) developing means to assess the likelihood that proposed health research options will satisfy the selected criteria; (vi) systematic listing of a large number of proposed health research options; (vii) pre-scoring check of all competing health research options; (viii) scoring of health research options using the chosen set of criteria; (ix) calculating intermediate scores for each health research option; (x) obtaining further input from the stakeholders; (xi) adjusting intermediate scores taking into account the values of stakeholders; (xii) calculating overall priority scores and assigning ranks; (xiii) performing an analysis of agreement between the scorers; (xiv) linking computed research priority scores with investment decisions; (xv) feedback and revision. The CHNRI method is a flexible process that enables prioritizing health research investments at any level: institutional, regional, national, international, or global. PMID:19090596

Pediatric Sepsis Guidelines: Summary for resource-limited countries

Science.gov (United States)

Khilnani, Praveen; Singhi, Sunit; Lodha, Rakesh; Santhanam, Indumathi; Sachdev, Anil; Chugh, Krishan; Jaishree, M.; Ranjit, Suchitra; Ramachandran, Bala; Ali, Uma; Udani, Soonu; Uttam, Rajiv; Deopujari, Satish

2010-01-01

Justification: Pediatric sepsis is a commonly encountered global issue. Existing guidelines for sepsis seem to be applicable to the developed countries, and only few articles are published regarding application of these guidelines in the developing countries, especially in resource-limited countries such as India and Africa. Process: An expert representative panel drawn from all over India, under aegis of Intensive Care Chapter of Indian Academy of Pediatrics (IAP) met to discuss and draw guidelines for clinical practice and feasibility of delivery of care in the early hours in pediatric patient with sepsis, keeping in view unique patient population and limited availability of equipment and resources. Discussion included issues such as sepsis definitions, rapid cardiopulmonary assessment, feasibility of early aggressive fluid therapy, inotropic support, corticosteriod therapy, early endotracheal intubation and use of positive end expiratory pressure/mechanical ventilation, initial empirical antibiotic therapy, glycemic control, and role of immunoglobulin, blood, and blood products. Objective: To achieve a reasonable evidence-based consensus on the basis of published literature and expert opinion to formulating clinical practice guidelines applicable to resource-limited countries such as India. Recommendations: Pediatric sepsis guidelines are presented in text and flow chart format keeping resource limitations in mind for countries such as India and Africa. Levels of evidence are indicated wherever applicable. It is anticipated that once the guidelines are used and outcomes data evaluated, further modifications will be necessary. It is planned to periodically review and revise these guidelines every 3–5 years as new body of evidence accumulates. PMID:20606908

Assessing students' communication skills: validation of a global rating.

Science.gov (United States)

Scheffer, Simone; Muehlinghaus, Isabel; Froehmel, Annette; Ortwein, Heiderose

2008-12-01

Communication skills training is an accepted part of undergraduate medical programs nowadays. In addition to learning experiences its importance should be emphasised by performance-based assessment. As detailed checklists have been shown to be not well suited for the assessment of communication skills for different reasons, this study aimed to validate a global rating scale. A Canadian instrument was translated to German and adapted to assess students' communication skills during an end-of-semester-OSCE. Subjects were second and third year medical students at the reformed track of the Charité-Universitaetsmedizin Berlin. Different groups of raters were trained to assess students' communication skills using the global rating scale. Validity testing included concurrent validity and construct validity: Judgements of different groups of raters were compared to expert ratings as a defined gold standard. Furthermore, the amount of agreement between scores obtained with this global rating scale and a different instrument for assessing communication skills was determined. Results show that communication skills can be validly assessed by trained non-expert raters as well as standardised patients using this instrument.

A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice.

Science.gov (United States)

Bernert, Rebecca A; Hom, Melanie A; Roberts, Laura Weiss

2014-10-01

The current paper aims to: (1) examine clinical practice guidelines in suicide prevention across fields, organizations, and clinical specialties and (2) inform emerging standards in clinical practice, research, and training. The authors conducted a systematic literature review to identify clinical practice guidelines and resource documents in suicide prevention and risk management. The authors used PubMed, Google Scholar, and Google Search, and keywords included: clinical practice guideline, practice guideline, practice parameters, suicide, suicidality, suicidal behaviors, assessment, and management. To assess for commonalities, the authors reviewed guidelines and resource documents across 13 key content categories and assessed whether each document suggested validated assessment measures. The search generated 101 source documents, which included N = 10 clinical practice guidelines and N = 12 additional resource documents (e.g., non-formalized guidelines, tool-kits). All guidelines (100 %) provided detailed recommendations for the use of evidence-based risk factors and protective factors, 80 % provided brief (but not detailed) recommendations for the assessment of suicidal intent, and 70 % recommended risk management strategies. By comparison, only 30 % discussed standardization of risk-level categorizations and other content areas considered central to best practices in suicide prevention (e.g., restricting access to means, ethical considerations, confidentiality/legal issues, training, and postvention practices). Resource documents were largely consistent with these findings. Current guidelines address similar aspects of suicide risk assessment and management, but significant discrepancies exist. A lack of consensus was evident in recommendations across core competencies, which may be improved by increased standardization in practice and training. Additional resources appear useful for supplemental use.

Technical Review Guidelines for Environmental Impact Assessments in the Tourism, Energy and Mining Sectors

Science.gov (United States)

EPA coordinated a regional collaborative process with Central America and Dominican Republic Free Trade Agreement (CAFTA-DR) partners to develop Environmental Impact Assessment (EIA) Technical Review Guidelines for three sectors.

Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology.

Science.gov (United States)

Cicchetti, Domenic V.

1994-01-01

In the context of developing assessment instruments in psychology, issues of standardization, norming procedures, and test reliability and validity are discussed. Criteria, guidelines, and rules of thumb are provided to help the clinician with instrument selection for a given psychological assessment. (SLD)

Terrain assessment guidelines : CAGC best practice. Version 3

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

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

European clinical guidelines for Tourette syndrome and other tic disorders. Part I: assessment

DEFF Research Database (Denmark)

Cath, Danielle C; Hedderly, Tammy; Ludolph, Andrea G

2011-01-01

members. Detailed clinical assessment guidelines of tic disorders and their comorbidities in both children and adults are presented. Screening methods that might be helpful and necessary for specialists' differential diagnosis process are suggested in order to further analyse cognitive abilities...

Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations.

Science.gov (United States)

Balsells, Evelyn; Filipescu, Teodora; Kyaw, Moe H; Wiuff, Camilla; Campbell, Harry; Nair, Harish

2016-12-01

Clostridium difficile is the leading cause of health care-associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance. We identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine. We reviewed CDI-targeted IPC recommendations and describe the assessment of evidence in available guidelines. We identified documents from 28 countries/territories, mainly from acute care hospitals in North America, the Western Pacific, and Europe (18 countries). We identified only a few specific recommendations for long-term care facilities (LTCFs) and from countries in South America (Uruguay and Chile), South East Asia (Thailand), and none for Africa or Eastern Mediterranean. Of 10 IPC areas, antimicrobial stewardship was universally recognized as essential and supported by high quality evidence. Five other widely reported "strong" recommendations were: effective environment cleaning (including medical equipment), case isolation, use of personal protective equipment, surveillance, and education. Several unresolved and emerging issues were documented and currently available evidence was classified mainly as of mixed quality. Our review underlines the need for targeted CDI IPC guidelines in several countries and for LTCFs. International harmonisation on the assessment of the evidence for best practices is needed as well as more robust evidence to support targeted recommendations.

A global probabilistic tsunami hazard assessment from earthquake sources

Science.gov (United States)

Davies, Gareth; Griffin, Jonathan; Lovholt, Finn; Glimsdal, Sylfest; Harbitz, Carl; Thio, Hong Kie; Lorito, Stefano; Basili, Roberto; Selva, Jacopo; Geist, Eric L.; Baptista, Maria Ana

2017-01-01

Large tsunamis occur infrequently but have the capacity to cause enormous numbers of casualties, damage to the built environment and critical infrastructure, and economic losses. A sound understanding of tsunami hazard is required to underpin management of these risks, and while tsunami hazard assessments are typically conducted at regional or local scales, globally consistent assessments are required to support international disaster risk reduction efforts, and can serve as a reference for local and regional studies. This study presents a global-scale probabilistic tsunami hazard assessment (PTHA), extending previous global-scale assessments based largely on scenario analysis. Only earthquake sources are considered, as they represent about 80% of the recorded damaging tsunami events. Globally extensive estimates of tsunami run-up height are derived at various exceedance rates, and the associated uncertainties are quantified. Epistemic uncertainties in the exceedance rates of large earthquakes often lead to large uncertainties in tsunami run-up. Deviations between modelled tsunami run-up and event observations are quantified, and found to be larger than suggested in previous studies. Accounting for these deviations in PTHA is important, as it leads to a pronounced increase in predicted tsunami run-up for a given exceedance rate.

Assessing biocomputational modelling in transforming clinical guidelines for osteoporosis management.

Science.gov (United States)

Thiel, Rainer; Viceconti, Marco; Stroetmann, Karl

2011-01-01

Biocomputational modelling as developed by the European Virtual Physiological Human (VPH) Initiative is the area of ICT most likely to revolutionise in the longer term the practice of medicine. Using the example of osteoporosis management, a socio-economic assessment framework is presented that captures how the transformation of clinical guidelines through VPH models can be evaluated. Applied to the Osteoporotic Virtual Physiological Human Project, a consequent benefit-cost analysis delivers promising results, both methodologically and substantially.

Radiological risk comparison guidelines

International Nuclear Information System (INIS)

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

1992-01-01

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

An assessement of global energy resource economic potentials

International Nuclear Information System (INIS)

Mercure, Jean-François; Salas, Pablo

2012-01-01

This paper presents an assessment of global economic energy potentials for all major natural energy resources. This work is based on both an extensive literature review and calculations using natural resource assessment data. Economic potentials are presented in the form of cost-supply curves, in terms of energy flows for renewable energy sources, or fixed amounts for fossil and nuclear resources, with strong emphasis on uncertainty, using a consistent methodology that allow direct comparisons to be made. In order to interpolate through available resource assessment data and associated uncertainty, a theoretical framework and a computational methodology are given based on statistical properties of different types of resources, justified empirically by the data, and used throughout. This work aims to provide a global database for natural energy resources ready to integrate into models of energy systems, enabling to introduce at the same time uncertainty over natural resource assessments. The supplementary material provides theoretical details and tables of data and parameters that enable this extensive database to be adapted to a variety of energy systems modelling frameworks. -- Highlights: ► Global energy potentials for all major energy resources are reported. ► Theory and methodology for calculating economic energy potentials is given. ► An uncertainty analysis for all energy economic potentials is carried out.

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

Science.gov (United States)

2010-03-29

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

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

Science.gov (United States)

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

2015-05-01

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

The assessment of genetic risk of breast cancer : a set of GP guidelines

NARCIS (Netherlands)

de Bock, GH; Vlieland, TPMV; Hageman, GCHA; Oosterwijk, JC; Springer, MP; Kievit, J

Background. Assessing a genetic risk for developing breast cancer is not an easy task for a GP. Current expert guidelines for referring and counselling women with a family history positive for breast cancer are complex and difficult to apply in general practice, and have only two strategies (to

Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

Science.gov (United States)

Erdim, Aylin; Aktan, Ahmet Özdemir

2017-01-01

This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

Public safety around dams guidelines

Energy Technology Data Exchange (ETDEWEB)

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

2010-07-01

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

APPLICATION OF SEDIMENT QUALITY GUIDELINES IN THE ASSESSMENT OF MANGROVE SURFACE SEDIMENT IN MENGKABONG LAGOON, SABAH, MALAYSIA

Directory of Open Access Journals (Sweden)

S. M. Praveena, M. Radojevic, M. H. Abdullah, A. Z. Aris

2008-01-01

Full Text Available There have been numerous sediment quality guidelines developed to monitor the sediments. Sediment quality guidelines are very useful to screen sediment contamination by comparing sediment contaminant concentration with the corresponding quality guideline, provide useful tools for screening sediment chemical data to identify pollutants of concern and prioritise problem sites and relatively good predictors of contaminations. However, these guidelines are chemical specific and do not include biological parameters. Aquatic ecosystems, including sediments, must be assessed in multiple components (biological data, toxicity, physicochemistry by using intregrated approaches in order to establish a complete and comprehensive set of sediment quality guidelines. Numerous sediment quality guidelines Washington Department of Ecology Sediment Quality Guideline, Australian and New Zealand Environment and Conservation Council, Swedish Environmental Sediment Quality, Screening Quick Reference Table, Portuguese Legislation on the Classification of Dredged Materials in Coastal Zones and Interim Sediment Quality Guideline for Hong Kong have been applied to the Mengkabong lagoon mangrove sediment and discussed. The most appropriate guideline that meets the prioritization criteria consistent with international initiatives and regulations is interim sediment quality values for Hong Kong. The guideline verifies that all the metals are below the Interim Sediment Quality Value-low. However, site-specific, biological testing and ecological analysis of exisiting benthics community structure related to sediment contamination are needed for final decision making in the case of Mengkabong lagoon.

Inverse relationship between nonadherence to original GOLD treatment guidelines and exacerbations of COPD.

Science.gov (United States)

Foda, Hussein D; Brehm, Anthony; Goldsteen, Karen; Edelman, Norman H

2017-01-01

Prescriber disagreement is among the reasons for poor adherence to COPD treatment guidelines; it is yet not clear whether this leads to adverse outcomes. We tested whether undertreatment according to the original Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines led to increased exacerbations. Records of 878 patients with spirometrically confirmed COPD who were followed from 2005 to 2010 at one Veterans Administration (VA) Medical Center were analyzed. Analysis of variance was performed to assess differences in exacerbation rates between severity groups. Logistic regression analysis was performed to assess the relationship between noncompliance with guidelines and exacerbation rates. About 19% were appropriately treated by guidelines; 14% overtreated, 44% under-treated, and in 23% treatment did not follow any guideline. Logistic regression revealed a strong inverse relationship between undertreatment and exacerbation rate when severity of obstruction was held constant. Exacerbations per year by GOLD stage were significantly different from each other: mild 0.15, moderate 0.27, severe 0.38, very severe 0.72, and substantially fewer than previously reported. The guidelines were largely not followed. Undertreatment predominated but, contrary to expectations, was associated with fewer exacerbations. Thus, clinicians were likely advancing therapy primarily based upon exacerbation rates as was subsequently recommended in revised GOLD and other more recent guidelines. In retrospect, a substantial lack of prescriber adherence to treatment guidelines may have been a signal that they required re-evaluation. This is likely to be a general principle regarding therapeutic guidelines. The identification of fewer exacerbations in this cohort than has been generally reported probably reflects the comprehensive nature of the VA system, which is more likely to identify relatively asymptomatic (ie, nonexacerbating) COPD patients. Accordingly, these rates may

Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

Science.gov (United States)

Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

2017-06-01

This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Focus: Assessing the regional impacts of global warming

International Nuclear Information System (INIS)

Woo, Mingko

1992-01-01

Five studies are presented which assess the impacts of global warming on physical, economic, and social systems in Canada. A study on the use of climatic change scenarios to estimate ecoclimatic impacts was carried out. These scenarios may include synthetic scenarios produced from historical data, global climate model (GCM) simulations, and hybrid scenarios. The advantages and drawbacks of various scenarios are discussed along with the criteria for selecting impact assessment models. An examination of water resources in the Great Lakes and the Saskatchewan River subbasin uses case studies of two areas that have experienced wide hydrological variations due to climatic variability in order to determine the impacts of global warming scenarios on net basin supply. Problems of developing regional models are discussed and results of projected changes in net basin supply are presented for GCM-based simulations and hypothetical warming scenarios. A study of the impacts of climate warming on transportation and the regional economy in northern Canada uses stochastic models to provide examples of how Mackenzie River barge traffic will be affected. The economic impacts of the resultant lengthened shipping season are outlined under three scenarios. The implications of climatic change on Ontario agriculture are assessed according to GCM scenarios. Results are presented for crop yields and production as well as land resource suitability. Finally, sociocultural implications of global warming on the Arctic and the Inuit are summarized, with reference to a past warming episode occurring around the year 1000. 45 refs., 4 figs., 3 tabs

[Clinical Practice Guidelines for Management of Schizophrenia: Evaluation Using AGREE II].

Science.gov (United States)

de la Hoz Bradford, Ana María; Ávila, Mauricio J; Bohórquez Peñaranda, Adriana Patricia; García Valencia, Jenny; Arenas Borrero, Álvaro Enrique; Vélez Traslaviña, Ángela; Jaramillo González, Luis Eduardo; Gómez-Restrepo, Carlos

2014-01-01

Colombia is developing multiple national practice guidelines from a range of diseases. Clinical practice guidelines represent a very useful tool to be able to take decision over a patient care that is widely available for the clinician. In psychiatry there are a good number of international clinical guidelines for the treatment of schizophrenia nevertheless there is no article that evaluate them scientifically In the settings of developing a Colombian schizophrenia practice guideline, a systematic search was performed in multiple databases and the results were then evaluated by two trained persons. We present the results globally and by domains. We found 164 matches for possible guidelines. After screening 7 guidelines were evaluated with the AGREE II instrument. Globally and by the different domains, the National Institute for Health and Care Excellence (NICE) was the guideline that got the best score. From the guidelines that were reviewed, 4 were from Europe and only 2 were from Latin America. None of the guidelines used GRADE methodology for the recommendations. The diversity of the schizophrenia treatment guidelines does not allow an easy adoption of the recommendation by a psychiatrist in Colombia. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

International Nuclear Information System (INIS)

Cooper, M.B.

1998-01-01

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

International Global Crop Condition Assessments in the framework of GEOGLAM

Science.gov (United States)

Becker-Reshef, I.; Justice, C. O.; Vermote, E.; Whitcraft, A. K.; Claverie, M.

2013-12-01

The Group on Earth Observations (partnership of governments and international organizations) developed the Global Agricultural Monitoring (GEOGLAM) initiative in response to the growing calls for improved agricultural information. The goal of GEOGLAM is to strengthen the international community's capacity to produce and disseminate relevant, timely and accurate forecasts of agricultural production at national, regional and global scales through the use of Earth observations. This initiative is designed to build on existing agricultural monitoring initiatives at national, regional and global levels and to enhance and strengthen them through international networking, operationally focused research, and data/method sharing. GEOGLAM was adopted by the G20 as part of the action plan on food price volatility and agriculture and is being implemented through building on the extensive GEO Agricultural Community of Practice (CoP) that was initiated in 2007 and includes key national and international agencies, organizations, and universities involved in agricultural monitoring. One of the early GEOGLAM activities is to provide harmonized global crop outlooks that offer timely qualitative consensus information on crop status and prospects. This activity is being developed in response to a request from the G-20 Agricultural Market Information System (AMIS) and is implemented within the global monitoring systems component of GEOGLAM. The goal is to develop a transparent, international, multi-source, consensus assessment of crop growing conditions, status, and agro-climatic conditions, likely to impact global production. These assessments are focused on the four primary crop types (corn, wheat, soy and rice) within the main agricultural producing regions of the world. The GEOGLAM approach is to bring together international experts from global, regional and national monitoring systems that can share and discuss information from a variety of independent complementary sources in

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

International Nuclear Information System (INIS)

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

2007-01-01

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

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

NARCIS (Netherlands)

Meijer, Ronald; van Limbeek, Jacques; de Haan, Rob

2006-01-01

The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our

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

NARCIS (Netherlands)

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

2006-01-01

The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our

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

Science.gov (United States)

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

2015-09-01

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

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

Directory of Open Access Journals (Sweden)

Matt W Hayward

2015-07-01

Full Text Available The IUCN Red List is the most widely used tool to measure extinction risk and report biodiversity trends. Accurate and standardised conservation status assessments for the IUCN Red List are limited by a lack of adequate information; and need consistent and unbiased interpretation of that information. Variable interpretation stems from a lack of quantified thresholds in certain areas of the Red List guidelines. Thus, even in situations with sufficient information to make a Red List assessment, inconsistency can occur when experts, especially from different regions, interpret the guidelines differently, thereby undermining the goals and credibility of the process. In such an information vacuum, assessors make assumptions depending on their level of Red List experience (subconscious bias and their personal values or agendas (conscious bias. We highlight two major issues where such bias influences assessments: relating to fenced subpopulations that require intensive management; and defining benchmark geographic distributions and thus the inclusion/exclusion of introduced subpopulations. We suggest assessor bias can be reduced by refining the Red List guidelines to include quantified thresholds for when to include fenced/intensively managed subpopulations or subpopulations outside the benchmark distribution; publishing case studies of difficult assessments to enhance cohesion between Specialist Groups; developing an online accreditation course on applying Red List criteria as a prerequisite for assessors; and ensuring that assessments of species subject to trade and utilisation are represented by all dissenting views (for example, both utilitarian and preservationist and reviewed by relevant Specialist Groups. We believe these interventions would ensure consistent, reliable assessments of threatened species between regions and across assessors with divergent views, and will thus improve comparisons between taxa and counteract the use of Red List

Personality Assessment of Global Talent: Conceptual and Methodological Issues

Science.gov (United States)

van de Vijver, Fons J. R.

2008-01-01

The recruitment of managers who will operate in a culturally heterogeneous context (as expatriate managers, managers in a global company, or managers of a multicultural workforce) is increasingly important in an age of globalization. This article describes conceptual and methodological issues in the assessment of such managers, notably in the…

Global mineral resource assessment: porphyry copper assessment of Mexico: Chapter A in Global mineral resource assessment

Science.gov (United States)

Hammarstrom, Jane M.; Robinson, Gilpin R.; Ludington, Steve; Gray, Floyd; Drenth, Benjamin J.; Cendejas-Cruz, Francisco; Espinosa, Enrique; Pérez-Segura, Efrén; Valencia-Moreno, Martín; Rodríguez-Castañeda, José Luis; Vásquez-Mendoza, Rigobert; Zürcher, Lukas

2010-01-01

Mineral resource assessments provide a synthesis of available information about distributions of mineral deposits in the Earth’s crust. A probabilistic mineral resource assessment of undiscovered resources in porphyry copper deposits in Mexico was done as part of a global mineral resource assessment. The purpose of the study was to (1) delineate permissive areas (tracts) for undiscovered porphyry copper deposits within 1 km of the surface at a scale of 1:1,000,000; (2) provide a database of known porphyry copper deposits and significant prospects; (3) estimate numbers of undiscovered deposits within those permissive tracts; and (4) provide probabilistic estimates of amounts of copper (Cu), molybdenum (Mo), gold (Au), and silver (Ag) that could be contained in undiscovered deposits for each permissive tract. The assessment was conducted using a three-part form of mineral resource assessment based on mineral deposit models (Singer, 1993). Delineation of permissive tracts primarily was based on distributions of mapped igneous rocks related to magmatic arcs that formed in tectonic settings associated with subduction boundary zones. Using a GIS, map units were selected from digital geologic maps based on lithology and age to delineate twelve permissive tracts associated with Jurassic, Laramide (~90 to 34 Ma), and younger Tertiary magmatic arcs. Stream-sediment geochemistry, mapped alteration, regional aeromagnetic data, and exploration history were considered in conjunction with descriptive deposit models and grade and tonnage models to guide estimates.

[Guidelines for the sociomedical assessment of performance in patients suffering from chronic non-malignant diseases of the liver and the bile ducts--for the Medical Assessment Services of the German Pension Fund].

Science.gov (United States)

Horn, S; Irle, H; Knorr, I; Pottins, I; Rohwetter, M; Schuhknecht, P; Timner, K; Becker, E

2009-06-01

The following guidelines were developed for the medical assessment services of the German pension fund. Starting from day-to-day practice, criteria and attributes to guide decisions for a systematisation of the sociomedical assessment of performance in diseases of the liver and the bile ducts were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent, e. g., for the assessment of applications for decreased earning capacity benefits. The guidelines summarise the typical manifestations of diseases of the liver and the bile ducts and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions, the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual. The guidelines followed from an extended procedure to attain a wide consensus in the setting of the German Pension Fund and an upgraded evidence base.

Assessment of Global Wind Energy Resource Utilization Potential

Science.gov (United States)

Ma, M.; He, B.; Guan, Y.; Zhang, H.; Song, S.

2017-09-01

Development of wind energy resource (WER) is a key to deal with climate change and energy structure adjustment. A crucial issue is to obtain the distribution and variability of WER, and mine the suitable location to exploit it. In this paper, a multicriteria evaluation (MCE) model is constructed by integrating resource richness and stability, utilization value and trend of resource, natural environment with weights. The global resource richness is assessed through wind power density (WPD) and multi-level wind speed. The utilizable value of resource is assessed by the frequency of effective wind. The resource stability is assessed by the coefficient of variation of WPD and the frequency of prevailing wind direction. Regression slope of long time series WPD is used to assess the trend of WER. All of the resource evaluation indicators are derived from the atmospheric reanalysis data ERA-Interim with spatial resolution 0.125°. The natural environment factors mainly refer to slope and land-use suitability, which are derived from multi-resolution terrain elevation data 2010 (GMTED 2010) and GlobalCover2009. Besides, the global WER utilization potential map is produced, which shows most high potential regions are located in north of Africa. Additionally, by verifying that 22.22 % and 48.8 9% operational wind farms fall on medium-high and high potential regions respectively, the result can provide a basis for the macroscopic siting of wind farm.

The Global Tsunami Model (GTM)

Science.gov (United States)

Lorito, S.; Basili, R.; Harbitz, C. B.; Løvholt, F.; Polet, J.; Thio, H. K.

2017-12-01

The tsunamis occurred worldwide in the last two decades have highlighted the need for a thorough understanding of the risk posed by relatively infrequent but often disastrous tsunamis and the importance of a comprehensive and consistent methodology for quantifying the hazard. In the last few years, several methods for probabilistic tsunami hazard analysis have been developed and applied to different parts of the world. In an effort to coordinate and streamline these activities and make progress towards implementing the Sendai Framework of Disaster Risk Reduction (SFDRR) we have initiated a Global Tsunami Model (GTM) working group with the aim of i) enhancing our understanding of tsunami hazard and risk on a global scale and developing standards and guidelines for it, ii) providing a portfolio of validated tools for probabilistic tsunami hazard and risk assessment at a range of scales, and iii) developing a global tsunami hazard reference model. This GTM initiative has grown out of the tsunami component of the Global Assessment of Risk (GAR15), which has resulted in an initial global model of probabilistic tsunami hazard and risk. Started as an informal gathering of scientists interested in advancing tsunami hazard analysis, the GTM is currently in the process of being formalized through letters of interest from participating institutions. The initiative has now been endorsed by the United Nations International Strategy for Disaster Reduction (UNISDR) and the World Bank's Global Facility for Disaster Reduction and Recovery (GFDRR). We will provide an update on the state of the project and the overall technical framework, and discuss the technical issues that are currently being addressed, including earthquake source recurrence models, the use of aleatory variability and epistemic uncertainty, and preliminary results for a probabilistic global hazard assessment, which is an update of the model included in UNISDR GAR15.

EAACI Guidelines on Allergen Immunotherapy

DEFF Research Database (Denmark)

Muraro, A; Roberts, G; Halken, S

2018-01-01

conflicting outcomes. This has resulted in confusion about the benefits and risks of AIT amongst policymakers and professionals, as well as in the variable availability of AIT products, regulation and reimbursement policies globally. In 2015 EAACI initiated the AIT Guidelines project as part...

Global Energy Assessment. Toward a Sustainable Future

Energy Technology Data Exchange (ETDEWEB)

Johansson, T B; Nakicenovic, N; Patwardhan, A; Gomez-Echeverri, L [eds.

2012-11-01

The Global Energy Assessment (GEA) brings together over 300 international researchers to provide an independent, scientifically based, integrated and policy-relevant analysis of current and emerging energy issues and options. It has been peer-reviewed anonymously by an additional 200 international experts. The GEA assesses the major global challenges for sustainable development and their linkages to energy; the technologies and resources available for providing energy services; future energy systems that address the major challenges; and the policies and other measures that are needed to realize transformational change toward sustainable energy futures. The GEA goes beyond existing studies on energy issues by presenting a comprehensive and integrated analysis of energy challenges, opportunities and strategies, for developing, industrialized and emerging economies. This volume is an invaluable resource for energy specialists and technologists in all sectors (academia, industry and government) as well as policymakers, development economists and practitioners in international organizations and national governments.

European trauma guideline compliance assessment: the ETRAUSS study.

Science.gov (United States)

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

2015-12-08

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

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

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

2005-01-01

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

The process of developing policy based on global environmental risk assessment

International Nuclear Information System (INIS)

Fisk, D.J.

1995-01-01

A brief presentation is given on developing policy based on a global environmental risk assessment. The author looks at the global warming issue as if it were a formal problem in risk assessment. He uses that framework to make one or two suggestions as to how the interaction of policy and research might evolve as the climate convention progresses

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

Science.gov (United States)

2012-07-31

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

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

Science.gov (United States)

2014-01-01

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

Global assessment of human losses due to earthquakes

Science.gov (United States)

Silva, Vitor; Jaiswal, Kishor; Weatherill, Graeme; Crowley, Helen

2014-01-01

Current studies have demonstrated a sharp increase in human losses due to earthquakes. These alarming levels of casualties suggest the need for large-scale investment in seismic risk mitigation, which, in turn, requires an adequate understanding of the extent of the losses, and location of the most affected regions. Recent developments in global and uniform datasets such as instrumental and historical earthquake catalogues, population spatial distribution and country-based vulnerability functions, have opened an unprecedented possibility for a reliable assessment of earthquake consequences at a global scale. In this study, a uniform probabilistic seismic hazard assessment (PSHA) model was employed to derive a set of global seismic hazard curves, using the open-source software OpenQuake for seismic hazard and risk analysis. These results were combined with a collection of empirical fatality vulnerability functions and a population dataset to calculate average annual human losses at the country level. The results from this study highlight the regions/countries in the world with a higher seismic risk, and thus where risk reduction measures should be prioritized.

ANALYSIS OF SCIENTIFIC RESEARCHES IN PHARMACEUTICAL PROMOTION GLOBALLY: TOWARDS INTERNATIONALLY DEVELOPING PRACTICALLY-ORIENTED GUIDELINES FOR PHARMACEUTICAL COMPANIES

Directory of Open Access Journals (Sweden)

M. M. Bahlol

2016-01-01

Full Text Available Purpose. Pharmaceutical industry is transnational and globally important. Many pharmaceutical companies operate their business in multinational and international forms in different countries. Diverse researches from different countries indicated and confirmed marketing promotion importance in pharmaceutical field. Therefore, marketing promotion and its effects are a very important issue that should be globally investigated in real life and evidence context. We oriented our research according to these scientific and practical values.Methodology. We reviewed pharmaceutical marketing promotion researches from more than 25 different countries, e.g., USA, Canada, Italy, France, Russia, India, Egypt and Syria where we employed our knowledge of three widely spread languages, i.e., English, Russian and Arabic. Such language variation supports us with large and variable amount of scientific knowledge, deep understanding and ability of analysis. Some studies investigated average response to pharmaceutical marketing promotion and few studies took into consideration heterogeneity in their effects with respect to advertising medium or drug characteristics.Originality. We investigated empirical evidences of pharmaceutical marketing promotion that can be directed to either consumer or healthcare professionals.Findings. We extracted, gathered and associated information of pharmaceutical promotion globally which oriented us to several evidence and practical facts with regard to employing promotion tools in different definite situations pertinent to main directions; their welfare and health enhancing effects and adverse effects. Practical Implications- Consequently, we developed practically-oriented guidelines for companies concerning pharmaceutical promotion globally ate the end of this paper.

Accountability for Early Childhood Education (Assessing Global Functioning).

Science.gov (United States)

Cassel, Russell N.

1995-01-01

Discusses the pacing of learning activity, knowledge of progress in student learning, teacher role, accountability in learning, feedback on knowledge of success, the global functioning assessment concept, and the mother surrogate. (RS)

Setting global standards for stem cell research and clinical translation : The 2016 ISSCR guidelines

NARCIS (Netherlands)

Daley, George Q.; Hyun, Insoo; Apperley, Jane F.; Barker, Roger A.; Benvenisty, Nissim; Bredenoord, Annelien L.; Breuer, Christopher K.; Caulfield, Timothy; Cedars, Marcelle I.; Frey-Vasconcells, Joyce; Heslop, Helen E.; Jin, Ying; Lee, Richard T.; McCabe, Christopher; Munsie, Megan; Murry, Charles E.; Piantadosi, Steven; Rao, Mahendra; Rooke, Heather M.; Sipp, Douglas; Studer, Lorenz; Sugarman, Jeremy; Takahashi, Masayo; Zimmerman, Mark; Kimmelman, Jonathan

2016-01-01

The International Society for Stem Cell Research (ISSCR) presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016). The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008) to address new and emerging areas of

Integrated assessment of the global warming problem. A decision-analytical approach

International Nuclear Information System (INIS)

Van Lenthe, J.; Hendrickx, L.; Vlek, C.A.J.

1995-01-01

The project on the title subject aims at developing a policy-oriented methodology for the integrated assessment of the global warming problem. Decision analysis in general and influence diagrams in particular appear to constitute an appropriate integrated assessment methodology. The influence-diagram approach is illustrated at a preliminary integrated modeling of the global warming problem. In next stages of the research, attention will be shifted from the methodology of integrated assessment to the contents of integrated models. 4 figs., 5 refs

ASSET guidelines. Revised 1991 Edition

International Nuclear Information System (INIS)

1991-12-01

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

Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain

NARCIS (Netherlands)

Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

2017-01-01

The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of

Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain

NARCIS (Netherlands)

Bier, Jasper D.; Scholten-Peeters, Wendy G.M.; Staal, J. Bart; Pool, Jan; van Tulder, Maurits W.; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P.

2018-01-01

The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of

Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain

NARCIS (Netherlands)

Bier, Jasper D.; Scholten-Peeters, Wendy G. M.; Staal, J. Bart; Pool, Jan; van Tulder, Maurits W.; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P.

The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of

Seismic and wind vulnerability assessment for the GAR-13 global risk assessment

OpenAIRE

Yamín Lacouture, Luis Eduardo; Hurtado Chaparro, Alvaro Ivan; Barbat Barbat, Horia Alejandro; Cardona Arboleda, Omar Dario

2014-01-01

A general methodology to evaluate vulnerability functions suitable for a probabilistic global risk assessment is proposed. The methodology is partially based in the methodological approach of the Multi-hazard Loss Estimation Methodology (Hazus) developed by the Federal Emergency Management Agency (FEMA). The vulnerability assessment process considers the resolution, information and limitations established for both the hazard and exposure models adopted. Seismic and wind vulnerability function...

Higher Education Globalization in the Context of American Guidelines

Science.gov (United States)

Bidyuk, Natalya

2016-01-01

The article deals with the problem of globalization impact on higher education system in the United Stated of America. It has been concluded that globalization as a phenomenon has been acquiring much significance in all the spheres, especially in higher education. Different views on the essence of globalization, especially in the context of higher…

High-resolution assessment of global technical and economic hydropower potential

NARCIS (Netherlands)

Gernaat, David E.H.J.; Bogaart, Patrick W.; Vuuren, van Detlef P.; Biemans, Hester; Niessink, Robin

2017-01-01

Hydropower is the most important renewable energy source to date, providing over 72% of all renewable electricity globally. Yet, only limited information is available on the global potential supply of hydropower and the associated costs. Here we provide a high-resolution assessment of the technical

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

Science.gov (United States)

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

2015-10-01

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

Assessing global resource utilization efficiency in the industrial sector

International Nuclear Information System (INIS)

Rosen, Marc A.

2013-01-01

Designing efficient energy systems, which also meet economic, environmental and other objectives and constraints, is a significant challenge. In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement. Energy analysis alone is inadequate, e.g., it yields energy efficiencies that do not provide limits to efficiency. To obtain meaningful and useful efficiencies for energy systems, and to clarify losses, exergy analysis is a beneficial and useful tool. Here, the global industrial sector and industries within it are assessed by using energy and exergy methods. The objective is to improve the understanding of the efficiency of global resource use in the industrial sector and, with this information, to facilitate the development, prioritization and ultimate implementation of rational improvement options. Global energy and exergy flow diagrams for the industrial sector are developed and overall efficiencies for the global industrial sector evaluated as 51% based on energy and 30% based on exergy. Consequently, exergy analysis indicates a less efficient picture of energy use in the global industrial sector than does energy analysis. A larger margin for improvement exists from an exergy perspective, compared to the overly optimistic margin indicated by energy. - Highlights: ► The global industrial sector and its industries are assessed by using energy and exergy methods. ► Global industrial sector efficiencies are evaluated as 51% based on energy and 30% based on exergy. ► Exergy analysis shows global industrial energy to be less efficient than does energy analysis. ► A misleadingly low margin for efficiency improvement is indicated by energy analysis. ► A significant and rational margin for efficiency improvement exists from an exergy perspective

Global warming and the challenge of international cooperation: an interdisciplinary assessment

International Nuclear Information System (INIS)

Bryner, G.C.

1992-01-01

The book aims to explore the nature of potential climatic change. It seeks to assess the scientific, economic legal and political issues related to the threat of global warming from an interdisciplinary perspective. The seven chapters have the following titles: the challenge of global warming; global warming and ozone depletion - certainties and uncertainties; consequences of global climate change for Earth's biosphere; global energy use and global warming; problems and prospects of institutionalizing ecological interdependence in a world of local independence; political institutions and climate change; and policy options for responding to the threat of global warming. Six chapters are abstracted separately. 158 refs

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

Science.gov (United States)

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

2015-11-01

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

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

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

Beyond offshoring: assess your company's global potential.

Science.gov (United States)

Farrell, Diana

2004-12-01

In the past few years, companies have become aware that they can slash costs by offshoring: moving jobs to lower-wage locations. But this practice is just the tip of the iceberg in terms of how globalization can transform industries, according to research by the McKinsey Global Institute (MGI). The institute's yearlong study suggests that by streamlining their production processes and supply chains globally, rather than just nationally or regionally, companies can lower their costs-as we've seen in the consumer-electronics and PC industries. Companies can save as much as 70% of their total costs through globalization--50% from offshoring, 5% from training and business-task redesign, and 15% from process improvements. But they don't have to stop there. The cost reductions make it possible to lower prices and expand into new markets, attracting whole new classes of customers. To date, however, few businesses have recognized the full scope of performance improvements that globalization makes possible, much less developed sound strategies for capturing those opportunities. In this article, Diana Farrell, director of MGI, offers a step-by-step approach to doing both things. Among her suggestions: Assess where your industry falls along the globalization spectrum, because not all sectors of the economy face the same challenges and opportunities at the same time. Also, pay attention to production, regulatory, and organizational barriers to globalization. If any of these can be changed, size up the cost-saving (and revenue-generating) opportunities that will emerge for your company as a result of those changes. Farrell also defines the five stages of globalization-market entry, product specialization, value chain disaggregation, value chain reengineering, and the creation of new markets-and notes the different levers for cutting costs and creating value that companies can use in each phase.

ASSESSMENT OF THE BUSINESS ENVIRONMENT FOR DEVELOPMENT OF GLOBAL MARKETING STRATEGY

Directory of Open Access Journals (Sweden)

V. Savelyev

2014-03-01

Full Text Available The article concerns with essence of assessment of the business environment and specific directions of analysis during the working out of global marketing strategy. The classification of the global marketing environment researches and tasks sequence in the context of the decisions made on each stage of global marketing strategy is proposed.

Integrated assessment of the global warming problem: A decision-analytical approach

International Nuclear Information System (INIS)

Van Lenthe, J.; Hendrickx, L.; Vlek, C.A.J.

1994-12-01

The multi-disciplinary character of the global warming problem asks for an integrated assessment approach for ordering and combining the various physical, ecological, economical, and sociological results. The Netherlands initiated their own National Research Program (NRP) on Global Air Pollution and Climate Change (NRP). The first phase (NRP-1) identified the integration theme as one of five central research themes. The second phase (NRP-2) shows a growing concern for integrated assessment issues. The current two-year research project 'Characterizing the risks: a comparative analysis of the risks of global warming and of relevant policy options, which started in September 1993, comes under the integrated assessment part of the Dutch NRP. The first part of the interim report describes the search for an integrated assessment methodology. It starts with emphasizing the need for integrated assessment at a relatively high level of aggregation and from a policy point of view. The conclusion will be that a decision-analytical approach might fit the purpose of a policy-oriented integrated modeling of the global warming problem. The discussion proceeds with an account on decision analysis and its explicit incorporation and analysis of uncertainty. Then influence diagrams, a relatively recent development in decision analysis, are introduced as a useful decision-analytical approach for integrated assessment. Finally, a software environment for creating and analyzing complex influence diagram models is discussed. The second part of the interim report provides a first, provisional integrated modeling of the global warming problem, emphasizing on the illustration of the decision-analytical approach. Major problem elements are identified and an initial problem structure is developed. The problem structure is described in terms of hierarchical influence diagrams. At some places the qualitative structure is filled with quantitative data

Guidelines for assessing favourable conservation status of Natura 2000 species and habitat types in Bulgaria

NARCIS (Netherlands)

Zingstra, H.L.; Kovachev, A.; Kitnaes, K.; Tzonev, R.; Dimova, D.; Tzvetkov, P.

2009-01-01

This executive summary describes the methodology for assessing the favourable conservation status of N2000 habitats and species on site level in Bulgaria and gives guidelines for its application. The methodology was developed in the frame of the BBI/Matra project 2006/014 “Favourable Conservation

Developing an International Assessment of Global Competence

Science.gov (United States)

Piacentini, Mario

2017-01-01

In 2014, an international, interdisciplinary group of experts came together under the auspices of the PISA Governing Board to consider a novel question: can an international assessment evaluate, the global competence of 15-year-old students? The experts recognized the need for data to understand how well students are prepared for life in…

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

DEFF Research Database (Denmark)

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

2018-01-01

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

The impact of evidence-based sepsis guidelines on emergency department clinical practice: a pre-post medical record audit.

Science.gov (United States)

Romero, Bernadine; Fry, Margaret; Roche, Michael

2017-11-01

To explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, emergency department management and time to antibiotics. Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis. To improve patient outcomes, the New South Wales government in Australia introduced sepsis guidelines into emergency departments. However, the impact of the guidelines on clinical practice remains unclear. A 12-month pre-post retrospective randomised medical record audit of adult patients with a sepsis diagnosis. Data were extracted from the emergency department database and paper medical record. Data included patient demographic (age, gender), clinical information (time of arrival, triage code, seen by time, disposition, time to antibiotic, pathology, time to intravenous fluids) and patient assessment data (heart rate, respiratory rate, blood pressure, temperature, oxygen saturations, medication). This study demonstrated a statistically significant 230-minute reduction in time to antibiotics post implementation of the guidelines. The post group (n = 165) received more urgent triage categories (n = 81; 49·1%), a 758-minute reduction in mean time to second litre of intravenous fluids and an improvement in collection of lactate (n = 112, 67·9%), also statistically significant. The findings highlight the impact the guidelines can have on clinician decision-making and behaviour that support best practice and positive patient outcomes. The sepsis guidelines improved the early assessment, recognition and management of patients presenting with sepsis in one tertiary referral emergency department. The use of evidenced-based guidelines can impact clinical decision-making and behaviour, resulting in the translation and support of

Setting Global Standards for Stem Cell Research and Clinical Translation: The 2016 ISSCR Guidelines

Directory of Open Access Journals (Sweden)

George Q. Daley

2016-06-01

Full Text Available The International Society for Stem Cell Research (ISSCR presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016. The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008 to address new and emerging areas of stem cell discovery and application and evolving ethical, social, and policy challenges. These guidelines provide an integrated set of principles and best practices to drive progress in basic, translational, and clinical research. The guidelines demand rigor, oversight, and transparency in all aspects of practice, providing confidence to practitioners and public alike that stem cell science can proceed efficiently and remain responsive to public and patient interests. Here, we highlight key elements and recommendations in the guidelines and summarize the recommendations and deliberations behind them.

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

Science.gov (United States)

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

2015-11-04

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

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

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

OpenAIRE

Safari, Sixtus Ruyumbu

2012-01-01

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

Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries.

Science.gov (United States)

Garnweidner-Holme, Lisa Maria; Dolvik, Stina; Frisvold, Cathrine; Mosdøl, Annhild

2016-02-01

To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Guideline-based survey of outpatient COPD management by pulmonary specialists in Germany

Directory of Open Access Journals (Sweden)

Buhl R

2012-02-01

Full Text Available Thomas Glaab1,2, Claus Vogelmeier3, Andreas Hellmann4, Roland Buhl11Department of Respiratory Diseases III, Medical Center of the Johannes Gutenberg-University, Mainz, 2Medical Affairs Germany, Respiratory Medicine, Boehringer Ingelheim Pharma GmbH and Co, KG, Ingelheim, 3Department of Respiratory Diseases, University Hospitals of Giessen and Marburg, Marburg, 4Federal Association of Pneumologists, Augsburg, GermanyBackground: Little is known about the role of guidelines for the practical management of chronic obstructive pulmonary disease (COPD by office-based pulmonary specialists. The aim of this study was to assess their outpatient management in relation to current guideline recommendations for COPD.Methods: A nationwide prospective cross-sectional COPD questionnaire survey in the form of a multiple-choice questionnaire was sent to 1000 office-based respiratory specialists in Germany. The product-neutral questions focused on routine COPD management and were based on current national and international COPD guideline recommendations being consistent in severity classification and treatment recommendations.Results: A total of 590 pulmonary specialists (59% participated in the survey. Body plethysmography was considered the standard for diagnosis (65.9%, followed by spirometry (32%. Most respondents were able to cite the correct spirometric criteria for classifying moderate (87% to very severe COPD (77%. A quarter of the respondents equated the World Health Organization (WHO definition of chronic bronchitis with COPD. Notably, most participants preferred the updated national COPD guidelines (51.4% to the Global Initiative for Chronic Obstructive Lung Disease (GOLD guidelines (40.2%. Improvement of functional exercise capacity and quality of life were considered the two most relevant treatment goals; whereas impact on mortality was secondary. Treatment of COPD largely complied with the guidelines. However, a significant percentage of the

[Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia].

Science.gov (United States)

Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Gil Lemus, Laura Marcela; Jaramillo, Luis Eduardo; García Valencia, Jenny; Bravo Narváez, Eliana; de la Hoz Bradford, Ana María; Palacio, Carlos

2013-01-01

Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it. To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression. Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them. Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Mexican Asthma Guidelines: GUIMA 2017

Directory of Open Access Journals (Sweden)

Désirée Larenas-Linnemann

2017-04-01

Full Text Available Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included. After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico.

Balancing Attended and Global Stimuli in Perceived Video Quality Assessment

DEFF Research Database (Denmark)

You, Junyong; Korhonen, Jari; Perkis, Andrew

2011-01-01

. This paper proposes a quality model based on the late attention selection theory, assuming that the video quality is perceived via two mechanisms: global and local quality assessment. First we model several visual features influencing the visual attention in quality assessment scenarios to derive......The visual attention mechanism plays a key role in the human perception system and it has a significant impact on our assessment of perceived video quality. In spite of receiving less attention from the viewers, unattended stimuli can still contribute to the understanding of the visual content...... an attention map using appropriate fusion techniques. The global quality assessment as based on the assumption that viewers allocate their attention equally to the entire visual scene, is modeled by four carefully designed quality features. By employing these same quality features, the local quality model...

Tropospheric Ozone Assessment Report: Assessment of global-scale model performance for global and regional ozone distributions, variability, and trends

Directory of Open Access Journals (Sweden)

P. J. Young

2018-01-01

Full Text Available The goal of the Tropospheric Ozone Assessment Report (TOAR is to provide the research community with an up-to-date scientific assessment of tropospheric ozone, from the surface to the tropopause. While a suite of observations provides significant information on the spatial and temporal distribution of tropospheric ozone, observational gaps make it necessary to use global atmospheric chemistry models to synthesize our understanding of the processes and variables that control tropospheric ozone abundance and its variability. Models facilitate the interpretation of the observations and allow us to make projections of future tropospheric ozone and trace gas distributions for different anthropogenic or natural perturbations. This paper assesses the skill of current-generation global atmospheric chemistry models in simulating the observed present-day tropospheric ozone distribution, variability, and trends. Drawing upon the results of recent international multi-model intercomparisons and using a range of model evaluation techniques, we demonstrate that global chemistry models are broadly skillful in capturing the spatio-temporal variations of tropospheric ozone over the seasonal cycle, for extreme pollution episodes, and changes over interannual to decadal periods. However, models are consistently biased high in the northern hemisphere and biased low in the southern hemisphere, throughout the depth of the troposphere, and are unable to replicate particular metrics that define the longer term trends in tropospheric ozone as derived from some background sites. When the models compare unfavorably against observations, we discuss the potential causes of model biases and propose directions for future developments, including improved evaluations that may be able to better diagnose the root cause of the model-observation disparity. Overall, model results should be approached critically, including determining whether the model performance is acceptable for

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

International Nuclear Information System (INIS)

Ghayur, S.; Tariq, H.

2013-01-01

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

Compliance with practice guidelines: clinical autonomy revisited

NARCIS (Netherlands)

Klazinga, N.

1994-01-01

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

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

Science.gov (United States)

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

2013-01-01

To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. All 19-year-old patients registered at eight public dental clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk classification was predominantly based on past caries and/or present caries activity. The majority was classified as 'some risk', while 16.7% were assessed as being of 'high' or 'very high risk'. The corresponding value for the two highest risk groups in the Cariogram model was 17.4%. The agreement between the two models was found acceptable (77.5%) for those assessed as low risk, while discrepancies were disclosed among those classified with higher risks. Although the proportion of subjects assessed with high or very high risk was similar using the PDS guidelines and the Cariogram model, the agreement between the models was fair. An acceptable agreement was only disclosed for the low risk category.

Reliability of scored patient generated subjective global assessment ...

African Journals Online (AJOL)

Objective: Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults. Methods: A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization ...

Validation of a global assessment of arthroscopic skills in a cadaveric knee model.

Science.gov (United States)

Slade Shantz, Jesse A; Leiter, Jeff R; Collins, John B; MacDonald, Peter B

2013-01-01

The purpose of this study was to determine whether a global assessment of arthroscopic skills was valid for blinded assessment of cadaveric diagnostic knee arthroscopy. A global skills assessment for arthroscopy was created using a published theory of the development of expertise. Faculty surgeons, fellows, and residents were consented and enrolled in this institutional review board-approved validation study. All participants were oriented to the equipment and procedures for diagnostic arthroscopy of the knee. After reviewing the anatomic structures to be visualized, participants were allowed 10 minutes to complete a diagnostic arthroscopy of the knee. The hands and arthroscopic view were recorded during this attempt. Resident participants completed a second filmed diagnostic arthroscopy 1 week after the initial attempt. Five blinded reviewers watched the synchronized videos and assessed arthroscopic skills with a procedure-specific checklist and the newly developed global skills assessment. The agreement between reviewers was determined by intraclass correlation coefficient. Internal consistency was determined with Cronbach's α. Test-retest reliability was measured by correlating repeated arthroscopies by residents. The ability of the global assessment to discriminate skill levels was determined with between-group Mann-Whitney U tests. The agreement between global assessment scores was strong (I.C.C. = 0.80, 95% C.I. 0.68-0.92). The internal consistency of evaluations was excellent (Cronbach's α = 0.97), and the test-retest reliability was strong (r = 0.52). The global assessment score was shown to be able to discriminate between skill levels by an analysis of variance indicating the difference in means among the various levels of training (P Assessment of Arthroscopic Skills is a useful adjunct to arthroscopic educators and learners and could be used for in-training evaluations. The Objective Assessment of Arthroscopic Skills is an instrument that can be

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

Science.gov (United States)

Westphal, Glauco Adrieno; Garcia, Valter Duro; de Souza, Rafael Lisboa; Franke, Cristiano Augusto; Vieira, Kalinca Daberkow; Birckholz, Viviane Renata Zaclikevis; Machado, Miriam Cristine; de Almeida, Eliana Régia Barbosa; Machado, Fernando Osni; Sardinha, Luiz Antônio da Costa; Wanzuita, Raquel; Silvado, Carlos Eduardo Soares; Costa, Gerson; Braatz, Vera; Caldeira Filho, Milton; Furtado, Rodrigo; Tannous, Luana Alves; de Albuquerque, André Gustavo Neves; Abdala, Edson; Gonçalves, Anderson Ricardo Roman; Pacheco-Moreira, Lúcio Filgueiras; Dias, Fernando Suparregui; Fernandes, Rogério; Giovanni, Frederico Di; de Carvalho, Frederico Bruzzi; Fiorelli, Alfredo; Teixeira, Cassiano; Feijó, Cristiano; Camargo, Spencer Marcantonio; de Oliveira, Neymar Elias; David, André Ibrahim; Prinz, Rafael Augusto Dantas; Herranz, Laura Brasil; de Andrade, Joel

2016-01-01

Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors. PMID:27737418

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

Science.gov (United States)

Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

2018-03-01

We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Global Assessment of Bisphenol A in the Environment

Directory of Open Access Journals (Sweden)

Jone Corrales

2015-07-01

Full Text Available Because bisphenol A (BPA is a high production volume chemical, we examined over 500 peer-reviewed studies to understand its global distribution in effluent discharges, surface waters, sewage sludge, biosolids, sediments, soils, air, wildlife, and humans. Bisphenol A was largely reported from urban ecosystems in Asia, Europe, and North America; unfortunately, information was lacking from large geographic areas, megacities, and developing countries. When sufficient data were available, probabilistic hazard assessments were performed to understand global environmental quality concerns. Exceedances of Canadian Predicted No Effect Concentrations for aquatic life were >50% for effluents in Asia, Europe, and North America but as high as 80% for surface water reports from Asia. Similarly, maximum concentrations of BPA in sediments from Asia were higher than Europe. Concentrations of BPA in wildlife, mostly for fish, ranged from 0.2 to 13 000 ng/g. We observed 60% and 40% exceedences of median levels by the US Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey in Europe and Asia, respectively. These findings highlight the utility of coordinating global sensing of environmental contaminants efforts through integration of environmental monitoring and specimen banking to identify regions for implementation of more robust environmental assessment and management programs.

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

Science.gov (United States)

Townend, William K; Cheeseman, Christopher R

2005-10-01

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

Design Guidelines for New Generation Network Architecture

Science.gov (United States)

Harai, Hiroaki; Fujikawa, Kenji; Kafle, Ved P.; Miyazawa, Takaya; Murata, Masayuki; Ohnishi, Masaaki; Ohta, Masataka; Umezawa, Takeshi

Limitations are found in the recent Internet because a lot of functions and protocols are patched to the original suite of layered protocols without considering global optimization. This reveals that end-to-end argument in the original Internet was neither sufficient for the current societal network and nor for a sustainable network of the future. In this position paper, we present design guidelines for a future network, which we call the New Generation Network, which provides the inclusion of diverse human requirements, reliable connection between the real-world and virtual network space, and promotion of social potentiality for human emergence. The guidelines consist of the crystal synthesis, the reality connection, and the sustainable & evolutional guidelines.

PIAAC Technical Standards and Guidelines

Science.gov (United States)

OECD Publishing, 2014

2014-01-01

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

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

Science.gov (United States)

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

2006-10-01

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

Assessing tourism's global environmental impact 1900–2050

NARCIS (Netherlands)

Gössling, Stefan; Peeters, Paul

2015-01-01

This paper pioneers the assessment of tourism's total global resource use, including its fossil fuel consumption, associated CO₂ emissions, fresh water, land, and food use. As tourism is a dynamic growth system, characterized by rapidly increasing tourist numbers, understanding its

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

NARCIS (Netherlands)

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

2017-01-01

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

Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams.

Science.gov (United States)

Creed, Michael; Whitley, Rob

2017-05-01

Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Articles about Robin Williams' suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the "Covering Suicide" section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was "Do tell others considering suicide how they can get help," which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se.

Global Water Scarcity Assessment under Post-SRES Scenarios

Science.gov (United States)

Hanasaki, N.; Fujimori, S.

2011-12-01

A large number of future projections contributed to the fourth Assessment Report of IPCC were based on Special Report on Emission Scenarios (SRES). Processes toward the fifth Assessment Report are under way, and post-SRES scenarios, called Shared Socio-economic Pathways (SSP) are being prepared. One of the key challenges of SSP is provision of detailed socio-economic scenarios compared to SRES for impact, adaptation and vulnerability studies. In this study, a comprehensive global water scarcity assessment was conducted, using a state of the art global water resources model H08 (Hanasaki et al., 2008a, 2008b, 2010). We used a prototype of SSP developed by National Institute for Environmental Studies, Japan. Two sets of socio economic scenarios and two sets of climate scenarios were prepared to run H08 for the period 2001-2100. Socio-economic scenarios include Business As Usual and High Mitigation Capacity. Climate scenarios include Reference and Mitigation which stabilizes green house gas concentration at a certain level. We analyzed the simulation results of four combinations, particularly focusing on the sensitivity of socio-economic scenarios to major water resources indices.

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

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-07-01

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

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

International Nuclear Information System (INIS)

Carter, R.J.

1997-07-01

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

An integrated model for the assessment of global water resources – Part 2: Applications and assessments

Directory of Open Access Journals (Sweden)

N. Hanasaki

2008-07-01

Full Text Available To assess global water resources from the perspective of subannual variation in water availability and water use, an integrated water resources model was developed. In a companion report, we presented the global meteorological forcing input used to drive the model and six modules, namely, the land surface hydrology module, the river routing module, the crop growth module, the reservoir operation module, the environmental flow requirement module, and the anthropogenic withdrawal module. Here, we present the results of the model application and global water resources assessments. First, the timing and volume of simulated agriculture water use were examined because agricultural use composes approximately 85% of total consumptive water withdrawal in the world. The estimated crop calendar showed good agreement with earlier reports for wheat, maize, and rice in major countries of production. In major countries, the error in the planting date was ±1 mo, but there were some exceptional cases. The estimated irrigation water withdrawal also showed fair agreement with country statistics, but tended to be underestimated in countries in the Asian monsoon region. The results indicate the validity of the model and the input meteorological forcing because site-specific parameter tuning was not used in the series of simulations. Finally, global water resources were assessed on a subannual basis using a newly devised index. This index located water-stressed regions that were undetected in earlier studies. These regions, which are indicated by a gap in the subannual distribution of water availability and water use, include the Sahel, the Asian monsoon region, and southern Africa. The simulation results show that the reservoir operations of major reservoirs (>1 km³ and the allocation of environmental flow requirements can alter the population under high water stress by approximately −11% to +5% globally. The integrated model is applicable to

Use of Subjective Global Assessment, Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 to evaluate the nutritional status of non-critically ill patients on parenteral nutrition.

Science.gov (United States)

Badia-Tahull, M B; Cobo-Sacristán, S; Leiva-Badosa, E; Miquel-Zurita, M E; Méndez-Cabalerio, N; Jódar-Masanés, R; Llop-Talaverón, J

2014-02-01

To evaluate the nutritional status of non-critically ill digestive surgery patients at the moment of parenteral nutrition initiation using three different nutritional test tools and to study their correlation. To study the association between the tests and the clinical and laboratory parameters used in the follow-up of PN treatment. Prospective study over 4 months. Anthropometric and clinical variables were recorded. Results of Subjective Global Assessment; Patient-Generated Subjective Global Assessment; and Nutritional Risk Screening 2002 were compared applying kappa test. Relationship between the clinical and laboratory parameters with Subjective Global Assessment was studied by multinominal regression and with the other two tests by multiple linear regression models. Age and sex were included as adjustment variables. Malnutrition in 45 studied patients varied from 51% to 57%. Subjective Global Assessment correlated well with Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 (κ = 0531 p = 0.000). The test with the greatest correlation with the clinical and analytical variables was the Nutritional Risk Screening 2002. Worse nutritional state in this test was associated with worse results in albumin (B = -0.087; CI = -0.169/-0.005], prealbumin (B = -0.005; CI = [-0.011/-0.001]), C-reactive protein (B = 0.006;CI = [0.001/ 0.011]) and leukocytes (B = 0.134; CI = [0.031/0.237]) at the en of parenteral nutrition treatment. Half of the digestive surgery patients were at malnutritional risk at the moment of initiating parenteral nutrition. Nutritional Risk Screening 2002 was the test with best association with the parameters used in the clinical follow-up of parenteral nutrition treated patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Guideline recommendations and antimicrobial resistance: the need for a change.

Science.gov (United States)

Elias, Christelle; Moja, Lorenzo; Mertz, Dominik; Loeb, Mark; Forte, Gilles; Magrini, Nicola

2017-07-26

Antimicrobial resistance has become a global burden for which inappropriate antimicrobial use is an important contributing factor. Any decisions on the selection of antibiotics use should consider their effects on antimicrobial resistance. The objective of this study was to assess the extent to which antibiotic prescribing guidelines have considered resistance patterns when making recommendations for five highly prevalent infectious syndromes. We used Medline searches complemented with extensive use of Web engine to identify guidelines on empirical treatment of community-acquired pneumonia, urinary tract infections, acute otitis media, rhinosinusitis and pharyngitis. We collected data on microbiology and resistance patterns and identified discrete pattern categories. We assessed the extent to which recommendations considered resistance, in addition to efficacy and safety, when recommending antibiotics. We identified 135 guidelines, which reported a total of 251 recommendations. Most (103/135, 79%) were from developed countries. Community-acquired pneumonia was the syndrome mostly represented (51, 39%). In only 16 (6.4%) recommendations, selection of empirical antibiotic was discussed in relation to resistance and specific microbiological data. In a further 69 (27.5%) recommendations, references were made in relation to resistance, but the attempt was inconsistent. Across syndromes, 12 patterns of resistance with implications on recommendations were observed. 50% to 75% of recommendations did not attempt to set recommendation in the context of these patterns. There is consistent evidence that guidelines on empirical antibiotic use did not routinely consider resistance in their recommendations. Decision-makers should analyse and report the extent of local resistance patterns to allow better decision-making. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

Directory of Open Access Journals (Sweden)

Samir Gupta

2016-01-01

Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

Framework for ecological risk assessment

International Nuclear Information System (INIS)

Rodier, D.; Norton, S.

1992-02-01

Increased interest in ecological issues such as global climate change, habitat loss, acid deposition, reduced biological diversity, and the ecological impacts of pesticides and toxic chemicals prompts this U.S. Environmental Protection Agency (EPA) report, A Framework for Ecological Risk Assessment ('Framework Report'). The report describes basic elements, or a framework, for evaluating scientific information on the adverse effects of physical and chemical stressors on the environment. The framework offers starting principles and a simple structure as guidance for current ecological risk assessments and as a foundation for future EPA proposals for risk assessment guidelines

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

Science.gov (United States)

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

2011-01-01

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

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

International Nuclear Information System (INIS)

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

1988-07-01

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

ASCOT guidelines

International Nuclear Information System (INIS)

1994-05-01

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

Systematic evaluation of clinical practice guidelines for pharmacogenomics.

Science.gov (United States)

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

2018-06-01

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

The distance between Mars and Venus: measuring global sex differences in personality.

Science.gov (United States)

Del Giudice, Marco; Booth, Tom; Irwing, Paul

2012-01-01

Sex differences in personality are believed to be comparatively small. However, research in this area has suffered from significant methodological limitations. We advance a set of guidelines for overcoming those limitations: (a) measure personality with a higher resolution than that afforded by the Big Five; (b) estimate sex differences on latent factors; and (c) assess global sex differences with multivariate effect sizes. We then apply these guidelines to a large, representative adult sample, and obtain what is presently the best estimate of global sex differences in personality. Personality measures were obtained from a large US sample (N = 10,261) with the 16PF Questionnaire. Multigroup latent variable modeling was used to estimate sex differences on individual personality dimensions, which were then aggregated to yield a multivariate effect size (Mahalanobis D). We found a global effect size D = 2.71, corresponding to an overlap of only 10% between the male and female distributions. Even excluding the factor showing the largest univariate ES, the global effect size was D = 1.71 (24% overlap). These are extremely large differences by psychological standards. The idea that there are only minor differences between the personality profiles of males and females should be rejected as based on inadequate methodology.

Environmental Engineering Curricula assessment in the global world

Science.gov (United States)

Caporali, Enrica; Catelani, Marcantonio; Manfrida, Giampaolo; Valdiserri, Juna

2014-05-01

Environmental engineers are technicians with specific expertise on the sustainability of human presence in the environment. Among other global dilemmas, to the environmental engineers it is often demanded to be able in developing systematic, innovative solutions in order to simultaneously meet water and energy needs, to build resilience to natural and technological disasters, to more accurately gauge and manage countries' greenhouse gas emissions. The general objectives of the Environmental Engineers are to establish actions of environmental sustainability as well as to verify progress toward global goals or international commitments. The globalization of challenges and problems to be faced, leads, in general, to the globalization of the engineering profession. In particular, since the environmental issues are without boundaries, and many and different are the involved professions and the competences, the environmental engineer must have a multidisciplinary and interdisciplinary approach to adequately answer to the demand of technical innovative knowledge at global scale. The environmental engineers, more and more, are involved in international projects were the effective collaboration requires not only the capacity to communicate in a common technical language, but also the assurance of an adequate and common level of technical competences, knowledge and understanding. The Europe-based EUR ACE system, currently operated by ENAEE - European Network for Accreditation of Engineering Education, can represent the proper framework and accreditation system in order to provide a set of measures to assess the quality of engineering degree programmes in Europe and abroad. In the global frame of the knowledge triangle: education-innovation-research, the accreditation and quality assurance of engineering curricula in Europe is discussed with reference to the Environmental engineering curricula, of the 1st and 2nd cycle, based on the European Credit Transfer System and in

Assessing flood risk at the global scale: model setup, results, and sensitivity

International Nuclear Information System (INIS)

Ward, Philip J; Jongman, Brenden; Weiland, Frederiek Sperna; Winsemius, Hessel C; Bouwman, Arno; Ligtvoet, Willem; Van Beek, Rens; Bierkens, Marc F P

2013-01-01

Globally, economic losses from flooding exceeded $19 billion in 2012, and are rising rapidly. Hence, there is an increasing need for global-scale flood risk assessments, also within the context of integrated global assessments. We have developed and validated a model cascade for producing global flood risk maps, based on numerous flood return-periods. Validation results indicate that the model simulates interannual fluctuations in flood impacts well. The cascade involves: hydrological and hydraulic modelling; extreme value statistics; inundation modelling; flood impact modelling; and estimating annual expected impacts. The initial results estimate global impacts for several indicators, for example annual expected exposed population (169 million); and annual expected exposed GDP ($1383 billion). These results are relatively insensitive to the extreme value distribution employed to estimate low frequency flood volumes. However, they are extremely sensitive to the assumed flood protection standard; developing a database of such standards should be a research priority. Also, results are sensitive to the use of two different climate forcing datasets. The impact model can easily accommodate new, user-defined, impact indicators. We envisage several applications, for example: identifying risk hotspots; calculating macro-scale risk for the insurance industry and large companies; and assessing potential benefits (and costs) of adaptation measures. (letter)

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

Science.gov (United States)

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

2016-01-01

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

Local to global: a collaborative approach to volcanic risk assessment

Science.gov (United States)

Calder, Eliza; Loughlin, Sue; Barsotti, Sara; Bonadonna, Costanza; Jenkins, Susanna

2017-04-01

Volcanic risk assessments at all scales present challenges related to the multitude of volcanic hazards, data gaps (hazards and vulnerability in particular), model representation and resources. Volcanic hazards include lahars, pyroclastic density currents, lava flows, tephra fall, ballistics, gas dispersal and also earthquakes, debris avalanches, tsunamis and more ... they can occur in different combinations and interact in different ways throughout the unrest, eruption and post-eruption period. Volcanoes and volcanic hazards also interact with other natural hazards (e.g. intense rainfall). Currently many hazards assessments consider the hazards from a single volcano but at national to regional scales the potential impacts of multiple volcanoes over time become important. The hazards that have the greatest tendency to affect large areas up to global scale are those transported in the atmosphere: volcanic particles and gases. Volcanic ash dispersal has the greatest potential to directly or indirectly affect the largest number of people worldwide, it is currently the only volcanic hazard for which a global assessment exists. The quantitative framework used (primarily at a regional scale) considers the hazard at a given location from any volcano. Flow hazards such as lahars and floods can have devastating impacts tens of kilometres from a source volcano and lahars can be devastating decades after an eruption has ended. Quantitative assessment of impacts is increasingly undertaken after eruptions to identify thresholds for damage and reduced functionality. Some hazards such as lava flows could be considered binary (totally destructive) but others (e.g. ash fall) have varying degrees of impact. Such assessments are needed to enhance available impact and vulnerability data. Currently, most studies focus on physical vulnerability but there is a growing emphasis on social vulnerability showing that it is highly variable and dynamic with pre-eruption socio

Industry guidelines for the calibration of maximum anemometers

Energy Technology Data Exchange (ETDEWEB)

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

1996-12-31

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

Reducing aquatic hazards of industrial chemicals: probabilistic assessment of sustainable molecular design guidelines.

Science.gov (United States)

Connors, Kristin A; Voutchkova-Kostal, Adelina M; Kostal, Jakub; Anastas, Paul; Zimmerman, Julie B; Brooks, Bryan W

2014-08-01

Basic toxicological information is lacking for the majority of industrial chemicals. In addition to increasing empirical toxicity data through additional testing, prospective computational approaches to drug development aim to serve as a rational basis for the design of chemicals with reduced toxicity. Recent work has resulted in the derivation of a "rule of 2," wherein chemicals with an octanol-water partition coefficient (log P) less than 2 and a difference between the lowest unoccupied molecular orbital and the highest occupied molecular orbital (ΔE) greater than 9 (log P9 eV) are predicted to be 4 to 5 times less likely to elicit acute or chronic toxicity to model aquatic organisms. The present study examines potential reduction of aquatic toxicity hazards from industrial chemicals if these 2 molecular design guidelines were employed. Probabilistic hazard assessment approaches were used to model the likelihood of encountering industrial chemicals exceeding toxicological categories of concern both with and without the rule of 2. Modeling predicted that utilization of these molecular design guidelines for log P and ΔE would appreciably decrease the number of chemicals that would be designated to be of "high" and "very high" concern for acute and chronic toxicity to standard model aquatic organisms and end points as defined by the US Environmental Protection Agency. For example, 14.5% of chemicals were categorized as having high and very high acute toxicity to the fathead minnow model, whereas only 3.3% of chemicals conforming to the design guidelines were predicted to be in these categories. Considerations of specific chemical classes (e.g., aldehydes), chemical attributes (e.g., ionization), and adverse outcome pathways in representative species (e.g., receptor-mediated responses) could be used to derive future property guidelines for broader classes of contaminants. © 2014 SETAC.

Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

Science.gov (United States)

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

2017-01-01

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

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

OpenAIRE

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

2015-01-01

The IUCN Red List is the most widely used tool to measure extinction risk and report biodiversity trends. Accurate and standardised conservation status assessments for the IUCN Red List are limited by a lack of adequate information; and need consistent and unbiased interpretation of that information. Variable interpretation stems from a lack of quantified thresholds in certain areas of the Red List guidelines. Thus, even in situations with sufficient information to make a Red List assessment,...

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

OpenAIRE

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

2015-01-01

The IUCN Red List is the most widely used tool to measure extinction risk and report biodiversity trends. Accurate and standardized conservation status assessments for the IUCN Red List are limited by a lack of adequate information; and need consistent and unbiased interpretation of that information. Variable interpretation stems from a lack of quantified thresholds in certain areas of the Red List guidelines. Thus, even in situations with sufficient information to make a Red List assessment,...

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

Science.gov (United States)

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

2016-03-01

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

Assessment in the global context: From ozone to ecosystems

CSIR Research Space (South Africa)

Scholes, B

2017-10-01

Full Text Available This presentation discusses the assessment in the global context: From ozone to ecosystems. Process to evaluate the status of knowledge on complex problems relevant to societies. A key element of the contemporary science-policy interface....

An Approach for Assessing the Benefits of IT Investments in Global Supply Chains

DEFF Research Database (Denmark)

Betz, Michaela; Henningsson, Stefan

2016-01-01

-duced by the technology as an isolated product. In contrast, research on global supply chains has shown that benefits generated from IT investments in this domain are typically generated by the coor-dinated use of many stakeholders and by technologies producing complimentary effects in systemic relationships......This paper develops and demonstrates a novel approach for ex-ante assessment of business benefits from IT investments in global supply chains. Extant IT assessment approaches are typically based on the assumption that benefit realization from IT investments involves a single stakeholder and are pro....... The assessment approach in this paper brings the contingent inter-organizational and technological dependencies of IT investments to the forefront of the assessment. It provides actors in industries relating to global supply chains the means to better apprehend the possible benefits from an IT investment...

Integrated assessment models of global climate change

International Nuclear Information System (INIS)

Parson, E.A.; Fisher-Vanden, K.

1997-01-01

The authors review recent work in the integrated assessment modeling of global climate change. This field has grown rapidly since 1990. Integrated assessment models seek to combine knowledge from multiple disciplines in formal integrated representations; inform policy-making, structure knowledge, and prioritize key uncertainties; and advance knowledge of broad system linkages and feedbacks, particularly between socio-economic and bio-physical processes. They may combine simplified representations of the socio-economic determinants of greenhouse gas emissions, the atmosphere and oceans, impacts on human activities and ecosystems, and potential policies and responses. The authors summarize current projects, grouping them according to whether they emphasize the dynamics of emissions control and optimal policy-making, uncertainty, or spatial detail. They review the few significant insights that have been claimed from work to date and identify important challenges for integrated assessment modeling in its relationships to disciplinary knowledge and to broader assessment seeking to inform policy- and decision-making. 192 refs., 2 figs

Open Source Tools for Assessment of Global Water Availability, Demands, and Scarcity

Science.gov (United States)

Li, X.; Vernon, C. R.; Hejazi, M. I.; Link, R. P.; Liu, Y.; Feng, L.; Huang, Z.; Liu, L.

2017-12-01

Water availability and water demands are essential factors for estimating water scarcity conditions. To reproduce historical observations and to quantify future changes in water availability and water demand, two open source tools have been developed by the JGCRI (Joint Global Change Research Institute): Xanthos and GCAM-STWD. Xanthos is a gridded global hydrologic model, designed to quantify and analyze water availability in 235 river basins. Xanthos uses a runoff generation and a river routing modules to simulate both historical and future estimates of total runoff and streamflows on a monthly time step at a spatial resolution of 0.5 degrees. GCAM-STWD is a spatiotemporal water disaggregation model used with the Global Change Assessment Model (GCAM) to spatially downscale global water demands for six major enduse sectors (irrigation, domestic, electricity generation, mining, and manufacturing) from the region scale to the scale of 0.5 degrees. GCAM-STWD then temporally downscales the gridded annual global water demands to monthly results. These two tools, written in Python, can be integrated to assess global, regional or basin-scale water scarcity or water stress. Both of the tools are extensible to ensure flexibility and promote contribution from researchers that utilize GCAM and study global water use and supply.

Misguided guidelines for managing labor.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2015-06-01

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

Golding, D.; White, A.

1990-12-01

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

Impact of globalization under the ICH guidelines on the conduct of reproductive toxicity studies--report on current status in Japan, Europe and the U.S. by questionnaire survey.

Science.gov (United States)

Mineshima, Hiroshi; Endo, Yoshihiko; Ogasawara, Hiroyuki; Nishigaki, Keiji; Numa, Toshiaki; Hirano, Fumiya; Matsuzawa, Toshiaki

2004-08-01

We surveyed interpretation of the ICH guidelines concerning reproductive toxicology. Valid responses were obtained from Japan (JPN), Europe (EUR) and the U.S. The results obtained were compared to those at the time of a previous survey targeted at JPN facilities in 1995-1996 as well as compared among all three regions. Compared to the previous survey in Japan, the number of facilities performing toxicokinetics (TK) in rats has slightly increased. This result was considered to represent changes of attitude toward TK in reproductive toxicity studies. Differences in interpretation of the guidelines between JPN, EUR and the US were widely seen. Clear differences were noted in sperm examinations, postnatal tests, fetal examinations, some examinations for F1 animals after culling and TK. Researchers in the West seemed to be interpreting the ICH guidelines more flexibly from the scientific point of view. JPN researchers appeared to interpret the guidelines, including notes, as rigid requirements. Most of the parts which produced different interpretations were the notes in the guidelines. The force of mention in the notes should be defined in the future. In addition, there were doubts about some parts, including notes, which had been found to have become unsuitable for the implementation of studies because of scientific progress or from long experience in using the guidelines. Therefore, updates of the guidelines may be needed in the future as well as the remedy of interpretation by JPN researchers. In JPN, the number of reproductive toxicity studies has decreased. The scanty experience in JPN therefore raises apprehension of appropriate selection and stagnating development of methodology, and might hinder the maintenance of the guidelines. In the future, the cooperation of CROs as well as global collaboration will be essential not only to scientific developments of reproductive toxicology but also updates of the guidelines.

Japanese guidelines for childhood asthma 2017.

Science.gov (United States)

Arakawa, Hirokazu; Hamasaki, Yuhei; Kohno, Yoichi; Ebisawa, Motohiro; Kondo, Naomi; Nishima, Sankei; Nishimuta, Toshiyuki; Morikawa, Akihiro

2017-04-01

The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2017 (JAGL 2017) includes a minor revision of the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. The section on child asthma in JAGL 2017 provides information on how to diagnose asthma between infancy and adolescence (0-15 years of age). It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management. This guideline will be of interest to non-specialist physicians involved in the care of children with asthma. JAGL differs from the Global Initiative for Asthma Guideline in that JAGL emphasizes diagnosis and early intervention of children with asthma at asthma control levels, is easy to understand; thus, this guideline is suitable for the routine medical care of children with asthma. JAGL also recommends using a control test in children, so that the physician aims for complete control by avoiding exacerbating factors and appropriately using anti-inflammatory drugs (for example, inhaled corticosteroids and leukotriene receptor antagonists). Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Inconsistencies in clinical guidelines for obstetric anaesthesia for Caesarean section

DEFF Research Database (Denmark)

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

2013-01-01

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

Framework for e-learning assessment in dental education: a global model for the future.

Science.gov (United States)

Arevalo, Carolina R; Bayne, Stephen C; Beeley, Josie A; Brayshaw, Christine J; Cox, Margaret J; Donaldson, Nora H; Elson, Bruce S; Grayden, Sharon K; Hatzipanagos, Stylianos; Johnson, Lynn A; Reynolds, Patricia A; Schönwetter, Dieter J

2013-05-01

The framework presented in this article demonstrates strategies for a global approach to e-curricula in dental education by considering a collection of outcome assessment tools. By combining the outcomes for overall assessment, a global model for a pilot project that applies e-assessment tools to virtual learning environments (VLE), including haptics, is presented. Assessment strategies from two projects, HapTEL (Haptics in Technology Enhanced Learning) and UDENTE (Universal Dental E-learning), act as case-user studies that have helped develop the proposed global framework. They incorporate additional assessment tools and include evaluations from questionnaires and stakeholders' focus groups. These measure each of the factors affecting the classical teaching/learning theory framework as defined by Entwistle in a standardized manner. A mathematical combinatorial approach is proposed to join these results together as a global assessment. With the use of haptic-based simulation learning, exercises for tooth preparation assessing enamel and dentine were compared to plastic teeth in manikins. Equivalence for student performance for haptic versus traditional preparation methods was established, thus establishing the validity of the haptic solution for performing these exercises. Further data collected from HapTEL are still being analyzed, and pilots are being conducted to validate the proposed test measures. Initial results have been encouraging, but clearly the need persists to develop additional e-assessment methods for new learning domains.

Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India

Directory of Open Access Journals (Sweden)

Surendra K Sharma

2017-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

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

NARCIS (Netherlands)

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

2009-01-01

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

Operational research on implementation of tuberculosis guidelines in Mozambique

NARCIS (Netherlands)

Brouwer, M.A.

2015-01-01

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

The appraisal of clinical guidelines in dentistry.

Science.gov (United States)

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

2009-01-01

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

Influenza vaccination guidelines and vaccine sales in southeast Asia: 2008-2011.

Directory of Open Access Journals (Sweden)

Vinay Gupta

Full Text Available BACKGROUND: Southeast Asia is a region with great potential for the emergence of a pandemic influenza virus. Global efforts to improve influenza surveillance in this region have documented the burden and seasonality of influenza viruses and have informed influenza prevention strategies, but little information exists about influenza vaccination guidelines and vaccine sales. METHODS: To ascertain the existence of influenza vaccine guidelines and define the scope of vaccine sales, we sent a standard three-page questionnaire to the ten member nations of the Association of Southeast Asian Nations. We also surveyed three multinational manufacturers who supply influenza vaccines in the region. RESULTS: Vaccine sales in the private sector were <1000 per 100,000 population in the 10 countries. Five countries reported purchasing vaccine for use in the public sector. In 2011, Thailand had the highest combined reported rate of vaccine sales (10,333 per 100,000. In the 10 countries combined, the rate of private sector sales during 2010-2011 (after the A(H1N12009pdm pandemic exceeded 2008 pre-pandemic levels. Five countries (Indonesia, Malaysia, Singapore, Thailand and Vietnam had guidelines for influenza vaccination but only two were consistent with global guidelines. Four recommended vaccination for health care workers, four for elderly persons, three for young children, three for persons with underlying disease, and two for pregnant women. CONCLUSIONS: The rate of vaccine sales in Southeast Asia remains low, but there was a positive impact in sales after the A(H1N12009pdm pandemic. Low adherence to global vaccine guidelines suggests that more work is needed in the policy arena.

Assessing Climate Change Impacts on Global Hydropower

Directory of Open Access Journals (Sweden)

Aanund Killingtveit

2012-02-01

Full Text Available Currently, hydropower accounts for close to 16% of the world’s total power supply and is the world’s most dominant (86% source of renewable electrical energy. The key resource for hydropower generation is runoff, which is dependent on precipitation. The future global climate is uncertain and thus poses some risk for the hydropower generation sector. The crucial question and challenge then is what will be the impact of climate change on global hydropower generation and what are the resulting regional variations in hydropower generation potential? This paper is a study that aims to evaluate the changes in global hydropower generation resulting from predicted changes in climate. The study uses an ensemble of simulations of regional patterns of changes in runoff, computed from global circulation models (GCM simulations with 12 different models. Based on these runoff changes, hydropower generation is estimated by relating the runoff changes to hydropower generation potential through geographical information system (GIS, based on 2005 hydropower generation. Hydropower data obtained from EIA (energy generation, national sites, FAO (water resources and UNEP were used in the analysis. The countries/states were used as computational units to reduce the complexities of the analysis. The results indicate that there are large variations of changes (increases/decreases in hydropower generation across regions and even within regions. Globally, hydropower generation is predicted to change very little by the year 2050 for the hydropower system in operation today. This change amounts to an increase of less than 1% of the current (2005 generation level although it is necessary to carry out basin level detailed assessment for local impacts which may differ from the country based values. There are many regions where runoff and hydropower generation will increase due to increasing precipitation, but also many regions where there will be a decrease. Based on this

No global consensus

DEFF Research Database (Denmark)

Scott, Courtney; Andersen, Christopher T; Valdez, Natali

2014-01-01

. METHODS: This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195...... guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. RESULTS: Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies...... included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less...

Multi-hazard national-level risk assessment in Africa using global approaches

Science.gov (United States)

Fraser, Stuart; Jongman, Brenden; Simpson, Alanna; Murnane, Richard

2016-04-01

In recent years Sub-Saharan Africa has been characterized by unprecedented opportunity for transformation and sustained growth. However, natural disasters such as droughts, floods, cyclones, earthquakes, landslides, volcanic eruptions and extreme temperatures cause significant economic and human losses, and major development challenges. Quantitative disaster risk assessments are an important basis for governments to understand disaster risk in their country, and to develop effective risk management and risk financing solutions. However, the data-scarce nature of many Sub-Saharan African countries as well as a lack of financing for risk assessments has long prevented detailed analytics. Recent advances in globally applicable disaster risk modelling practices and data availability offer new opportunities. In December 2013 the European Union approved a € 60 million contribution to support the development of an analytical basis for risk financing and to accelerate the effective implementation of a comprehensive disaster risk reduction. The World Bank's Global Facility for Disaster Reduction and Recovery (GFDRR) was selected as the implementing partner of the Program for Result Area 5: the "Africa Disaster Risk Assessment and Financing Program." As part of this effort, the GFDRR is overseeing the production of national-level multi-hazard risk profiles for a range of countries in Sub-Saharan Africa, using a combination of national and global datasets and state-of-the-art hazard and risk assessment methodologies. In this presentation, we will highlight the analytical approach behind these assessments, and show results for the first five countries for which the assessment has been completed (Kenya, Uganda, Senegal, Niger and Ethiopia). The presentation will also demonstrate the visualization of the risk assessments into understandable and visually attractive risk profile documents.

Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment

Science.gov (United States)

Mackey, Tim K.; Liang, Bryan A.; York, Peter; Kubic, Thomas

2015-01-01

Counterfeit medicines are a global public health risk. We assess counterfeit reports involving the legitimate supply chain using 2009–2011 data from the Pharmaceutical Security Institute Counterfeit Incident System (PSI CIS) database that uses both open and nonpublic data sources. Of the 1,510 identified CIS reports involving counterfeits, 27.6% reported China as the source country of the incident/detection. Further, 51.3% were reported as counterfeit but the specific counterfeit subcategory was not known or verifiable. The most prevalent therapeutic category was anti-infectives (21.1%) with most reports originating from health-related government agencies. Geographically, Asian and Latin American regions and, economically, middle-income markets were most represented. A total of 127 (64.8%) of a total of 196 countries had no legitimate supply chain CIS counterfeit reports. Improvements in surveillance, including detection of security breaches, data collection, analysis, and dissemination are urgently needed to address public health needs to combat the global counterfeit medicines trade. PMID:25897059

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos)

NARCIS (Netherlands)

Yokoe, Masamichi; Hata, Jiro; Takada, Tadahiro; Strasberg, Steven M.; Asbun, Horacio J.; Wakabayashi, Go; Kozaka, Kazuto; Endo, Itaru; Deziel, Daniel J.; Miura, Fumihiko; Okamoto, Kohji; Hwang, Tsann-Long; Huang, Wayne Shih-Wei; Ker, Chen-Guo; Chen, Miin-Fu; Han, Ho-Seong; Yoon, Yoo-Seok; Choi, In-Seok; Yoon, Dong-Sup; Noguchi, Yoshinori; Shikata, Satoru; Ukai, Tomohiko; Higuchi, Ryota; Gabata, Toshifumi; Mori, Yasuhisa; Iwashita, Yukio; Hibi, Taizo; Jagannath, Palepu; Jonas, Eduard; Liau, Kui-Hin; Dervenis, Christos; Gouma, Dirk J.; Cherqui, Daniel; Belli, Giulio; Garden, O. James; Giménez, Mariano Eduardo; de Santibañes, Eduardo; Suzuki, Kenji; Umezawa, Akiko; Supe, Avinash Nivritti; Pitt, Henry A.; Singh, Harjit; Chan, Angus C. W.; Lau, Wan Yee; Teoh, Anthony Yuen Bun; Honda, Goro; Sugioka, Atsushi; Asai, Koji; Gomi, Harumi; Itoi, Takao; Kiriyama, Seiki; Yoshida, Masahiro; Mayumi, Toshihiko; Matsumura, Naoki; Tokumura, Hiromi; Kitano, Seigo; Hirata, Koichi; Inui, Kazuo; Sumiyama, Yoshinobu; Yamamoto, Masakazu

2018-01-01

The Tokyo Guidelines 2013 (TG13) for acute cholangitis and cholecystitis were globally disseminated and various clinical studies about the management of acute cholecystitis were reported by many researchers and clinicians from all over the world. The 1st edition of the Tokyo Guidelines 2007 (TG07)

Steam generator tube fitness-for-service guidelines

International Nuclear Information System (INIS)

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

1995-07-01

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

Initial Assessment of Cyclone Global Navigation Satellite System (CYGNSS) Observations

Science.gov (United States)

McKague, D. S.; Ruf, C. S.

2017-12-01

The NASA Cyclone Global Navigation Satellite System (CYNSS) mission provides high temporal resolution observations of cyclones from a constellation of eight low-Earth orbiting satellites. Using the relatively new technique of Global Navigation Satellite System reflectometry (GNSS-R), all-weather observations are possible, penetrating even deep convection within hurricane eye walls. The compact nature of the GNSS-R receivers permits the use of small satellites, which in turn enables the launch of a constellation of satellites from a single launch vehicle. Launched in December of 2016, the eight CYGNSS satellites provide 25 km resolution observations of mean square slope (surface roughness) and surface winds with a 2.8 hour median revisit time from 38 S to 38 N degrees latitude. In addition to the calibration and validation of CYGNSS sea state observations, the CYGNSS science team is assessing the ability of the mission to provide estimates of cyclone size, intensity, and integrated kinetic energy. With its all-weather ability and high temporal resolution, the CYGNSS mission will add significantly to our ability to monitor cyclone genesis and intensification and will significantly reduce uncertainties in our ability to estimate cyclone intensity, a key variable in predicting its destructive potential. Members of the CYGNSS Science Team are also assessing the assimilation of CYGNSS data into hurricane forecast models to determine the impact of the data on forecast skill, using the data to study extra-tropical cyclones, and looking at connections between tropical cyclones and global scale weather, including the global hydrologic cycle. This presentation will focus on the assessment of early on-orbit observations of cyclones with respect to these various applications.

Physiotherapy in rheumatoid arthritis: development of a practice guideline.

Science.gov (United States)

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

2011-01-01

To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and

Non-adherence to standard treatment guidelines in a rural paediatric hospital in Sierra Leone.

Science.gov (United States)

De Bruycker, M; Van den Bergh, R; Dahmane, A; Khogali, M; Schiavetti, B; Nzomukunda, Y; Alders, P; Allaouna, M; Cloquet, C; Enarson, D A; Satyarayanan, S; Magbity, E; Zachariah, R

2013-06-21

A rural paediatric hospital in Bo, Sierra Leone. To assess the level of adherence to standard treatment guidelines among clinicians prescribing treatment for children admitted with a diagnosis of malaria and/or lower respiratory tract infection (LRTI), and determine the association between (non) adherence and hospital outcomes, given that non-rational use of medicines is a serious global problem. Secondary analysis of routine programme data. Data were collected for 865 children admitted with an entry diagnosis of malaria and 690 children with LRTI during the period January to April 2011; some patients were classified in both categories. Non-adherence to guidelines comprised use of non-standard drug regimens, dosage variations, non-standard frequency of administration and treatment duration. Cumulative non-adherence to guidelines for LRTI cases was 86%. For malaria, this involved 12% of patients. Potentially harmful non-adherence was significantly associated with an unfavourable hospital outcome, both for malaria and for LRTI cases. Overall non-adherence to standard treatment guidelines by clinicians in a routine hospital setting is very high and influences hospital outcomes. This study advocates for the implementation of routine measures to monitor and improve rational drug use and the quality of clinical care in such hospitals.

Inequality measures perform differently in global and local assessments: An exploratory computational experiment

Science.gov (United States)

Chiang, Yen-Sheng

2015-11-01

Inequality measures are widely used in both the academia and public media to help us understand how incomes and wealth are distributed. They can be used to assess the distribution of a whole society-global inequality-as well as inequality of actors' referent networks-local inequality. How different is local inequality from global inequality? Formalizing the structure of reference groups as a network, the paper conducted a computational experiment to see how the structure of complex networks influences the difference between global and local inequality assessed by a selection of inequality measures. It was found that local inequality tends to be higher than global inequality when population size is large; network is dense and heterophilously assorted, and income distribution is less dispersed. The implications of the simulation findings are discussed.

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease

Science.gov (United States)

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-01-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1–13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols. PMID:25077519

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.

Science.gov (United States)

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-09-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions - the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.

Global Aquaculture Performance Index (GAPI: The First Global Environmental Assessment of Marine Fish Farming

Directory of Open Access Journals (Sweden)

Jenna M.S. Stoner

2013-09-01

Full Text Available “Sustainable” is among the most sought after of all seafood product adjectives. Ironically it is also one of the most poorly defined and understood. The Global Aquaculture Performance Index (GAPI is the first tool to assess environmental performance of global marine aquaculture production, permitting direct comparison of disparate species, production methods and jurisdictions. Clear patterns emerge from this analysis; significant variation of environmental performance is driven by the species being farmed, significant room for improvement exists across the entire sector, the worst performing players are also the fastest growing, particularly within Asia, and perhaps most importantly, this work highlights the potential trap awaiting policy makers who focus too narrowly on farm production efficiency alone as a solution to diminishing seafood availability.

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

International Nuclear Information System (INIS)

1999-01-01

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

Methods for global sensitivity analysis in life cycle assessment

NARCIS (Netherlands)

Groen, Evelyne A.; Bokkers, Eddy; Heijungs, Reinout; Boer, de Imke J.M.

2017-01-01

Purpose: Input parameters required to quantify environmental impact in life cycle assessment (LCA) can be uncertain due to e.g. temporal variability or unknowns about the true value of emission factors. Uncertainty of environmental impact can be analysed by means of a global sensitivity analysis to

The Global Seismic Hazard Assessment Program (GSHAP - 1992/1999

Directory of Open Access Journals (Sweden)

D. Giardini

1999-06-01

Full Text Available The United Nations, recognizing natural disasters as a major threat to human life and development, designed the 1990-1999 period as the International Decade for Natural Disaster Reduction (UN/IDNDR; UN Res. 42/169/ 1987. Among the IDNDR Demonstration Projects is the Global Seismic Hazard Assessment Program (GSHAP, launched in 1992 by the International Lithosphere Program (ILP and implemented in the 1992-1999 period. In order to mitigate the risk associated to the recurrence of earthquakes, the GSHAP promoted a regionally coordinated, homogeneous approach to seismic hazard evaluation. To achieve a global dimension, the GSHAP established initially a mosaic of regions and multinational test areas, then expanded to cover whole continents and finally the globe. The GSHAP Global Map of Seismic Hazard integrates the results obtained in the regional areas and depicts Peak-Ground-Acceleration (PGA with 10% chance of exceedance in 50 years, corresponding to a return period of 475 years. All regional results and the Global Map of Seismic Hazard are published in 1999 and available on the GSHAP homepage on http://seismo.ethz.ch/GSHAP/.

Labour management guidelines for a Tanzanian referral hospital

DEFF Research Database (Denmark)

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

2017-01-01

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

The development of evidence-based guidelines in dentistry.

Science.gov (United States)

Faggion, C M

2013-02-01

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

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

Science.gov (United States)

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

2015-01-01

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

A Critical Review of Low Back Pain Guidelines.

Science.gov (United States)

Chetty, Laran

2017-09-01

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

Global Land Use Implications of Dietary Trends: A Tragedy of the Commons

OpenAIRE

Anand, Madhur; Pagnutti, Chris; Bauch, Chris; Rizvi, Sarah

2017-01-01

Global food security and agricultural land management represent two urgent and intimately related challenges that humans must face in the coming decades. Here, we quantify the changes in the global agricultural land footprint if the world were to adhere to the dietary guidelines put forth by the United States Department of Agriculture (USDA), while accounting for the land use change incurred by import/export required to meet those guidelines. We analyze data at country, continent, and global ...

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

Science.gov (United States)

Thole, Henning

2011-01-01

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

Development of environmental guidelines for electronic appliances

DEFF Research Database (Denmark)

Legarth, Jens Brøbech; Alting, Leo; Erichsen, Hanne K. Linnet

1994-01-01

This paper presents a general method for the development of environmental guidelines for complex products. The method is based on the life cycle concept. The application of life cycle assessment methods reveals the peak environmental impacts, and their source resulting in environmental guidelines...

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

Science.gov (United States)

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

2015-01-01

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

Management of acute diarrhoeal disease at Edendale Hospital: Are standard treatment guidelines followed?

Directory of Open Access Journals (Sweden)

Kershinee Reddy

2016-12-01

Full Text Available Background. Diarrhoeal disease (DD is a major cause of childhood mortality in developing countries. In South Africa (SA, it ranks as one of the top five causes of under-5 mortality. Local and global guidelines on the management of acute DD are readily available. The Standard Treatment Guidelines (STGs and Essential Drugs List for Hospital Level Paediatrics are a recognised standard of care for children in SA hospitals. However, children still die from this preventable disease. Objective. To determine whether doctors adhered to standard treatment guidelines when treating children under 5 years of age presenting to Edendale Hospital in Pietermaritzburg, KwaZulu-Natal Province, with acute DD. Methods. The study was a retrospective clinical audit of individual patient records. Results. One hundred and thirty-five patient records were reviewed. Forty-seven percent had a correct nutritional assessment, 41% were correctly assessed for shock and 27% for dehydration. Appropriate investigations were undertaken in 12%. Ninety-seven percent of patients had appropriate fluid plans prescribed. Zinc was prescribed in only 39% of patients, whereas 84% were appropriately not prescribed antibiotics and no patients received anti-diarrhoeal medication. In 90% of patients, the correct post-care patient referral was made, and 47% of caregivers were adequately advised about ongoing care of their children. Conclusion. This study identifies substantial non-adherence to the SA STGs for the management of young children with acute DD.

British Columbia water quality guidelines (criteria): 1998 edition

Energy Technology Data Exchange (ETDEWEB)

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

1998-08-01

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

Appraising and comparing pressure ulcer guidelines.

Science.gov (United States)

Wimpenny, Peter; van Zelm, Ruben

2007-01-01

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

A multi-model assessment of the co-benefits of climate mitigation for global air quality

NARCIS (Netherlands)

Rao, Shilpa; Klimont, Zbigniew; Leitao, Joana; Riahi, Keywan; van Dingenen, Rita; Aleluia Reis, Lara; Calvin, Katherine; Dentener, Frank; Drouet, Laurent; Fujimori, Shinichiro; Harmsen, Mathijs; Luderer, Gunnar; Heyes, Chris; Strefler, Jessica; Tavoni, Massimo; van Vuuren, Detlef P.

2016-01-01

We present a model comparison study that combines multiple integrated assessment models with a reduced-form global air quality model to assess the potential co-benefits of global climate mitigation policies in relation to the World Health Organization (WHO) goals on air quality and health. We

A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

Science.gov (United States)

Davíd-Chavez, D. M.; Gavin, M. C.

2017-12-01

Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves

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

Science.gov (United States)

Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

2009-04-01

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

Inverse relationship between nonadherence to original GOLD treatment guidelines and exacerbations of COPD

Directory of Open Access Journals (Sweden)

Foda HD

2017-01-01

Full Text Available Hussein D Foda,1,2 Anthony Brehm,1,2 Karen Goldsteen,3 Norman H Edelman2,4 1Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, Veterans Affairs Medical Center, Northport, 2Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, Stony Brook University Medical Center, Stony Brook, NY, 3MPH Program, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, 4Department of Preventative Medicine and Program in Public Health, Stony Brook University Medical Center, Stony Brook, NY, USA Background: Prescriber disagreement is among the reasons for poor adherence to COPD treatment guidelines; it is yet not clear whether this leads to adverse outcomes. We tested whether undertreatment according to the original Global Initiative for Chronic Obstructive Lung Disease (GOLD guidelines led to increased exacerbations.Methods: Records of 878 patients with spirometrically confirmed COPD who were followed from 2005 to 2010 at one Veterans Administration (VA Medical Center were analyzed. Analysis of variance was performed to assess differences in exacerbation rates between severity groups. Logistic regression analysis was performed to assess the relationship between noncompliance with guidelines and exacerbation rates.Findings: About 19% were appropriately treated by guidelines; 14% overtreated, 44% undertreated, and in 23% treatment did not follow any guideline. Logistic regression revealed a strong inverse relationship between undertreatment and exacerbation rate when severity of obstruction was held constant. Exacerbations per year by GOLD stage were significantly different from each other: mild 0.15, moderate 0.27, severe 0.38, very severe 0.72, and substantially fewer than previously reported.Interpretation: The guidelines were largely not followed. Undertreatment predominated but, contrary to expectations, was associated with fewer exacerbations. Thus, clinicians were likely

Effort in Multitasking: Local and Global Assessment of Effort.

Science.gov (United States)

Kiesel, Andrea; Dignath, David

2017-01-01

When performing multiple tasks in succession, self-organization of task order might be superior compared to external-controlled task schedules, because self-organization allows optimizing processing modes and thus reduces switch costs, and it increases commitment to task goals. However, self-organization is an additional executive control process that is not required if task order is externally specified and as such it is considered as time-consuming and effortful. To compare self-organized and externally controlled task scheduling, we suggest assessing global subjective and objectives measures of effort in addition to local performance measures. In our new experimental approach, we combined characteristics of dual tasking settings and task switching settings and compared local and global measures of effort in a condition with free choice of task sequence and a condition with cued task sequence. In a multi-tasking environment, participants chose the task order while the task requirement of the not-yet-performed task remained the same. This task preview allowed participants to work on the previously non-chosen items in parallel and resulted in faster responses and fewer errors in task switch trials than in task repetition trials. The free-choice group profited more from this task preview than the cued group when considering local performance measures. Nevertheless, the free-choice group invested more effort than the cued group when considering global measures. Thus, self-organization in task scheduling seems to be effortful even in conditions in which it is beneficiary for task processing. In a second experiment, we reduced the possibility of task preview for the not-yet-performed tasks in order to hinder efficient self-organization. Here neither local nor global measures revealed substantial differences between the free-choice and a cued task sequence condition. Based on the results of both experiments, we suggest that global assessment of effort in addition to

Adherence to physical activity guidelines and functional fitness of elderly women, using objective measurement.

Science.gov (United States)

Nawrocka, Agnieszka; Mynarski, Władysław; Cholewa, Jarosław

2017-12-23

Physical activity is an important factor in maintaining the health and functional fitness of elderly people. The aim of the study was to determine the number of senior women meeting the physical activity guidelines, and their level of functional fitness in comparison to women who are not sufficiently physically active. The study involved 61 women, aged 60-75. Physical activity was monitored on seven consecutive days of the week, using a triaxial accelerometer ActiGraph GT3X. Results of the assessment of physical activity were verified against the Global Recommendations of Physical Activity for Health. The Senior Fitness Test (Fullerton Test) was used to evaluate functional fitness. In the studied group, 36.1% achieved the recommended level of physical activity. All those examined mainly undertook physical activity of low intensity. Vigorous physical activity during the week was noted in only 6 seniors. Women who met the recommendations of physical activity achieved significantly better results in test trials, e.g. Chair Stands, Up and Go, Six Minute Step Test. Adherence to physical activity guidelines was associated with better functional fitness of older women. However, less than half of the examined seniors met the Global Recommendations on Physical Activity for Health.

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

Science.gov (United States)

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

2017-12-01

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

Developing International Guidelines on Volcanic Hazard Assessments for Nuclear Facilities

Science.gov (United States)

Connor, Charles

2014-05-01

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

Compliance with standard treatment guidelines in the management ...

African Journals Online (AJOL)

Introduction: Hypertension is a leading lifestyle disease and major cause of morbidity and mortality in South Africa, and globally. Standard Treatment Guidelines are issued in this country to assist healthcare workers in the diagnosis and management there of. Considering the debilitating effects caused by hypertension, the ...

Systematic review of guidelines on peripheral artery disease screening.

Science.gov (United States)

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

2012-02-01

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

Climate Prediction Center(CPC)Global Tropics Hazards and Benefits Assessment

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Global Tropics Hazards and Benefits Assessment (GTH) is an outlook product for the areas in the Tropics. Forecasts for the Week-1 and Week-2 period are given for...

Development of Authentic Assessment instruments for Critical Thinking skills in Global Warming with a Scientific Approach

Directory of Open Access Journals (Sweden)

R. Surya Damayanti

2017-12-01

Full Text Available This study aims to develop an authentic assessment instrument to measure critical thinking skills in global warming learning and to describe the suitability, easiness, and usefulness of the use instruments which are developed base on the teacher’s opinion.   The development design is carried out by Borg & Gall (2003 development model, which is conducted with seven stages: information gathering stage, planning stage, product development stage, product test stage, product revision stage, field trial stage, and final product. The test subjects are students and teachers in SMA Lampung Tengah by using purposive sampling technique.  Global warming learning using authentic assessment consists of a series of learning activities, including observing, discussing, exploring, associating and communicating.  The results show the authentic assessment techniques global warming to measure and cultivate critical thinking skills consisting of written tests, performance, portfolios, projects, and attitudes.  The developed assessment model meets content and constructs validity, and effectively improves students' critical thinking skills and has a high level of suitability, easiness, and usefulness well-being. The assessment techniques are used in global warming learning are performance assessment techniques, portfolios, projects, products, and attitude that together contribute to the improvement of critical thinking skills on 97,4% of global warming learning.

Family relations, mental health and adherence to nutritional guidelines in patients facing dialysis initiation.

Science.gov (United States)

Untas, Aurélie; Rascle, Nicole; Idier, Laetitia; Lasseur, Catherine; Combe, Christian

2012-01-01

This study investigated the effect of family relations on patients' adjustment to dialysis. The two main aims were to develop a family typology, and to explore the influence of family profile on the patient's anxiety, depression and adherence to nutritional guidelines. The sample consisted of 120 patients (mean age 63 years; 67.5% of men). They completed several measures 1, 6 and 12 months after dialysis initiation. The scales used were the Family Relationship Index and the Hospital Anxiety and Depression Scale. Perceived adherence to nutritional guidelines was assessed using two visual analogical scales. Results showed that family relations remained stable over time. Cluster analysis yielded three family profiles, which were named conflict, communicative and supportive families. Patients belonging to conflict families perceived themselves as less adhering to nutritional guidelines. For these patients, anxiety and depressive moods increased significantly over time, whereas mental health remained stable over time for communicative and supportive families. This research underlines that family relations are essential in global consideration of the care of patients treated by dialysis. Conflict families seem especially at risk. They should be identified early to help them adapt to this stressful treatment.

Assessing global resource utilization efficiency in the industrial sector.

Science.gov (United States)

Rosen, Marc A

2013-09-01

Designing efficient energy systems, which also meet economic, environmental and other objectives and constraints, is a significant challenge. In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement. Energy analysis alone is inadequate, e.g., it yields energy efficiencies that do not provide limits to efficiency. To obtain meaningful and useful efficiencies for energy systems, and to clarify losses, exergy analysis is a beneficial and useful tool. Here, the global industrial sector and industries within it are assessed by using energy and exergy methods. The objective is to improve the understanding of the efficiency of global resource use in the industrial sector and, with this information, to facilitate the development, prioritization and ultimate implementation of rational improvement options. Global energy and exergy flow diagrams for the industrial sector are developed and overall efficiencies for the global industrial sector evaluated as 51% based on energy and 30% based on exergy. Consequently, exergy analysis indicates a less efficient picture of energy use in the global industrial sector than does energy analysis. A larger margin for improvement exists from an exergy perspective, compared to the overly optimistic margin indicated by energy. Copyright © 2012 Elsevier B.V. All rights reserved.

QUANTITATIVE MEASUREMENT AND ASSESSMENT OF THE EFFECTS OF GLOBALIZATION OF COMPANIES AND MARKETS

Directory of Open Access Journals (Sweden)

N. Kovtun

2015-10-01

Full Text Available The results of improving the author’s methodology linked with the assessment of companies’ and markets’ globalization level were presented in this paper. Based on the analysis of the global companies’ and global markets’ features referred to in scientific literature, the specifications which can be used to determine the globalization level of companies and markets were suggested. In addition, the globalization level of the largest top-ten companies (according to the rating of Forbes Global 2000 Leading Companies in 2015 was identified as well as that of corresponding industry markets: auto and truck manufacturers, major banks, software and programming, large department stores (retailers, telecommunication services, electronics producers, electronics, oil and gas operations.

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2007-01-01

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

Assessing Compatibility of Direct Detection Data: Halo-Independent Global Likelihood Analyses

CERN Document Server

Gelmini, Graciela B.

2016-10-18

We present two different halo-independent methods utilizing a global maximum likelihood that can assess the compatibility of dark matter direct detection data given a particular dark matter model. The global likelihood we use is comprised of at least one extended likelihood and an arbitrary number of Poisson or Gaussian likelihoods. In the first method we find the global best fit halo function and construct a two sided pointwise confidence band, which can then be compared with those derived from the extended likelihood alone to assess the joint compatibility of the data. In the second method we define a "constrained parameter goodness-of-fit" test statistic, whose $p$-value we then use to define a "plausibility region" (e.g. where $p \\geq 10\\%$). For any halo function not entirely contained within the plausibility region, the level of compatibility of the data is very low (e.g. $p < 10 \\%$). As an example we apply these methods to CDMS-II-Si and SuperCDMS data, assuming dark matter particles with elastic s...

Risk Assessment Method for Offshore Structure Based on Global Sensitivity Analysis

Directory of Open Access Journals (Sweden)

Zou Tao

2012-01-01

Full Text Available Based on global sensitivity analysis (GSA, this paper proposes a new risk assessment method for an offshore structure design. This method quantifies all the significances among random variables and their parameters at first. And by comparing the degree of importance, all minor factors would be negligible. Then, the global uncertainty analysis work would be simplified. Global uncertainty analysis (GUA is an effective way to study the complexity and randomness of natural events. Since field measured data and statistical results often have inevitable errors and uncertainties which lead to inaccurate prediction and analysis, the risk in the design stage of offshore structures caused by uncertainties in environmental loads, sea level, and marine corrosion must be taken into account. In this paper, the multivariate compound extreme value distribution model (MCEVD is applied to predict the extreme sea state of wave, current, and wind. The maximum structural stress and deformation of a Jacket platform are analyzed and compared with different design standards. The calculation result sufficiently demonstrates the new risk assessment method’s rationality and security.

Critical Guidelines for U.S.-Based Counselor Educators When Working Transnationally: A Delphi Study

Science.gov (United States)

Smith, Paul H.; Benshoff, James M.; Gonzalez, Laura M.

2018-01-01

U.S.-based counselor education faculty increasingly are participating in transnational experiences, such as global research and study abroad. The purpose of this study was to develop guidelines for U.S.-based counselor educators when working transnationally. Using Delphi methodology, 69 consensus guidelines were developed from an expert panel.…

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

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

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

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

International Nuclear Information System (INIS)

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

1995-01-01

As part of NOAA's National Status and Trends (NS and T) Bioeffects Assessment program and studies conducted by the National Biological Service, numerous sediment quality assessment surveys have recently been conducted along the Atlantic and Gulf coasts of the US using the sea urchin (Arbacia punctulata) fertilization and embryological development tests with pore water. Additional toxicity tests were also conducted in conjunction with most of these studies. The areas that have been sampled include Boston harbor, Massachusetts; Charleston Harbor, Winyah Bay, and Savannah River, South Carolina; St. Simon Sound, Georgia; Biscayne Bay, Tampa Bay, Choctawhatchee Bay, Apalachicola Bay, St. Andrew Bay, and Pensacola Bay, Florida; Galveston Bay, Lavaca Bay, and Sabine Lake, Texas, and 200 stations in the vicinity of offshore oil and gas production platforms in the Gulf of Mexico. Sufficient data are now available from this series of surveys to calculate test specific sediment effect concentrations (SECs). Based on these recent studies, SECs were developed for the sea urchin porewater and amphipod tests and compared with existing marine sediment quality assessment guidelines

Guidelines for personal exposure monitoring of chemicals: Part III.

Science.gov (United States)

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

2018-01-25

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

Guidelines for personal exposure monitoring of chemicals: Part IV.

Science.gov (United States)

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

2018-03-27

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

Guidelines for personal exposure monitoring of chemicals: Part II.

Science.gov (United States)

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

2017-11-25

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

Guidelines for personal exposure monitoring of chemicals: Part I.

Science.gov (United States)

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

2017-09-28

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

Guidelines for personal exposure monitoring of chemicals: Part V.

Science.gov (United States)

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

2018-05-25

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

How nurses seek and evaluate clinical guidelines on the Internet

NARCIS (Netherlands)

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

2010-01-01

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

Objectives for Stakeholder Engagement in Global Environmental Assessments

Directory of Open Access Journals (Sweden)

Jennifer Garard

2017-09-01

Full Text Available Global environmental assessments (GEAs are among the most large-scale, formalized processes for synthesizing knowledge at the science–policy–society interface. The successful engagement of diverse stakeholders in GEAs is often described as a crucial mechanism for increasing their legitimacy, salience and credibility. However, the diversity of perspectives on the more precise objectives for stakeholder engagement remains largely unclear. The aims of this study are to categorize and characterize the diversity of perspectives on objectives for stakeholder engagement in GEAs; to explore differences in perspectives within and between different stakeholder groups and categories; and to test whether the more practical prioritization and selection of objectives in GEAs can be linked to deliberative policy learning as a higher-level rationale for stakeholder engagement. For these purposes, we conduct a grounded theory analysis and a keyword analysis of interview material and official GEA documents relating to two GEAs: UN Environment’s Fifth Global Environment Outlook and the Working Group III contribution to the Intergovernmental Panel on Climate Change Fifth Assessment Report. Based on the analysis, we identify six categories of objectives and present as hypotheses promising ways forward for prioritizing and characterizing objectives for stakeholder engagement in GEAs, as well as potential reasons for the differences between perspectives on objectives. This study draws attention to the need for future GEA processes to have more explicit discussions on the objectives for stakeholder engagement, as well as the importance of moving towards increasingly deliberative and inclusive assessment processes more broadly.

Replacement of chlorofluorocarbons at the DOE gaseous diffusion plants: An assessment of global impacts

International Nuclear Information System (INIS)

Socolof, M.L.; McCold, L.N.; Saylor, R.E.

1997-01-01

Three gaseous diffusion plants (GDPs) for enriching uranium maintain a large inventory of chlorofluorocarbon-114 (CFC-114) as a coolant. To address the continued use of CFC-114, an ozone-depleting substance, the US Department of Energy (DOE) considered introducing perfluorocarbons (PFCs) by the end of 1995. These PFCs would not contribute to stratospheric ozone depletion but would be larger contributors to global warming than would CFC-114. The paper reports the results of an assessment of the global impacts of four alternatives for modifying GDP coolant system operations over a three-year period beginning in 1996. The overall contribution of GDP coolant releases to impacts on ozone depletion and global warming were quantified by parameters referred to as ozone-depletion impact and global-warming impact. The analysis showed that these parameters could be used as surrogates for predicting global impacts to all resources and could provide a framework for assessing environmental impacts of a permanent coolant replacement, eliminating the need for subsequent resource-specific analyses

An Improved Global Wind Resource Estimate for Integrated Assessment Models: Preprint

Energy Technology Data Exchange (ETDEWEB)

Eurek, Kelly [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sullivan, Patrick [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gleason, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hettinger, Dylan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lopez, Anthony [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-02-01

This paper summarizes initial steps to improving the robustness and accuracy of global renewable resource and techno-economic assessments for use in integrated assessment models. We outline a method to construct country-level wind resource supply curves, delineated by resource quality and other parameters. Using mesoscale reanalysis data, we generate estimates for wind quality, both terrestrial and offshore, across the globe. Because not all land or water area is suitable for development, appropriate database layers provide exclusions to reduce the total resource to its technical potential. We expand upon estimates from related studies by: using a globally consistent data source of uniquely detailed wind speed characterizations; assuming a non-constant coefficient of performance for adjusting power curves for altitude; categorizing the distance from resource sites to the electric power grid; and characterizing offshore exclusions on the basis of sea ice concentrations. The product, then, is technical potential by country, classified by resource quality as determined by net capacity factor. Additional classifications dimensions are available, including distance to transmission networks for terrestrial wind and distance to shore and water depth for offshore. We estimate the total global wind generation potential of 560 PWh for terrestrial wind with 90% of resource classified as low-to-mid quality, and 315 PWh for offshore wind with 67% classified as mid-to-high quality. These estimates are based on 3.5 MW composite wind turbines with 90 m hub heights, 0.95 availability, 90% array efficiency, and 5 MW/km2 deployment density in non-excluded areas. We compare the underlying technical assumption and results with other global assessments.

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

Science.gov (United States)

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

2011-01-01

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

2004 Guidelines for Advancement and Promotion

CERN Multimedia

2004-01-01

Original : English 1- General The Director-General has now fixed the guidelines and schedule for the 2004 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular 26 (Rev. 4). Decisions will be made, where possible, by 1 July 2004 except for career path changes for staff in Career Paths A to D which will be made by 31 October 2004 and applied retroactively to 1 July 2004. The calendar for the interviews has been fixed between 1 January and 31 March 2004. Departments are invited to strictly comply with the target date of 31 March. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. 2- Budget guidelines Within the annual advancement budget, the guideline allocations have been defined by the Director-General on a departmental basis for staff in Career Paths A to E and on a CERN-wide basis for staff in Career Paths F and G. Within their global advancement allocations, Department Head...

2003 Guidelines for Advancement and Promotion

CERN Multimedia

2003-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2003 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). The full details have been presented to the Management Board and the Standing Concertation Committee. Procedures are set out in Administrative Circular 26 (Rev. 3) except that the completion date for annual interviews is extended to 15 March 2003. As in previous years, decisions will be made, where possible, by 1 July 2003 except for career path changes for staff in Career Paths A to D which will be made by 31 October 2003 and applied retroactively to 1 July 2003. 2. Budget guidelines The budget allocation for the annual advancement and promotions (periodic and additional steps, entry into and advancement within exceptional zones) in 2002/3 is 1.6% of the basic salary budget, corresponding to the average global level over the last 5 years of all advancement and awards. Within this budget, the guideline allocations have been def...

Comparison of international guidelines for regenerative medicine: Knee cartilage repair and replacement using human-derived cells and tissues.

Science.gov (United States)

Itoh, Kuni; Kano, Shingo

2016-07-01

Regenerative medicine (RM) is an emerging field using human-derived cells and tissues (HCT). Due to the complexity and diversity of HCT products, each country has its own regulations for authorization and no common method has been applied to date. Individual regulations were previously clarified at the level of statutes but no direct comparison has been reported at the level of guidelines. Here, we generated a new analytical framework that allows comparison of guidelines independent from local definitions of RM, using 2 indicators, product type and information type. The guidelines for products for repair and replacement of knee cartilage in Japan, the United States of America, and Europe were compared and differences were detected in both product type and information type by the proposed analytical framework. Those findings will be critical not only for the product developers to determine the region to initiate the clinical trials but also for the regulators to assess and build their regulations. This analytical framework is potentially expandable to other RM guidelines to identify gaps, leading to trigger discussion of global harmonization in RM regulations. Copyright © 2016 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

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

Biobanks in South Africa: A global perspective on privacy and confidentiality

Directory of Open Access Journals (Sweden)

Riaan Rheeder

2017-05-01

Full Text Available The Universal Declaration of Bioethics and Human Rights (UDBHR of the United Nations Educational, Scientific and Cultural Organization (UNESCO was adopted unanimously in 2005 by the world community as a universal guideline, according to which members of the global community were accountable to each other. Research results from UNESCO show that the UDBHR has had little or no impact in South Africa (SA. The primary objective of this article is to promote awareness of the UDBHR in SA and Africa by focusing on Article 9 of the Declaration, which accepts the right to privacy and confidentiality. For this objective to be relevant in the SA context, depends on whether the guidelines of the National Department of Health’s Ethics in Health Research: Principles, Processes and Structures of 2015 acknowledge biobanks of the universally accepted ethical guidelines on privacy and confidentiality of autonomous persons and whether these guidelines are broadly in accordance with global bioethical guidelines.

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

Science.gov (United States)

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

2007-06-01

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

Disaster resilience assessment and the global agenda: A journey from India to South America

Science.gov (United States)

Fanchiotti, Margherita; Torres, Jair; Burton, Christopher; Makarigakis, Alexandros

2016-04-01

Governments and stakeholders worldwide are placing great emphasis on fostering the resilience of communities to natural hazards and disasters. This is partially because communities that can increase their resilience are in a better position to withstand the adverse effects of damaging hazard events when they occur. With disaster risk reduction having emerged as a global challenge, the Sendai Framework for Disaster Risk Reduction 2015-2030 has recognised the need to invest in enhancing disaster resilience as a priority on the international agenda. In order to successfully build community resilience to natural hazards, it then becomes essential to first understand, identify and assess all sets of conditions that contribute to resilience. The ability to measure resilience is increasingly being identified as a key step towards disaster risk reduction as a result. Relatively few studies, however, have been conducted to develop guidelines for measuring the concept, and more research is needed to develop effective tools for assessment of resilience in developing countries. This is because various environmental, built-environment, and social factors will operate and interact differentially across disaster and development contexts. This paper presents preliminary findings from two large projects in which the authors have been involved, namely the 'Enhancing Natural HAzards resilience iN South America' (ENHANS) and 'Deltas, Vulnerability & Climate Change: Migration & Adaptation' (DECCMA) projects. In collaboration with the Global Earthquake Model (GEM), the Understanding and Managing Extremes (UME) School of the Institute for Advanced Study (IUSS) of Pavia and the University of Southampton, UNESCO is working on the development of methods for disaster resilience measurement in developing nations. The studies build on the available literature to provide an ad-hoc conceptual framework for the quantification of community resilience in each study site by means of a bottom

Guidelines for assessing the knowledge management maturity of organizations

Directory of Open Access Journals (Sweden)

C. J. Kruger

2007-11-01

Full Text Available In a recent article Kruger and Snyman hypothesized that progressions in knowledge management maturity (from a strategic perspective are directly related to an increased ability to speed up the strategic cycle of imitation, consolidation and innovation. The arguments proposed, however, neglected to supply the reader with a practical toolkit or even a roadmap (a time-related matrix, or questionnaire to successfully measure succession in knowledge management maturity. This article builds on the previous one and proposes a questionnaire consisting of six sections, containing 101 descriptive questions, to enable organizations to test and assess their knowledge management maturity empirically. The development of an instrument to measure knowledge management maturity required adhering to a research design that combined theoretical propositions with practical experimentation. As a point of departure, a knowledge management maturity matrix consisting of seven maturity levels was formulated. All questions contained within the matrix were benchmarked against a survey questionnaire developed by the public management service of the OECD (PUMA and were also pre-tested and validated. This process of refinement led to the formulation of the Knowledge Management Maturity Questionnaire. To avoid any taint of this research being based only on theoretical propositions, the questionnaire was tested by 178 master students of the University of Pretoria, South Africa, in nine different industries. The proposed questionnaire provides a bridge between theoretical propositions and practical usability, not only enabling knowledge management practitioners to assess the level of knowledge management maturity reached successfully but, more importantly, also serving as a guideline to institutionalize further and future knowledge management endeavours.

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

Science.gov (United States)

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

2001-01-01

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

The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II.

Science.gov (United States)

Ng, Jeremy Y; Liang, Laurel; Gagliardi, Anna R

2016-10-29

Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available

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

International Nuclear Information System (INIS)

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

1986-09-01

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

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.

Methodological guidelines

International Nuclear Information System (INIS)

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

1999-01-01

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

Evidence-based guidelines

DEFF Research Database (Denmark)

Wattjes, Mike P; Rovira, Àlex; Miller, David

2015-01-01

. This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...

Towards a Global Water Scarcity Risk Assessment Framework: Incorporation of Probability Distributions and Hydro-Climatic Variability

Science.gov (United States)

Veldkamp, T. I. E.; Wada, Y.; Aerts, J. C. J. H.; Ward, P. J.

2016-01-01

Changing hydro-climatic and socioeconomic conditions increasingly put pressure on fresh water resources and are expected to aggravate water scarcity conditions towards the future. Despite numerous calls for risk-based water scarcity assessments, a global-scale framework that includes UNISDR's definition of risk does not yet exist. This study provides a first step towards such a risk based assessment, applying a Gamma distribution to estimate water scarcity conditions at the global scale under historic and future conditions, using multiple climate change and population growth scenarios. Our study highlights that water scarcity risk, expressed in terms of expected annual exposed population, increases given all future scenarios, up to greater than 56.2% of the global population in 2080. Looking at the drivers of risk, we find that population growth outweigh the impacts of climate change at global and regional scales. Using a risk-based method to assess water scarcity, we show the results to be less sensitive than traditional water scarcity assessments to the use of fixed threshold to represent different levels of water scarcity. This becomes especially important when moving from global to local scales, whereby deviations increase up to 50% of estimated risk levels.

Lithium Resources and Production: Critical Assessment and Global Projections

Directory of Open Access Journals (Sweden)

Steve H. Mohr

2012-03-01

Full Text Available This paper critically assesses if accessible lithium resources are sufficient for expanded demand due to lithium battery electric vehicles. The ultimately recoverable resources (URR of lithium globally were estimated at between 19.3 (Case 1 and 55.0 (Case 3 Mt Li; Best Estimate (BE was 23.6 Mt Li. The Mohr 2010 model was modified to project lithium supply. The Case 1 URR scenario indicates sufficient lithium for a 77% maximum penetration of lithium battery electric vehicles in 2080 whereas supply is adequate to beyond 2200 in the Case 3 URR scenario. Global lithium demand approached a maximum of 857 kt Li/y, with a 100% penetration of lithium vehicles, 3.5 people per car and 10 billion population.

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

International Nuclear Information System (INIS)

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

2016-01-01

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

Invited review: A position on the Global Livestock Environmental Assessment Model (GLEAM).

Science.gov (United States)

MacLeod, M J; Vellinga, T; Opio, C; Falcucci, A; Tempio, G; Henderson, B; Makkar, H; Mottet, A; Robinson, T; Steinfeld, H; Gerber, P J

2018-02-01

The livestock sector is one of the fastest growing subsectors of the agricultural economy and, while it makes a major contribution to global food supply and economic development, it also consumes significant amounts of natural resources and alters the environment. In order to improve our understanding of the global environmental impact of livestock supply chains, the Food and Agriculture Organization of the United Nations has developed the Global Livestock Environmental Assessment Model (GLEAM). The purpose of this paper is to provide a review of GLEAM. Specifically, it explains the model architecture, methods and functionality, that is the types of analysis that the model can perform. The model focuses primarily on the quantification of greenhouse gases emissions arising from the production of the 11 main livestock commodities. The model inputs and outputs are managed and produced as raster data sets, with spatial resolution of 0.05 decimal degrees. The Global Livestock Environmental Assessment Model v1.0 consists of five distinct modules: (a) the Herd Module; (b) the Manure Module; (c) the Feed Module; (d) the System Module; (e) the Allocation Module. In terms of the modelling approach, GLEAM has several advantages. For example spatial information on livestock distributions and crops yields enables rations to be derived that reflect the local availability of feed resources in developing countries. The Global Livestock Environmental Assessment Model also contains a herd model that enables livestock statistics to be disaggregated and variation in livestock performance and management to be captured. Priorities for future development of GLEAM include: improving data quality and the methods used to perform emissions calculations; extending the scope of the model to include selected additional environmental impacts and to enable predictive modelling; and improving the utility of GLEAM output.

Japanese guidelines for allergic rhinitis 2017

Directory of Open Access Journals (Sweden)

Kimihiro Okubo

2017-04-01

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

Global ex-situ crop diversity conservation and the Svalbard Global Seed Vault: assessing the current status.

Directory of Open Access Journals (Sweden)

Ola T Westengen

Full Text Available Ex-situ conservation of crop diversity is a global concern, and the development of an efficient and sustainable conservation system is a historic priority recognized in international law and policy. We assess the completeness of the safety duplication collection in the Svalbard Global Seed Vault with respect to data on the world's ex-situ collections as reported by the Food and Agriculture Organization of the United Nations. Currently, 774,601 samples are deposited at Svalbard by 53 genebanks. We estimate that more than one third of the globally distinct accessions of 156 crop genera stored in genebanks as orthodox seeds are conserved in the Seed Vault. The numbers of safety duplicates of Triticum (wheat, Sorghum (sorghum, Pennisetum (pearl millet, Eleusine (finger millet, Cicer (chickpea and Lens (lentil exceed 50% of the estimated numbers of distinct accessions in global ex-situ collections. The number of accessions conserved globally generally reflects importance for food production, but there are significant gaps in the safety collection at Svalbard in some genera of high importance for food security in tropical countries, such as Amaranthus (amaranth, Chenopodium (quinoa, Eragrostis (teff and Abelmoschus (okra. In the 29 food-crop genera with the largest number of accessions stored globally, an average of 5.5 out of the ten largest collections is already represented in the Seed Vault collection or is covered by existing deposit agreements. The high coverage of ITPGRFA Annex 1 crops and of those crops for which there is a CGIAR mandate in the current Seed Vault collection indicates that existence of international policies and institutions are important determinants for accessions to be safety duplicated at Svalbard. As a back-up site for the global conservation system, the Seed Vault plays not only a practical but also a symbolic role for enhanced integration and cooperation for conservation of crop diversity.

Global ex-situ crop diversity conservation and the Svalbard Global Seed Vault: assessing the current status.

Science.gov (United States)

Westengen, Ola T; Jeppson, Simon; Guarino, Luigi

2013-01-01

Ex-situ conservation of crop diversity is a global concern, and the development of an efficient and sustainable conservation system is a historic priority recognized in international law and policy. We assess the completeness of the safety duplication collection in the Svalbard Global Seed Vault with respect to data on the world's ex-situ collections as reported by the Food and Agriculture Organization of the United Nations. Currently, 774,601 samples are deposited at Svalbard by 53 genebanks. We estimate that more than one third of the globally distinct accessions of 156 crop genera stored in genebanks as orthodox seeds are conserved in the Seed Vault. The numbers of safety duplicates of Triticum (wheat), Sorghum (sorghum), Pennisetum (pearl millet), Eleusine (finger millet), Cicer (chickpea) and Lens (lentil) exceed 50% of the estimated numbers of distinct accessions in global ex-situ collections. The number of accessions conserved globally generally reflects importance for food production, but there are significant gaps in the safety collection at Svalbard in some genera of high importance for food security in tropical countries, such as Amaranthus (amaranth), Chenopodium (quinoa), Eragrostis (teff) and Abelmoschus (okra). In the 29 food-crop genera with the largest number of accessions stored globally, an average of 5.5 out of the ten largest collections is already represented in the Seed Vault collection or is covered by existing deposit agreements. The high coverage of ITPGRFA Annex 1 crops and of those crops for which there is a CGIAR mandate in the current Seed Vault collection indicates that existence of international policies and institutions are important determinants for accessions to be safety duplicated at Svalbard. As a back-up site for the global conservation system, the Seed Vault plays not only a practical but also a symbolic role for enhanced integration and cooperation for conservation of crop diversity.

GRADE Equity Guidelines 3

DEFF Research Database (Denmark)

Welch, Vivian A; Akl, Elie A; Pottie, Kevin

2017-01-01

OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

Lack of international consensus in low-risk drinking guidelines.

Science.gov (United States)

Furtwaengler, Nina A F F; de Visser, Richard O

2013-01-01

To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Appraisal tools for clinical practice guidelines: a systematic review.

Directory of Open Access Journals (Sweden)

Ulrich Siering

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

Global assessment of the economics of land degradation and improvement

Science.gov (United States)

Nkonya, Ephraim

2017-04-01

Land degradation—defined by the Millennium Ecosystem Assessment report as the long-term loss of ecosystems services—is a global problem, negatively affecting the livelihoods and food security of billions of people. Intensifying efforts, mobilizing more investments and strengthening the policy commitment for addressing land degradation at the global level needs to be supported by a careful evaluation of the costs and benefits of action versus costs of inaction against land degradation. Consistent with the definition of land degradation, we adopt the Total Economic Value (TEV) approach to determine the costs of land degradation and use remote sensing data and global statistical databases in our analysis. The results show that the annual costs of land degradation due to land use and land cover change (LUCC) are about US231 billion per year or about 0.41 % of the global GDP of US56.49 trillion in 2007. Contrary to past global land degradation assessment studies, land degradation is severe in both tropical and temperate countries. However, the losses from LUCC are especially high in Sub-Saharan Africa, which accounts for 26 % of the total global costs of land degradation due to LUCC. However, the local tangible losses (mainly provisioning services) account only for 46 % of the total cost of land degradation and the rest of the cost is due to the losses of ecosystem services (ES) accruable largely to beneficiaries other than the local land users. These external ES losses include carbon sequestration, biodiversity, genetic information and cultural services. This implies that the global community bears the largest cost of land degradation, which suggests that efforts to address land degradation should be done bearing in mind that the global community,as a whole, incurs larger losses than the local communities experiencing land degradation. The cost of soil fertility mining due to using land degrading management practices on maize, rice and wheat is estimated to be

A comparative review of pharmacoeconomic guidelines.

Science.gov (United States)

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

1995-09-01

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

Integrating Global Open Geo-Information for Major Disaster Assessment: A Case Study of the Myanmar Flood

Directory of Open Access Journals (Sweden)

Suju Li

2017-07-01

Full Text Available Major disasters typically impact large areas, cause considerable damages, and result in significant human and economic losses. The timely and accurate estimation of impacts and damages is essential to better understand disaster conditions and to support emergency response operations. Geo-information drawn from various sources at multi spatial-temporal scales can be used for disaster assessments through a synthesis of hazard, exposure, and post disaster information based on pertinent approaches. Along with the increased availability of open sourced data and cooperation initiatives, more global scale geo-information, including global land cover datasets, has been produced and can be integrated with other information for disaster dynamic damage assessment (e.g., impact estimation immediately after a disaster occurs, physical damage assessment during the emergency response stage, and comprehensive assessment following an emergency response. Residential areas and arable lands affected by the flood disaster occurring from July to August 2015 in Myanmar were assessed based on satellite images, GlobeLand30 data, and other global open sourced information as a study case. The results show that integrating global open geo-information could serve as a practical and efficient means of assessing damage resulting from major disasters worldwide, especially at the early emergency response stage.

Global approach of mean service satisfaction assessment

Directory of Open Access Journals (Sweden)

Ahmed Dooguy Kora

2014-01-01

Full Text Available A theoretical expression for mobile service satisfaction assessment has been proposed. Mobile networks users’ satisfaction is a major concern for the operators and regulators. Therefore a certain level of network qualification is required to be offered to consumers by operators thanks to the decisions initiated by the regulation authority. For the assessment of the level of satisfaction, several methodologies and tools (measuring and monitoring have emerged. Ranking in two broad categories, namely the objective and subjective methods, both have advantages as well as disadvantages. This Letter has proposed a unified approach to evaluate more objectively users’ level of satisfaction of a service based on the most common network key performance indicators (KPIs rate following the different methods. This approach's main advantage is that it has taken advantages of the different positive aspects of the existing methods and outperformed their limitations thanks to the introduced concept of global KPI. In addition, the size of samples according to each method has been considered. A mean service satisfaction theoretical expression has been proposed to regulation authority, consumers association and operators as common base of service satisfaction assessment.

Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets.

Science.gov (United States)

Waning, Brenda; Kyle, Margaret; Diedrichsen, Ellen; Soucy, Lyne; Hochstadt, Jenny; Bärnighausen, Till; Moon, Suerie

2010-05-25

Universal access to antiretroviral therapy (ART) in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV) medicines, limited financing, and few fixed-dose combination (FDC) products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO) HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal) and United States (US) Food and Drug Administration (FDA) approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM), US President's Emergency Plan for AIDS Relief (PEPFAR) and UNITAID. WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year) with more expensive zidovudine- ($154-260/person/year) or tenofovir-based ($244-465/person/year) regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir) increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Global initiatives facilitated the creation of fairly efficient markets

[Considerations on the development of nutrition-related guidelines by the World Health Organization and their implementation].

Science.gov (United States)

Zamora, Gerardo; Meneses, Daniela; De-Regil, Luz Maria; Neufeld, Lynnette; Peña-Rosas, Juan Pablo; Sinisterra, Odalis Teresa

2015-03-01

The World Health Organization (WHO) follows a complex and rigorous process to develop global guidelines. With regard to nutrition-related guidelines, the joint participation of national authorities from Member States and their partners, including those of the social economy, is key to strengthening the process of evidence-informed guideline development and the subsequent implementation as part of national public health strategies. WHO puts forward a series of tools that can assist national authorities on health and social development in the elaboration of evidence-informed policies, considering their pertinence, relevance and implementability. This adoption and adaptation process must consider equity in order to avoid widening existing inequities. WHO global nutrition guidelines contribute to the effective implementation of nutrition interventions in Member States. Two experiences of implementation, one in Panama and one in Peru, exemplify this process. The paper ends by suggesting a deeper understanding and utilization of implementation research during programmes to identify what factors ensure effective interventions, appropriate scale up strategies and greater health equity.

Global assessment of promising forest management practices for sequestration of carbon

International Nuclear Information System (INIS)

Winjum, J.K.; Dixon, R.K.; Schroeder, P.E.

1991-01-01

In the 1980s, forests covered an estimated 4.08 billion hectares and contained a carbon pool of 1,400 gigatonnes, or 64% of the total terrestrial pool. Forest biomass productivity per unit of land can be enhanced by proper management practices and it is suggested that by implementing such practices, forests could store more carbon globally and thereby slow the increase in atmospheric CO 2 . Currently, only about 10% of world forests are managed at an active level. An assessment is presented of the amount of carbon that could be sequestered globally by implementing the practices of reforestation, afforestation, natural regeneration, silviculture, and agroforestry. The assessment is based on the development of a global database on managed forest and agroforestry systems. For each of the above five practices, the database contains information on carbon sequestered per hectare, implementation costs, and estimates of the amount of land technically suitable for such practices throughout the world. Results are presented for each practice in the boreal, temperate, and tropical regions. Preliminary estimates show that promising forestry and agroforestry practices could sequester, over a 50-y period, ca 50-100 gigatonnes of carbon at a cost of $170-340 million. This would be a significant contribution as a mitigating measure regarding atmospheric CO 2 buildup and projections for global warming, at present rates of anthropogenic carbon emissions (300-400 gigatonnes carbon over 50 y). 19 refs., 2 figs., 4 tabs

Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital

Directory of Open Access Journals (Sweden)

Dilnasheen Sheikh

2017-06-01

Full Text Available The objective of the study is to assess the medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. A prospective observational study was carried out for a period of 8 months from June 2015 to February 2016 at tertiary care hospital. At inpatient department regular chart review of patient case records was carried out to assess the medication errors. The observed medication errors were assessed for level of harm by using NCCMERP index. The outpatient prescriptions were screened for adherence to WHO prescription writing guidelines. Out of 200 patients, 40 patients developed medication errors. Most of the medication errors were observed in the age group above 61 years (40%. Majority of the medication errors were observed with drug class of antibiotics 9 (22.5% and bronchodilators 9 (22.5%. Most of the errors were under the NCCMERP index category C. Out of 545 outpatient prescriptions, 51 (9.37% prescriptions did not have prescriber’s name and all of the prescriptions lack prescriber’s personal contact number. Eighteen prescriptions did not have patient’s name and 426 (78.2% prescriptions did not have patient’s age. The prevalence of medication errors in this study was relatively low (20% without any fatal outcome. Omission error was the most frequently observed medication errors 31 (77.5%. In the present study, the patient’s age was missing in 78.2% of the prescriptions and none of the prescriptions had patient’s address and the drug names were not mentioned by their generic names.

Stem cell engineering a WTEC global assessment

CERN Document Server

Loring, Jeanne; McDevitt, Todd; Palecek, Sean; Schaffer, David; Zandstra, Peter

2014-01-01

This book describes a global assessment of stem cell engineering research, achieved through site visits by a panel of experts to leading institutes, followed by dedicated workshops. The assessment made clear that engineers and the engineering approach with its quantitative, system-based thinking can contribute much to the progress of stem cell research and development. The increased need for complex computational models and new, innovative technologies, such as high-throughput screening techniques, organ-on-a-chip models and in vitro tumor models require an increasing involvement of engineers and physical scientists. Additionally, this book will show that although the US is still in a leadership position in stem cell engineering, Asian countries such as Japan, China and Korea, as well as European countries like the UK, Germany, Sweden and the Netherlands are rapidly expanding their investments in the field. Strategic partnerships between countries could lead to major advances of the field and scalable expansi...

Limitless Learning: Assessing Social Media Use for Global Workplace Learning

Science.gov (United States)

Breunig, Karl Joachim

2016-01-01

Purpose: This empirical paper aims to assess how social media can foster workplace learning within a globally dispersed project environment. In general, there are few studies on the use of social media in organizations, and many of these emphasize on issues related to knowledge transfer. Although learning traditionally has been as acquisition of…

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment.

Directory of Open Access Journals (Sweden)

Aline Guttmann

Full Text Available In cluster detection of disease, the use of local cluster detection tests (CDTs is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps.

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment

Science.gov (United States)

Guttmann, Aline; Li, Xinran; Feschet, Fabien; Gaudart, Jean; Demongeot, Jacques; Boire, Jean-Yves; Ouchchane, Lemlih

2015-01-01

In cluster detection of disease, the use of local cluster detection tests (CDTs) is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC) is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps. PMID:26086911

Porphyry copper assessment of Southeast Asia and Melanesia: Chapter D in Global mineral resource assessment

Science.gov (United States)

Hammarstrom, Jane M.; Bookstrom, Arthur A.; Dicken, Connie L.; Drenth, Benjamin J.; Ludington, Steve; Robinson, Gilpin R.; Setiabudi, Bambang Tjahjono; Sukserm, Wudhikarn; Sunuhadi, Dwi Nugroho; Wah, Alexander Yan Sze; Zientek, Michael L.

2013-01-01

The U.S. Geological Survey collaborated with member countries of the Coordinating Committee for Geoscience Programmes in East and Southeast Asia (CCOP) on an assessment of the porphyry copper resources of Southeast Asia and Melanesia as part of a global mineral resource assessment. The region hosts world-class porphyry copper deposits and underexplored areas that are likely to contain undiscovered deposits. Examples of known porphyry copper deposits include Batu Hijau and Grasberg in Indonesia; Panguna, Frieda River, and Ok Tedi in Papua New Guinea; and Namosi in Fiji.

Peak load arrangements : Assessment of Nordel guidelines

Energy Technology Data Exchange (ETDEWEB)

2009-07-01

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

Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei.

Directory of Open Access Journals (Sweden)

Direk Limmathurotsakul

Full Text Available Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling.An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011 was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and 'low-tech' methodology that is applicable in both developed and developing countries.The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei.

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

Directory of Open Access Journals (Sweden)

Paul C Langley

2017-01-01

Full Text Available Pricing decisions and access to pharmaceuticals should be evidence based. Unfortunately, the French guidelines for technology assessment, in their adoption of the National Institute for Health and Clinical Excellence (NICE reference case modeling standard ensure that this is not the case. Rather than requiring the submission of claims that are credible, evaluable and replicable, the Haute Autorité de Sante (HAS mandates the creation of imaginary worlds to support comparative effectiveness and cost-outcome claims. The purpose of this commentary is to make the case that HAS should reconsider this commitment to standards for health technology assessment that are more appropriately seen as pseudoscience. The recommendation is that HAS should put to one side mandating lifetime cost-per-quality adjusted life year (QALY or life years saved claims in favor of short-term claims that can be evaluated and reported to health system decision makers as part of a provisional assessment of new products as well as supporting ongoing disease area and therapeutic class reviews.   Type: Commentary

Global assessment of onshore wind power resources considering the distance to urban areas

International Nuclear Information System (INIS)

Silva Herran, Diego; Dai, Hancheng; Fujimori, Shinichiro; Masui, Toshihiko

2016-01-01

This study assessed global onshore wind power resources considering the distance to urban areas in terms of transmission losses and costs, and visibility (landscape impact) restrictions. Including this factor decreased the economic potential considerably depending on the level of supply cost considered (at least 37% and 16% for an economic potential below 10 and 14 US cents/kWh, respectively). Its importance compared to other factors was secondary below 15 US cents/kWh. At higher costs it was secondary only to land use, and was more important than economic and technical factors. The impact of this factor was mixed across all regions of the world, given the heterogeneity of wind resources in remote and proximal areas. Regions where available resources decreased the most included the European Union, Japan, Southeast Asia, the Middle East, and Africa. The supply cost chosen to evaluate the economic potential and uncertainties influencing the estimation of distance to the closest urban area are critical for the assessment. Neglecting the restrictions associated with integration into energy systems and social acceptability resulted in an overestimation of global onshore wind resources. These outcomes are fundamental for global climate policies because they help to clarify the limits of wind energy resource availability. - Highlights: • Global onshore wind resources were assessed including the distance to urban areas. • We evaluate the impact of transmission losses and cost, and visibility restrictions. • The distance to urban areas' impact was considerable, depending on the supply cost. • This factor's importance was secondary to economic, land use, and technical factors. • Neglecting this factor resulted in an overestimation of global wind resources.

Clinical algorithms to aid osteoarthritis guideline dissemination

DEFF Research Database (Denmark)

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

2016-01-01

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

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

Science.gov (United States)

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

2015-01-22

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

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

Science.gov (United States)

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

2017-08-01

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

Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

Directory of Open Access Journals (Sweden)

Patrick Harris

2015-01-01

Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

Porphyry copper assessment of western Central Asia: Chapter N in Global mineral resource assessment

Science.gov (United States)

Berger, Byron R.; Mars, John L.; Denning, Paul; Phillips, Jeffrey D.; Hammarstrom, Jane M.; Zientek, Michael L.; Dicken, Connie L.; Drew, Lawrence J.; with contributions from Alexeiev, Dmitriy; Seltmann, Reimar; Herrington, Richard J.

2014-01-01

The U.S. Geological Survey conducted an assessment of resources associated with porphyry copper deposits in the western Central Asia countries of Kyrgyzstan, Uzbekistan, Kazakhstan, and Tajikistan and the southern Urals of Kazakhstan and Russia as part of a global mineral resource assessment. The purpose of the study was to (1) delineate permissive areas (tracts) for undiscovered porphyry copper deposits; (2) compile a database of known porphyry copper deposits and significant prospects; (3) where data permit, estimate numbers of undiscovered deposits within those permissive tracts; and (4) provide probabilistic estimates the amounts of copper (Cu), molybdenum (Mo), gold (Au), and silver (Ag) that could be contained in those undiscovered deposits.

Graphical Methodology of Global Pollution Index for the Environmental Impact Assessment Using Two Environmental Components

OpenAIRE

Corneliu Cojocaru; Diana Mariana Cocârţă; Irina Aura Istrate; Igor Creţescu

2017-01-01

One of the applied methods for environmental impact assessment is the index of global pollution (IGP) proposed by Rojanschi in 1991. This methodology enables the global estimation for the ecosystem state affected more or less by human activities. Unfortunately, Rojanschi’s method has a limitation; it can be applied only if at least three environmental components are considered. Frequently, many environmental impact assessment applications rely on analysis of only two environmental components....

Sustainable water future with global implications: everyone's responsibility.

Science.gov (United States)

Kuylenstierna, J L; Bjorklund, G; Najlis, P

1997-01-01

The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

Global bioethics: utopia or reality?

Science.gov (United States)

Hellsten, Sirkku K

2008-08-01

This article discusses what 'global bioethics' means today and what features make bioethical research 'global'. The article provides a historical view of the development of the field of 'bioethics', from medical ethics to the wider study of bioethics in a global context. It critically examines the particular problems that 'global bioethics' research faces across cultural and political borders and suggests some solutions on how to move towards a more balanced and culturally less biased dialogue in the issues of bioethics. The main thesis is that we need to bring global and local aspects closer together when looking for international guidelines, by paying more attention to particular cultures and local economic and social circumstances in reaching a shared understanding of the main values and principles of bioethics, and in building 'biodemocracy'.

Global assessment of ocean carbon export by combining satellite observations and food-web models

Science.gov (United States)

Siegel, D. A.; Buesseler, K. O.; Doney, S. C.; Sailley, S. F.; Behrenfeld, M. J.; Boyd, P. W.

2014-03-01

The export of organic carbon from the surface ocean by sinking particles is an important, yet highly uncertain, component of the global carbon cycle. Here we introduce a mechanistic assessment of the global ocean carbon export using satellite observations, including determinations of net primary production and the slope of the particle size spectrum, to drive a food-web model that estimates the production of sinking zooplankton feces and algal aggregates comprising the sinking particle flux at the base of the euphotic zone. The synthesis of observations and models reveals fundamentally different and ecologically consistent regional-scale patterns in export and export efficiency not found in previous global carbon export assessments. The model reproduces regional-scale particle export field observations and predicts a climatological mean global carbon export from the euphotic zone of 6 Pg C yr-1. Global export estimates show small variation (typically model parameter values. The model is also robust to the choices of the satellite data products used and enables interannual changes to be quantified. The present synthesis of observations and models provides a path for quantifying the ocean's biological pump.

Implementing New Reform Guidelines in Teaching Introductory College Statistics Courses

Science.gov (United States)

Everson, Michelle; Zieffler, Andrew; Garfield, Joan

2008-01-01

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

Factors controlling volume errors through 2D gully erosion assessment: guidelines for optimal survey design

Science.gov (United States)

Castillo, Carlos; Pérez, Rafael

2017-04-01

The assessment of gully erosion volumes is essential for the quantification of soil losses derived from this relevant degradation process. Traditionally, 2D and 3D approaches has been applied for this purpose (Casalí et al., 2006). Although innovative 3D approaches have recently been proposed for gully volume quantification, a renewed interest can be found in literature regarding the useful information that cross-section analysis still provides in gully erosion research. Moreover, the application of methods based on 2D approaches can be the most cost-effective approach in many situations such as preliminary studies with low accuracy requirements or surveys under time or budget constraints. The main aim of this work is to examine the key factors controlling volume error variability in 2D gully assessment by means of a stochastic experiment involving a Monte Carlo analysis over synthetic gully profiles in order to 1) contribute to a better understanding of the drivers and magnitude of gully erosion 2D-surveys uncertainty and 2) provide guidelines for optimal survey designs. Owing to the stochastic properties of error generation in 2D volume assessment, a statistical approach was followed to generate a large and significant set of gully reach configurations to evaluate quantitatively the influence of the main factors controlling the uncertainty of the volume assessment. For this purpose, a simulation algorithm in Matlab® code was written, involving the following stages: - Generation of synthetic gully area profiles with different degrees of complexity (characterized by the cross-section variability) - Simulation of field measurements characterised by a survey intensity and the precision of the measurement method - Quantification of the volume error uncertainty as a function of the key factors In this communication we will present the relationships between volume error and the studied factors and propose guidelines for 2D field surveys based on the minimal survey

Weather Avoidance Guidelines for NASA Global Hawk High-Altitude UAS

Science.gov (United States)

Cecil, Daniel J.; Zipser, Edward J.; Velden, Chris; Monette, Sarah; Heymsfield, Gerry; Braun, Scott; Newman, Paul; Black, Pete; Black, Michael; Dunion, Jason

2014-01-01

NASA operates two Global Hawk unmanned aircraft systems for Earth Science research projects. In particular, they are used in the Hurricane and Severe Storm Sentinel (HS3) project during 2012, 2013, and 2014 to take measurements from the environment around tropical cyclones, and from directly above tropical cyclones. There is concern that strict adherence to the weather avoidance rules used in 2012 may sacrifice the ability to observe important science targets. We have proposed modifications to these weather avoidance rules that we believe will improve the ability to observe science targets without compromising aircraft safety. The previous guidelines, used in 2012, specified: Do not approach thunderstorms within 25 nm during flight at FL500 or below. When flying above FL500: Do not approach reported lightning within 25NM in areas where cloud tops are reported at FL500 or higher. Aircraft should maintain at least 10000 ft vertical separation from reported lightning if cloud tops are below FL500. No over-flight of cumulus tops higher than FL500. No flight into forecast or reported icing conditions. No flight into forecast or reported moderate or severe turbulence Based on past experience with high-altitude flights over tropical cyclones, we have recommended changing this guidance to: Do not approach thunderstorms within 25 nm during flight at FL500 or below. Aircraft should maintain at least 5000 ft vertical separation from significant convective cloud tops except: a) When cloud tops above FL500: In the event of reported significant lightning activity or indicators of significant overshooting tops, do not approach within 10-25 nm, depending on pilot discretion and advice from Mission Scientist. b) When cloud tops are below FL500, maintain 10000 ft separation from reported significant lightning or indicators of significant overshooting tops. No flight into forecasted or reported icing conditions. No flight into forecasted or reported moderate or severe turbulence The

Canadian clinical practice guidelines for acute and chronic rhinosinusitis

Directory of Open Access Journals (Sweden)

Desrosiers Martin

2011-02-01

Full Text Available Abstract This document provides healthcare practitioners with information regarding the management of acute rhinosinusitis (ARS and chronic rhinosinusitis (CRS to enable them to better meet the needs of this patient population. These guidelines describe controversies in the management of acute bacterial rhinosinusitis (ABRS and include recommendations that take into account changes in the bacteriologic landscape. Recent guidelines in ABRS have been released by American and European groups as recently as 2007, but these are either limited in their coverage of the subject of CRS, do not follow an evidence-based strategy, or omit relevant stakeholders in guidelines development, and do not address the particulars of the Canadian healthcare environment. Advances in understanding the pathophysiology of CRS, along with the development of appropriate therapeutic strategies, have improved outcomes for patients with CRS. CRS now affects large numbers of patients globally and primary care practitioners are confronted by this disease on a daily basis. Although initially considered a chronic bacterial infection, CRS is now recognized as having multiple distinct components (eg, infection, inflammation, which have led to changes in therapeutic approaches (eg, increased use of corticosteroids. The role of bacteria in the persistence of chronic infections, and the roles of surgical and medical management are evolving. Although evidence is limited, guidance for managing patients with CRS would help practitioners less experienced in this area offer rational care. It is no longer reasonable to manage CRS as a prolonged version of ARS, but rather, specific therapeutic strategies adapted to pathogenesis must be developed and diffused. Guidelines must take into account all available evidence and incorporate these in an unbiased fashion into management recommendations based on the quality of evidence, therapeutic benefit, and risks incurred. This document is focused on

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

DEFF Research Database (Denmark)

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

2012-01-01

Abstract Objectives. To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. Materials and methods. All 19-year-old patients registered at eight public dental...... clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according...... to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. Results. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk...

The assessment of Global Precipitation Measurement estimates over the Indian subcontinent

Science.gov (United States)

Murali Krishna, U. V.; Das, Subrata Kumar; Deshpande, Sachin M.; Doiphode, S. L.; Pandithurai, G.

2017-08-01

Accurate and real-time precipitation estimation is a challenging task for current and future spaceborne measurements, which is essential to understand the global hydrological cycle. Recently, the Global Precipitation Measurement (GPM) satellites were launched as a next-generation rainfall mission for observing the global precipitation characteristics. The purpose of the GPM is to enhance the spatiotemporal resolution of global precipitation. The main objective of the present study is to assess the rainfall products from the GPM, especially the Integrated Multi-satellitE Retrievals for the GPM (IMERG) data by comparing with the ground-based observations. The multitemporal scale evaluations of rainfall involving subdaily, diurnal, monthly, and seasonal scales were performed over the Indian subcontinent. The comparison shows that the IMERG performed better than the Tropical Rainfall Measuring Mission (TRMM)-3B42, although both rainfall products underestimated the observed rainfall compared to the ground-based measurements. The analyses also reveal that the TRMM-3B42 and IMERG data sets are able to represent the large-scale monsoon rainfall spatial features but are having region-specific biases. The IMERG shows significant improvement in low rainfall estimates compared to the TRMM-3B42 for selected regions. In the spatial distribution, the IMERG shows higher rain rates compared to the TRMM-3B42, due to its enhanced spatial and temporal resolutions. Apart from this, the characteristics of raindrop size distribution (DSD) obtained from the GPM mission dual-frequency precipitation radar is assessed over the complex mountain terrain site in the Western Ghats, India, using the DSD measured by a Joss-Waldvogel disdrometer.

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

Science.gov (United States)

McCauley, Janet L

2015-01-01

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

A global water scarcity assessment under Shared Socio-economic Pathways – Part 1: Water use

Directory of Open Access Journals (Sweden)

N. Hanasaki

2013-07-01

Full Text Available A novel global water scarcity assessment for the 21st century is presented in a two-part paper. In this first paper, water use scenarios are presented for the latest global hydrological models. The scenarios are compatible with the socio-economic scenarios of the Shared Socio-economic Pathways (SSPs, which are a part of the latest set of scenarios on global change developed by the integrated assessment, the IAV (climate change impact, adaptation, and vulnerability assessment, and the climate modeling community. The SSPs depict five global situations based on substantially different socio-economic conditions during the 21st century. Water use scenarios were developed to reflect not only quantitative socio-economic factors, such as population and electricity production, but also key qualitative concepts such as the degree of technological change and overall environmental consciousness. Each scenario consists of five factors: irrigated area, crop intensity, irrigation efficiency, and withdrawal-based potential industrial and municipal water demands. The first three factors are used to estimate the potential irrigation water demand. All factors were developed using simple models based on a literature review and analysis of historical records. The factors are grid-based at a spatial resolution of 0.5° × 0.5° and cover the whole 21st century in five-year intervals. Each factor shows wide variation among the different global situations depicted: the irrigated area in 2085 varies between 2.7 × 106 and 4.5 × 106 km2, withdrawal-based potential industrial water demand between 246 and 1714 km3 yr−1, and municipal water between 573 and 1280 km3 yr−1. The water use scenarios can be used for global water scarcity assessments that identify the regions vulnerable to water scarcity and analyze the timing and magnitude of scarcity conditions.

Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases

Science.gov (United States)

2012-01-01

Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders

Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

Science.gov (United States)

Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

2015-10-21

Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

Global assessment of internal audit competence: Does one size fi t all?

African Journals Online (AJOL)

Data from the Institute of Internal Auditors' (IIA's) latest global Common Body of Knowledge ... Australia consistently indicated different perceptions of the levels of ... Australia's need for a country-specifi c internal audit competency assessment.

Assessment of global phase uncertainty in case-control studies

Directory of Open Access Journals (Sweden)

van Houwelingen Hans C

2009-09-01

Full Text Available Abstract Background In haplotype-based candidate gene studies a problem is that the genotype data are unphased, which results in haplotype ambiguity. The measure 1 quantifies haplotype predictability from genotype data. It is computed for each individual haplotype, and for a measure of global relative efficiency a minimum value is suggested. Alternatively, we developed methods directly based on the information content of haplotype frequency estimates to obtain global relative efficiency measures: and based on A- and D-optimality, respectively. All three methods are designed for single populations; they can be applied in cases only, controls only or the whole data. Therefore they are not necessarily optimal for haplotype testing in case-control studies. Results A new global relative efficiency measure was derived to maximize power of a simple test statistic that compares haplotype frequencies in cases and controls. Application to real data showed that our proposed method gave a clear and summarizing measure for the case-control study conducted. Additionally this measure might be used for selection of individuals, who have the highest potential for improving power by resolving phase ambiguity. Conclusion Instead of using relative efficiency measure for cases only, controls only or their combined data, we link uncertainty measure to case-control studies directly. Hence, our global efficiency measure might be useful to assess whether data are informative or have enough power for estimation of a specific haplotype risk.

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

Science.gov (United States)

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

2018-04-01

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

Patient-generated subjective global assessment: Innovation from paper to digital app

OpenAIRE

Ottery, Faith D.; Kasenic, Suzanne; Sealy, Martine J.; DeBolt, Susan P.; Isenring, Elizabeth; Jager-Wittenaar, Harriët

2015-01-01

Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening, assessment and monitoring, triageing for multimodal intervention and for evaluation of clinical and health economic outcomes. There have been ad hoc translations, often with permission of the origin...

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

Science.gov (United States)

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

2017-09-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-02-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Postponement in logistics strategies of global supply chains

Directory of Open Access Journals (Sweden)

Agnieszka Szmelter

2015-12-01

Full Text Available The paper aims to present postponement strategy as a crucial element of logistics strategies of today’s global supply chains. The article presents the history of postponement, characteristics of this concept, types of postponement and important information about its implementation in global supply chains. The paper also contains guidelines for future research on postponement concept.

Assessment of global cloud datasets from satellites: Project and database initiated by the GEWEX radiation panel

OpenAIRE

Stubenrauch , C.J.; Rossow , W.B.; Kinne , S.; Ackerman , S.; Cesana , G.; Chepfer , H.; Di Girolamo , L.; Getzewich , B.; Guignard , A.; Heidinger , A.; Maddux , B.C.; Menzel , W.P.; Minnis , P.; Pearl , C.; Platnick , S.

2013-01-01

International audience; The Global Energy and Water Cycle Experiment (GEWEX) Radiation Panel initiated the GEWEX Cloud Assessment in 2005 to compare available, global, long-term cloud data products with the International Satellite Cloud Climatology Project (ISCCP). The GEWEX Cloud Assessment database included cloud properties retrieved from different satellite sensor measurements, taken at various local times and over various time periods. The relevant passive satellite sensors measured radia...

Assessing historical rate changes in global tsunami occurrence

Science.gov (United States)

Geist, E.L.; Parsons, T.

2011-01-01

The global catalogue of tsunami events is examined to determine if transient variations in tsunami rates are consistent with a Poisson process commonly assumed for tsunami hazard assessments. The primary data analyzed are tsunamis with maximum sizes >1m. The record of these tsunamis appears to be complete since approximately 1890. A secondary data set of tsunamis >0.1m is also analyzed that appears to be complete since approximately 1960. Various kernel density estimates used to determine the rate distribution with time indicate a prominent rate change in global tsunamis during the mid-1990s. Less prominent rate changes occur in the early- and mid-20th century. To determine whether these rate fluctuations are anomalous, the distribution of annual event numbers for the tsunami catalogue is compared to Poisson and negative binomial distributions, the latter of which includes the effects of temporal clustering. Compared to a Poisson distribution, the negative binomial distribution model provides a consistent fit to tsunami event numbers for the >1m data set, but the Poisson null hypothesis cannot be falsified for the shorter duration >0.1m data set. Temporal clustering of tsunami sources is also indicated by the distribution of interevent times for both data sets. Tsunami event clusters consist only of two to four events, in contrast to protracted sequences of earthquakes that make up foreshock-main shock-aftershock sequences. From past studies of seismicity, it is likely that there is a physical triggering mechanism responsible for events within the tsunami source 'mini-clusters'. In conclusion, prominent transient rate increases in the occurrence of global tsunamis appear to be caused by temporal grouping of geographically distinct mini-clusters, in addition to the random preferential location of global M >7 earthquakes along offshore fault zones.

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

Science.gov (United States)

2014-01-01

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

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

Science.gov (United States)

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

2015-01-01

Background Physical activity (PA) is associated with health enhancement. The aim of this study was to assess: 1) levels and patterns of PA in university students by using accelerometers; and 2) the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines. Methods Observational cross-sectional study (Cuenca’s Adults Study) involving 296 (206 women) healthy Spanish university students aged 18–25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA) was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (pstudents met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day. Conclusions Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used. PMID:26536605

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

Science.gov (United States)

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

2016-08-15

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

Kidney Disease Outcomes Quality Initiative (K/DOQI) and the Dialysis Outcomes and Practice Patterns Study (DOPPS): nutrition guidelines, indicators, and practices.

Science.gov (United States)

Combe, Christian; McCullough, Keith P; Asano, Yasushi; Ginsberg, Nancy; Maroni, Bradley J; Pifer, Trinh B

2004-11-01

Nutritional markers are important predictors of morbidity and mortality in dialysis patients. The Clinical Practice Guidelines for Nutrition in Chronic Renal Failure provides guidelines for assessing nutritional status that were evaluated using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS). The level of various nutritional markers (serum albumin, modified subjective global assessment, serum creatinine, normalized protein catabolic rate [nPCR], and body mass index) were described for representative samples of patients and facilities from 7 countries (France, Germany, Italy, Spain, Japan, United Kingdom, and United States) participating in the DOPPS. A strong inverse association was observed between mortality and serum albumin, with a mortality risk 1.38 times higher for patients with serum albumin concentration less than 3.5 g/dL (35 g/L). There were significant differences by country in the proportion of moderately and severely malnourished patients as determined by the modified subjective global assessment score. In the US sample, severely and moderately malnourished patients had a higher mortality risk compared with those not malnourished, 33% and 5% higher, respectively. An inverse relationship exists between serum creatinine concentration and mortality, with a mortality risk 60% to 70% higher in the lowest quartile group compared with the highest quartile group in Europe and the United States. Levels of nPCR varied significantly between European countries, and there was no association between mortality and nPCR in US data. After adjustment for demographic and comorbidity factors, the mortality risk decreased as body mass index increased in both US and European samples. DOPPS data highlight the importance of routine assessment of nutritional status, using multiple parameters, in clinical practice to improve patient care.

Use of Standard Guidelines for Department of Medicine Summary Letters.

Science.gov (United States)

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

2018-04-12

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

Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets

Directory of Open Access Journals (Sweden)

Hochstadt Jenny

2010-05-01

Full Text Available Abstract Background Universal access to antiretroviral therapy (ART in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV medicines, limited financing, and few fixed-dose combination (FDC products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. Methods We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal and United States (US Food and Drug Administration (FDA approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM, US President's Emergency Plan for AIDS Relief (PEPFAR and UNITAID. Results WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year with more expensive zidovudine- ($154-260/person/year or tenofovir-based ($244-465/person/year regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Conclusions Global initiatives

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

Science.gov (United States)

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

2015-06-01

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

Clinical algorithms to aid osteoarthritis guideline dissemination.

Science.gov (United States)

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

2016-09-01

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

The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders

Directory of Open Access Journals (Sweden)

Mairead C. Cardamone-Breen

2017-09-01

Full Text Available Background Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1 validate the PRADAS as a criterion-referenced measure; (2 examine parental concordance with the guidelines in the sample; and (3 examine correlates of parental concordance with the guidelines. Methods Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12–15 also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. Results One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education

Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy

Directory of Open Access Journals (Sweden)

Anthony D. Harries

2016-09-01

Full Text Available Abstract The scale-up of antiretroviral therapy (ART in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.

Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy.

Science.gov (United States)

Harries, Anthony D; Ford, Nathan; Jahn, Andreas; Schouten, Erik J; Libamba, Edwin; Chimbwandira, Frank; Maher, Dermot

2016-09-06

The scale-up of antiretroviral therapy (ART) in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO) in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.

Successful global assessments and monitoring: The roles of the international community and the United States

International Nuclear Information System (INIS)

Lund, H.G.

1991-01-01

Successful global assessments and monitoring of natural resources requires teamwork between participating nations and the international communities charged with the responsibility for collecting and disseminating information. In an attempt to identify emerging information needs and to promote coordination, the International Union of Forestry Research Organizations (IUFRO) and other national and international groups held a major conference and workshop in Venice, Italy, on global monitoring last September. The results of the meeting and subsequent events in Montreal indicated a need for more aggressive leadership at the international level and more cooperation at the national level. This paper reports on the outcome of the Venice conference and list some things that the international community and the United States must do to make global assessments and monitoring a reality

Patient-generated subjective global assessment : innovation from paper to digital app

NARCIS (Netherlands)

Ottery, Faith D.; Isenring, Elizabeth; Kasenic, Suzanne; DeBolt, Susan P.; Sealy, Martine; Jager-Wittenaar, Harriët

2015-01-01

Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening,

Patient-generated subjective global assessment : Innovation from paper to digital app

NARCIS (Netherlands)

Faith D. Ottery; Suzanne Kasenic; Martine J. Sealy; Susan P. DeBolt; Elizabeth Isenring; Dr. Harriët Jager-Wittenaar

2015-01-01

Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening,

Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline Number 3.

Science.gov (United States)

Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

This package includes a clinical practice guideline, quick reference guide for clinicians, and patient's guide to predicting and preventing pressure ulcers in adults. The clinical practice guideline includes the following: overview of the incidence and prevalence of pressure ulcers; clinical practice guideline (introduction, risk assessment tools…

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

Science.gov (United States)

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

2018-03-12

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

An Assessment of Global Oral Health Education in U.S. Dental Schools.

Science.gov (United States)

Sung, Janet; Gluch, Joan I

2017-02-01

Dental schools need to produce graduates who are adequately prepared to respond to the complex needs and challenges of the increasingly diverse and interconnected world in which they will practice dentistry. To enhance discussions about the coverage of global oral health competencies in dental education, the aims of this study were to assess how global health education is currently incorporated into predoctoral dental training in the U.S. and which global oral health competencies are being covered. Surveys were emailed to all 64 accredited U.S. dental schools during the 2015-16 academic year. Respondents from 52 schools completed the survey (response rate 81%). The results showed that social determinants of oral diseases and conditions, how to identify barriers to use of oral health services, and how to work with patients who have limited dental health literacy were covered in the greatest number of responding schools' curricula. Key areas of global health curricula that were covered rarely included global dental infrastructure, data collection design, and horizontal and vertical programming approaches to health improvement. Despite current dialogue on the addition of global oral health competencies to dental curricula, only 41% of the responding schools were currently planning to expand their global oral health education. Based on these results, the authors conclude that it may be most feasible for dental schools to add recommended global oral health competencies to their curricula by incorporating didactic content into already established courses.

Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

Directory of Open Access Journals (Sweden)

Mary Wickenden

2012-10-01

Objectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document. Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries. Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team. Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes have prompted organisations to adapt their own policies and programmes in order to be more responsive to the local needs and concerns of PWDs.

The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

Science.gov (United States)

Ruane, Alex; Rosenzweig, Cynthia; Elliott, Joshua; Antle, John

2015-01-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIPs community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPsSSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate changes impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIPs 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

Science.gov (United States)

Ruane, A. C.; Rosenzweig, C.; Antle, J. M.; Elliott, J. W.

2015-12-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIP's community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPs/SSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate change's impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIP's 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

Assessments of global drivers of vaccine hesitancy in 2014-Looking beyond safety concerns.

Directory of Open Access Journals (Sweden)

Melanie Marti

Full Text Available Vaccine hesitancy has become the focus of growing attention and concern globally despite overwhelming evidence of the value of vaccines in preventing disease and saving the lives of millions of individuals every year. Measuring vaccine hesitancy and its determinants worldwide is important in order to understand the scope of the problem and for the development of evidence-based targeted strategies to reduce hesitancy. Two indicators to assess vaccine hesitancy were developed to capture its nature and scope at the national and subnational level to collect data in 2014: 1 The top 3 reasons for not accepting vaccines according to the national schedule in the past year and whether the response was opinion- or assessment-based and 2 Whether an assessment (or measurement of the level of confidence in vaccination had taken place at national or subnational level in the previous 5 years. The most frequently cited reasons for vaccine hesitancy globally related to (1 the risk-benefit of vaccines, (2 knowledge and awareness issues, (3 religious, cultural, gender or socio-economic factors. Major issues were fear of side effects, distrust in vaccination and lack of information on immunization or immunization services. The analysis revealed that 29% of all countries had done an assessment of the level of confidence in their country, suggesting that vaccine confidence was an issue of importance. Monitoring vaccine hesitancy is critical because of its influence on the success of immunization programs. To our knowledge, the proposed indicators provide the first global snapshot of reasons driving vaccine hesitancy and depicting its widespread nature, as well as the extent of assessments conducted by countries.

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

Science.gov (United States)

AlMarshedi, Alaa; Wills, Gary; Ranchhod, Ashok

2017-05-12

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

Social Media Guidelines and the News Paradigm

DEFF Research Database (Denmark)

Blumell, Lindsey; Hellmueller, Lea; Etter, Michael

Social network use continues to increase in the majority of regions around the world, with a global increase of 17.6% in 2012, and another projected 12.6% in 2014 (digital.org, 2014). Social media have also been incorporated into daily routines of American journalists, with 53.8% reporting...... that they use microblogs like Twitter on a regular basis to both gather and disseminate information (Willnat & Weaver, 2014). The aim of this study is to investigate how social media, more specifically, social media guidelines, implemented at the organizational level intercede with journalism practices...... and if these guidelines challenge the news paradigm. While using social media have been a “loop-hole” of sorts to disseminating political information in countries that have strong censorship (the Arab Spring being a premiere example, Eltantawy & Wiest, 2011; Lotan, Graeff, Ananny, Gaffney, & Pearce, 2011), journalists...

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

NARCIS (Netherlands)

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

2009-01-01

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

Improved guidelines for RELAP4/MOD6 reflood calculations

International Nuclear Information System (INIS)

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

1980-01-01

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

Assessment of the Policy Guidelines for the Teaching and Learning of Geography at the Senior High School Level in Ghana

Science.gov (United States)

Ababio, Bethel T.; Dumba, Hillary

2014-01-01

This article empirically assessed the extent to which geography teachers adhered to the Ghana Education Service policy guidelines on the teaching of geography at the Senior High School Level in Ghana. Census survey was used to collect data from seven geography teachers because of the researchers' objective of gaining a quick insight into the…

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

Directory of Open Access Journals (Sweden)

Rabia Kahveci

2018-03-01

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

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

Science.gov (United States)

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

2012-07-04

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

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

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

2018-02-01

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

Awareness and enforcement of guidelines for publishing industry-sponsored medical research among publication professionals: the Global Publication Survey.

Science.gov (United States)

Wager, Elizabeth; Woolley, Karen; Adshead, Viv; Cairns, Angela; Fullam, Josh; Gonzalez, John; Grant, Tom; Tortell, Stephanie

2014-04-19

To gather information about current practices and implementation of publication guidelines among publication professionals working in or for the pharmaceutical industry. Web-based survey publicised via email and social media to members of the International Society for Medical Publication Professionals (ISMPP) and other organisations from November 2012 to February 2013. 469 individuals involved in publishing industry-sponsored research in peer-reviewed journals, mainly working in pharmaceutical or device companies ('industry', n=144), communication agencies ('agency', n=238), contract research organisations (CRO, n=15) or as freelancers (n=34). Most respondents (78%) had worked on medical publications for ≥5 years and 62% had a PhD/MD. Over 90% of industry, agency and CRO respondents routinely refer to Good Publication Practice (GPP2) and the International Committee of Medical Journal Editors' Uniform Requirements. Most respondents (78% industry, 79% agency) received mandatory training on ethical publication practices. Over 90% of respondents' companies had publication guidelines or policies and required medical writing support to be acknowledged in publications (96% industry, 99% agency). Many industry respondents used publication management tools to monitor compliance with company guidelines and about half (46%) stated that their company had formal publication audits. Fewer agencies audited adherence to guidelines but 20% of agency respondents reported audits of employees and 6% audits of freelancers. Of concern, 37% of agency respondents reported requests from authors or sponsors that they believed were unethical, although 93% of these requests were withdrawn after respondents explained the need for compliance with guidelines. Most respondents' departments (63% industry, 58% agency, 60% CRO) had been involved in publishing studies with negative or inconclusive results. Within this sample, most publication professionals working in or for industry were aware of

Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians

Directory of Open Access Journals (Sweden)

Shillinglaw Benjamin

2012-01-01

Full Text Available Abstract Background Global coronary heart disease (CHD risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US physicians' awareness, use, and attitudes regarding global CHD risk assessment in clinical practice, and how these vary by provider specialty. Methods Using a web-based survey of US family physicians, general internists, and cardiologists, we examined awareness of tools available to calculate CHD risk, method and use of CHD risk assessment, attitudes towards CHD risk assessment, and frequency of using CHD risk assessment to guide recommendations of aspirin, lipid-lowering and blood pressure (BP lowering therapies for primary prevention. Characteristics of physicians indicating they use CHD risk assessments were compared in unadjusted and adjusted analyses. Results A total of 952 physicians completed the questionnaire, with 92% reporting awareness of tools available to calculate CHD global risk. Among those aware of such tools, over 80% agreed that CHD risk calculation is useful, improves patient care, and leads to better decisions about recommending preventive therapies. However, only 41% use CHD risk assessment in practice. The most commonly reported barrier to CHD risk assessment is that it is too time consuming. Among respondents who calculate global CHD risk, 69% indicated they use it to guide lipid lowering therapy recommendations; 54% use it to guide aspirin therapy recommendations; and 48% use it to guide BP lowering therapy. Only 40% of respondents who use global CHD risk routinely tell patients their risk. Use of a personal digital assistant or smart phone was associated with reported use of CHD risk assessment (adjusted OR 1.58; 95% CI 1.17-2.12. Conclusions Reported awareness of tools to calculate global CHD risk appears high, but the majority of physicians in this sample do not

Assessing the vertical structure of baroclinic tidal currents in a global model

Science.gov (United States)

Timko, Patrick; Arbic, Brian; Scott, Robert

2010-05-01

Tidal forcing plays an important role in many aspects of oceanography. Mixing, transport of particulates and internal wave generation are just three examples of local phenomena that may depend on the strength of local tidal currents. Advances in satellite altimetry have made an assessment of the global barotropic tide possible. However, the vertical structure of the tide may only be observed by deployment of instruments throughout the water column. Typically these observations are conducted at pre-determined depths based upon the interest of the observer. The high cost of such observations often limits both the number and the length of the observations resulting in a limit to our knowledge of the vertical structure of tidal currents. One way to expand our insight into the baroclinic structure of the ocean is through the use of numerical models. We compare the vertical structure of the global baroclinic tidal velocities in 1/12 degree HYCOM (HYbrid Coordinate Ocean Model) to a global database of current meter records. The model output is a subset of a 5 year global simulation that resolves the eddying general circulation, barotropic tides and baroclinic tides using 32 vertical layers. The density structure within the simulation is both vertically and horizontally non-uniform. In addition to buoyancy forcing the model is forced by astronomical tides and winds. We estimate the dominant semi-diurnal (M2), and diurnal (K1) tidal constituents of the model data using classical harmonic analysis. In regions where current meter record coverage is adequate, the model skill in replicating the vertical structure of the dominant diurnal and semi-diurnal tidal currents is assessed based upon the strength, orientation and phase of the tidal ellipses. We also present a global estimate of the baroclinic tidal energy at fixed depths estimated from the model output.

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

Science.gov (United States)

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

2015-10-01

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

Assessing the readiness of a school system to adopt food allergy management guidelines.

Science.gov (United States)

Eldredge, Christina; Patterson, Leslie; White, Brenda; Schellhase, Kenneth

2014-08-01

The prevalence of potentially fatal food allergies in school-aged children is rising. It is important for schools to have a food allergy management policy and an emergency action plan for each affected student. To examine the current status of food allergy guideline and/or policy implementation and adoption in a large school system in southeastern Wisconsin. A 24-item anonymous electronic survey was developed and completed by school principals and administrators in the Archdiocese of Milwaukee School System (approximately 125 schools) in southeastern Wisconsin. One in 4 responding schools reported no guidelines or policy. Schools that reported having students with special needs due to food allergy were more likely to have a local food allergy policy compared to schools that did not report having students with food allergy special needs (OR 6.3, 1.5-26, P = 0.01). Schools with food allergy guidelines/policies were 3.5 times more likely to require student individual action plans than schools with no guidelines or policies (OR 3.5, 1.00-12.2, P = 0.05). Gaps in evidence-based food allergy policy implementation were found in this school system. Schools with food-allergic children with special needs were more likely to have guidelines/policy, however, they were not more likely to require emergency action plans. The majority of schools (66, 90%) reported interest in receiving further information or training on food allergy management.

Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality

Directory of Open Access Journals (Sweden)

Joslyn S. Kirby

2015-01-01

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

Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

International Nuclear Information System (INIS)

Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

2013-01-01

Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences. (letter)

Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment