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Sample records for hand assessment procedure

  1. Comparison of hand hygiene procedures for removing Bacillus cereus spores.

    Science.gov (United States)

    Sasahara, Teppei; Hayashi, Shunji; Hosoda, Kouichi; Morisawa, Yuji; Hirai, Yoshikazu

    2014-01-01

    Bacillus cereus is a spore-forming bacterium. B. cereus occasionally causes nosocomial infections, in which hand contamination with the spores plays an important role. Therefore, hand hygiene is the most important practice for controlling nosocomial B. cereus infections. This study aimed to determine the appropriate hand hygiene procedure for removing B. cereus spores. Thirty volunteers' hands were experimentally contaminated with B. cereus spores, after which they performed 6 different hand hygiene procedures. We compared the efficacy of the procedures in removing the spores from hands. The alcohol-based hand-rubbing procedures scarcely removed them. The soap washing procedures reduced the number of spores by more than 2 log10. Extending the washing time increased the spore-removing efficacy of the washing procedures. There was no significant difference in efficacy between the use of plain soap and antiseptic soap. Handwashing with soap is appropriate for removing B. cereus spores from hands. Alcohol-based hand-rubbing is not effective.

  2. Hand washing frequencies and procedures used in retail food services.

    Science.gov (United States)

    Strohbehn, Catherine; Sneed, Jeannie; Paez, Paola; Meyer, Janell

    2008-08-01

    Transmission of viruses, bacteria, and parasites to food by way of improperly washed hands is a major contributing factor in the spread of foodborne illnesses. Field observers have assessed compliance with hand washing regulations, yet few studies have included consideration of frequency and methods used by sectors of the food service industry or have included benchmarks for hand washing. Five 3-h observation periods of employee (n = 80) hand washing behaviors during menu production, service, and cleaning were conducted in 16 food service operations for a total of 240 h of direct observation. Four operations from each of four sectors of the retail food service industry participated in the study: assisted living for the elderly, childcare, restaurants, and schools. A validated observation form, based on 2005 Food Code guidelines, was used by two trained researchers. Researchers noted when hands should have been washed, when hands were washed, and how hands were washed. Overall compliance with Food Code recommendations for frequency during production, service, and cleaning phases ranged from 5% in restaurants to 33% in assisted living facilities. Procedural compliance rates also were low. Proposed benchmarks for the number of times hand washing should occur by each employee for each sector of food service during each phase of operation are seven times per hour for assisted living, nine times per hour for childcare, 29 times per hour for restaurants, and 11 times per hour for schools. These benchmarks are high, especially for restaurant employees. Implementation would mean lost productivity and potential for dermatitis; thus, active managerial control over work assignments is needed. These benchmarks can be used for training and to guide employee hand washing behaviors.

  3. Hand-held electronic data collection and procedure environment

    International Nuclear Information System (INIS)

    Kennedy, E.; Doniz, K.

    1996-01-01

    As part of a CANDU Owners Group project, AECL has developed a hand-held electronic data collection and procedure environment. Integral to this environment is the C omputerized Procedure Engine . The development of the CPE allows operators, maintainers, and technical support staff to execute virtually any type of station procedure on a general-purpose PC-compatible hand-held computer. There are several advantages to using the computerized procedures: less paper use and handling, reduction in human error, reduction in rework in the field, an increase in procedural compliance, and immediate availability of data to download to databases and plant information systems. The paper describes: the advantages of using computerized procedures, why early forms of computerized procedures were inadequate, the features that the C omputerized Procedure Engine o ffers to the user, the streamlined life cycle of a computerized procedure, and field experience. The paper concludes that computerized procedures are ready for pilot applications at stations. (author)

  4. Essential hand surgery procedures for mastery by graduating plastic surgery residents: a survey of program directors.

    Science.gov (United States)

    Noland, Shelley S; Fischer, Lauren H; Lee, Gordon K; Friedrich, Jeffrey B; Hentz, Vincent R

    2013-12-01

    This study was designed to establish the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. This framework can then be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach technical skills in hand surgery. Ten expert hand surgeons were surveyed regarding the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. The top 10 procedures from this survey were then used to survey all 89 Accreditation Council for Graduate Medical Education-approved plastic surgery program directors. There was a 69 percent response rate to the program director survey (n = 61). The top nine hand surgery procedures included open carpal tunnel release, open A1 pulley release, digital nerve repair with microscope, closed reduction and percutaneous pinning of metacarpal fracture, excision of dorsal or volar ganglion, zone II flexor tendon repair with multistrand technique, incision and drainage of the flexor tendon sheath for flexor tenosynovitis, flexor tendon sheath steroid injection, and open cubital tunnel release. Surgical educators need to develop objective methods to teach and document technical skill. The Objective Structured Assessment of Technical Skill is a valid method for accomplishing this task. There has been no consensus regarding which hand surgery procedures should be mastered by graduating plastic surgery residents. The authors have identified nine procedures that are overwhelmingly supported by plastic surgery program directors. These nine procedures can be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach and document technical skills in hand surgery.

  5. The Visible Hand of Research Performance Assessment

    Science.gov (United States)

    Hamann, Julian

    2016-01-01

    Far from allowing a governance of universities by the invisible hand of market forces, research performance assessments do not just measure differences in research quality, but yield themselves visible symptoms in terms of a stratification and standardization of disciplines. The article illustrates this with a case study of UK history departments…

  6. Waste minimization assessment procedure

    International Nuclear Information System (INIS)

    Kellythorne, L.L.

    1993-01-01

    Perry Nuclear Power Plant began developing a waste minimization plan early in 1991. In March of 1991 the plan was documented following a similar format to that described in the EPA Waste Minimization Opportunity Assessment Manual. Initial implementation involved obtaining management's commitment to support a waste minimization effort. The primary assessment goal was to identify all hazardous waste streams and to evaluate those streams for minimization opportunities. As implementation of the plan proceeded, non-hazardous waste streams routinely generated in large volumes were also evaluated for minimization opportunities. The next step included collection of process and facility data which would be useful in helping the facility accomplish its assessment goals. This paper describes the resources that were used and which were most valuable in identifying both the hazardous and non-hazardous waste streams that existed on site. For each material identified as a waste stream, additional information regarding the materials use, manufacturer, EPA hazardous waste number and DOT hazard class was also gathered. Once waste streams were evaluated for potential source reduction, recycling, re-use, re-sale, or burning for heat recovery, with disposal as the last viable alternative

  7. Evaluation of Hands-Free Devices for the Display of Maintenance Procedures

    Science.gov (United States)

    Whitmore, Mihriban; Hoffman, Ronald B.; Litaker, Harry, Jr.; Solem, Jody; Holden, Kritina; Twyford, Evan; Conlee, Carl

    2007-01-01

    Over the past year, NASA's focus has turned to crewed long duration and exploration missions. On these journeys, crewmembers will be required to execute thousands of procedures to maintain life support systems, check out space suits, conduct science experiments, and perform medical exams. To support the many complex tasks crewmembers undertake in microgravity, NASA is interested in providing crewmembers a hands-free work environment to promote more efficient operations. The overarching objective is to allow crewmembers to use both of their hands for tasks related to their mission, versus holding a paper manual or interacting with a display. The use of advanced, hands-free tools will undoubtedly make the crewmembers task easier, but they can also add to overall task complexity if not properly designed. A leading candidate technology for supporting a hands-free environment is the Head-Mounted Display (HMD). A more recent technology (e-book reader) that could be easily temp-stowed near the work area is also a potential hands-free solution. Previous work at NASA involved the evaluation of several commercially available HMDs for visual quality, comfort, and fit, as well as suitability for use in microgravity. Based on results from this work, three HMDs were selected for further evaluation (along with an e-book reader), using International Space Station (ISS)-like maintenance procedures. Two evaluations were conducted in the Space Station Mockup and Trainer Facility (SSMTF) located at the NASA Johnson Space Center (building 9). The SSMTF is a full scale, medium fidelity replica of the pressurized portions of the ISS. It supports crew training such as ingress and egress, habitability, and emergency procedures. In each of the two evaluations, the participants performed two maintenance procedures. One maintenance procedure involved inspecting air filters in a life support system and replacing them with a clean filter if one were found to be contaminated. The second

  8. Environmental Impact Assessment: A Procedure.

    Science.gov (United States)

    Stover, Lloyd V.

    Prepared by a firm of consulting engineers, this booklet outlines the procedural "whys and hows" of assessing environmental impact, particularly for the construction industry. Section I explores the need for environmental assessment and evaluation to determine environmental impact. It utilizes a review of the National Environmental Policy Act and…

  9. Hand washing in operating room: a procedural comparison

    Directory of Open Access Journals (Sweden)

    Alessia Stilo

    2016-09-01

    Full Text Available BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO, and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction, washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction. CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infections

  10. Construction of a anthropomorphic phantom for dose measurement in hands in brachytherapy procedures

    International Nuclear Information System (INIS)

    Papp, Cinthia M.

    2013-01-01

    The main objective of this work was to show the differences between the dose value measured by dosimeter endpoint and the values measured in different points inside the hand during brachytherapy procedures. For this, the procedures involved in the handling of sources were analyzed and the simulated using an anthropomorphic phantom hand

  11. Recommendations to reduce hand exposure for standard nuclear medicine procedures

    International Nuclear Information System (INIS)

    Sans-Merce, M.; Ruiz, N.; Barth, I.; Carnicer, A.; Donadille, L.; Ferrari, P.; Fulop, M.; Ginjaume, M.; Gualdrini, G.; Krim, S.; Mariotti, F.; Ortega, X.; Rimpler, A.; Vanhavere, F.; Baechler, S.

    2011-01-01

    The optimization of the extremity dosimetry of medical staff in nuclear medicine was the aim of the Work Package 4 (WP4) of the ORAMED project, a Collaborative Project (2008–2011) supported by the European Commission within its 7th Framework Programme. Hand doses and dose distributions across the hands of medical staff working in nuclear medicine departments were evaluated through an extensive measurement program involving 32 hospitals in Europe and 139 monitored workers. The study included the most frequently used radionuclides, 99m Tc- and 18 F-labelled radiopharmaceuticals for diagnostic and 90 Y-labelled Zevalin ® and DOTATOC for therapy. Furthermore, Monte Carlo simulations were performed in different predefined scenarios to evaluate separately the efficacy of different radiation protection measures by comparing hand dose distributions according to various parameters. The present work gives recommendations based on results obtained with both measurements and simulations. This results in nine practical recommendations regarding the positioning of the dosemeters for an appropriate skin dose monitoring and the best protection means to reduce the personnel exposure.

  12. The psychological assessment of candidates for reconstructive hand transplantation.

    Science.gov (United States)

    Kumnig, Martin; Jowsey, Sheila G; Rumpold, Gerhard; Weissenbacher, Annemarie; Hautz, Theresa; Engelhardt, Timm O; Brandacher, Gerald; Gabl, Markus; Ninkovic, Marina; Rieger, Michael; Zelger, Bernhard; Zelger, Bettina; Blauth, Michael; Margreiter, Raimund; Pierer, Gerhard; Pratschke, Johann; Schneeberger, Stefan

    2012-05-01

    Standardized psychological assessment of candidates for reconstructive hand transplantation (RHT) is a new approach in transplantation medicine. Currently, international guidelines and standardized criteria for the evaluation are not established. Patients suffering from the loss of a hand or an upper extremity have to cope with multiple challenges. For a selected group of patients, RHT represents an option for restoring natural function and for regaining daily living independence. The identification of at-risk patients and those requiring ongoing counseling due to poor coping or limited psychological resources are the primary focus of the psychological assessment. We have developed the 'Innsbruck Psychological Screening Program for Reconstructive Transplantation (iRT-PSP)' which utilizes a semi-structured interview and standardized psychological screening procedures and continuous follow-up ratings. Between January 2011 and October 2011, four candidates were evaluated using the iRT-PSP. Psychological impairments including social withdrawal, embarrassment, reduced self-esteem, and a depressive coping style were identified and poor quality of life was reported. The motivation for transplantation was diverse, depending on many factors such as bi- or unilateral impairment, native or accidental loss of hand, and social integration. © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.

  13. A combined hands-on teaching programme and clinical pathway focused on pleural ultrasound and procedure supervision transforms pleural procedure outcomes.

    Science.gov (United States)

    Edwards, Timothy; Cook, Alistair; Salamonsen, Matthew; Bashirzadeh, Farzad; Fielding, David

    2017-11-01

    Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines, focusing on pleural ultrasound and a hands-on teaching programme followed by procedure supervision that enabled many operators to perform such procedures. This is a retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013). A total of 171 procedures involving 129 patients (pre-pathway group) and 146 procedures involving 115 patients (post-pathway group) was analysed. The rate of complications prior to the pleural pathway was 22.2% (38 of 171 procedures). Following the pathway, the rate of complications declined to 7.5% (11 of 146 procedures, P < 0.003). The use of pleural ultrasound increased dramatically (72.5 vs 90.2%). The number of patients who underwent repeated procedures (defined as ≥3) reduced dramatically (21 vs 7, P < 0.01). This improvement occurred using many supervised operators who completed the hands-on teaching programme (n = 32) and followed the pleural pathway (127 of 146 procedures). The instigation of a clinical pathway focused on the use of bedside pleural ultrasound, and teaching of drainage techniques with procedure supervision vastly improved patient outcomes. This not only allowed better quality of care for patients, it also provided the acquisition of new skills to medical staff, not limiting these skills to specialised staff. © 2017 Royal Australasian College of Physicians.

  14. Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

  15. The human touch: skin temperature during the rubber hand illusion in manual and automated stroking procedures.

    Directory of Open Access Journals (Sweden)

    Marieke Rohde

    Full Text Available A difference in skin temperature between the hands has been identified as a physiological correlate of the rubber hand illusion (RHI. The RHI is an illusion of body ownership, where participants perceive body ownership over a rubber hand if they see it being stroked in synchrony with their own occluded hand. The current study set out to replicate this result, i.e., psychologically induced cooling of the stimulated hand using an automated stroking paradigm, where stimulation was delivered by a robot arm (PHANToM(TM force-feedback device. After we found no evidence for hand cooling in two experiments using this automated procedure, we reverted to a manual stroking paradigm, which is closer to the one employed in the study that first produced this effect. With this procedure, we observed a relative cooling of the stimulated hand in both the experimental and the control condition. The subjective experience of ownership, as rated by the participants, by contrast, was strictly linked to synchronous stroking in all three experiments. This implies that hand-cooling is not a strict correlate of the subjective feeling of hand ownership in the RHI. Factors associated with the differences between the two designs (differences in pressure of tactile stimulation, presence of another person that were thus far considered irrelevant to the RHI appear to play a role in bringing about this temperature effect.

  16. Monte Carlo evaluation of hand and finger doses due to exposure to 18F in PET procedures

    International Nuclear Information System (INIS)

    Pessanha, Paula R.; Queiroz Filho, Pedro P.; Santos, Denison S.; Mauricio, Claudia L.P.

    2011-01-01

    The increasing number of PET procedures performed in nuclear medicine, and, consequently, of workers handling radiopharmaceuticals, is a potential hazard in radiation protection. It is then necessary to evaluate the doses of workers employed in the practice of PET. In this work, the Geant4 Monte Carlo code was used to evaluate doses to fingers and hands of those workers. A geometric phantom, representing the hand of the professional inserted in the clinical procedure, was implemented in the simulation code, with dimensions of a standard man's forearm, which in this case will assess the exposure of the extremities. The geometric phantom is designed so that a simple definition of joint angles configures the fingers, allowing investigations into alternative configurations. Thus, it was possible the placement of the phantom fingers, to simulate all forms of manipulation of a syringe, and subsequently obtain exposure data, relating to the administration procedure of the PET radiopharmaceutical to the patient. The simulation was validated by the irradiation of a REMAB R hand phantom, consisting of a human skeleton hand covered by a tenite II shell, which can be filled with water. Air Kerma values were obtained from the beam dosimetry, which was done with a calibrated ionization chamber. The reading of TLD's, placed on certain points of the surface of the phantom, were compared with the values obtained in the Monte Carlo simulation. After validation of the program, we obtained dose values for the PET procedure, simulating syringes with and without shielding. (author)

  17. Hygienic status assessment of dish washing waters, utensils, hands ...

    African Journals Online (AJOL)

    Hygienic status assessment of dish washing waters, utensils, hands and pieces of money from street food processing sites in Ouagadougou (Burkina Faso). N Barro, AR Bello, A Savadogo, CAT Ouattara, AJ Iiboudo, AS Traoré ...

  18. Plans for Hand-Held/Portable Oil Assessment Devices

    National Research Council Canada - National Science Library

    Urbansky, Edward

    2005-01-01

    At the request of the U.S. Army Oil Analysis Program, the JOAP TSC conducted a market study, assembled a plan of action, and prepared a worksheet for the evaluation of portable or hand-held oil assessment devices...

  19. METHOD OF PHYSIOTHERAPY MEDICAL PROCEDURES FOR THERMAL IMPACT ON SELECTED AREAS WITH HUMAN HANDS THERMOELECTRIC DEVICES

    Directory of Open Access Journals (Sweden)

    A. B. Sulin

    2015-01-01

    Full Text Available The device for thermal impact on separate zones of a hand of the person executed on the basis of thermoelectric converters of energy is considered. The advantages consisting in high environmental friendliness, noiselessness, reliability, functionality, universality are noted it. The technique of carrying out medical (preventive physiotherapeutic procedures, the hands of the person consisting in contrast thermal impact on a site with various level of heating and cooling, and also lasting expositions is described.

  20. Putting Assessment Back in the Hands of Teachers

    Science.gov (United States)

    McCrann, John R. Troutman

    2018-01-01

    John R. Troutman McCrann, a math educator and teacher leader at Harvest Collegiate High School in New York City, writes that teachers' autonomy to design and assess student learning has been siphoned away. In this article, he makes an argument for why assessment should be left in the hands of those who know students and standards…

  1. Ultrasound-guided procedures around the wrist and hand: How to do

    International Nuclear Information System (INIS)

    Orlandi, Davide; Corazza, Angelo; Silvestri, Enzo; Serafini, Giovanni; Savarino, Edoardo Vincenzo; Garlaschi, Giacomo; Mauri, Giovanni; Cimmino, Marco Amedeo; Sconfienza, Luca Maria

    2014-01-01

    Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand

  2. Ultrasound-guided procedures around the wrist and hand: How to do

    Energy Technology Data Exchange (ETDEWEB)

    Orlandi, Davide; Corazza, Angelo [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Silvestri, Enzo [Diagnostica per Immagini, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16100 Genova (Italy); Serafini, Giovanni [Dipartimento di Diagnostica per Immagini, Ospedale Santa Corona, Via XXV Aprile 38, 17037 Pietra Ligure, Savona (Italy); Savarino, Edoardo Vincenzo [Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Via Giustiniani, Padova (Italy); Garlaschi, Giacomo [Dipartimento di Scienze per la Salute, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Mauri, Giovanni [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Cimmino, Marco Amedeo [Dipartimento di Medicina Interna, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, San Donato Milanese, Milano (Italy)

    2014-07-15

    Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand.

  3. Photographic Documentation and Hand Eczema Severity Index for Severity Assessment of Hand Eczema

    DEFF Research Database (Denmark)

    Zabludovska, Kristine; Ibler, Kristina S; Jemec, Gregor B E

    2017-01-01

    .003), respectively, and major worsening, r = 0.41 (P = 0.021). With respect to minor changes, no statistically significant correlations were found (P > 0.05). CONCLUSIONS: In patients with mild HE, photographic assessment was found useful for major and moderate changes only. Further studies would need......BACKGROUND: Hand eczema (HE) is a fluctuating disease, and an objective assessment of HE severity is coveted. OBJECTIVES: This study was undertaken to test the association between Hand Eczema Severity Index (HECSI) score and panel scores of photographs taken by dermatologists. METHODS: A total...... were engaged in blinded evaluation of photographs. RESULTS: The highest correlation coefficients between delta HECSI scores and delta panel scores of photographs in the first and second evaluation rounds were found for moderate improvement and moderate worsening, rs = -0.46 (P = 0.009) and 0.52 (P = 0...

  4. A quantitative assessment method for Ascaris eggs on hands

    DEFF Research Database (Denmark)

    Jeandron, Aurelie; Ensink, Jeroen H. J.; Thamsborg, Stig Milan

    2014-01-01

    The importance of hands in the transmission of soil transmitted helminths, especially Ascaris and Trichuris infections, is under-researched. This is partly because of the absence of a reliable method to quantify the number of eggs on hands. Therefore, the aim of this study was to develop a method...... to assess the number of Ascaris eggs on hands and determine the egg recovery rate of the method. Under laboratory conditions, hands were seeded with a known number of Ascaris eggs, air dried and washed in a plastic bag retaining the washing water, in order to determine recovery rates of eggs for four...... different detergents (cationic [benzethonium chloride 0.1% and cetylpyridinium chloride CPC 0.1%], anionic [7X 1% - quadrafos, glycol ether, and dioctyl sulfoccinate sodium salt] and non-ionic [Tween80 0.1% -polyethylene glycol sorbitan monooleate]) and two egg detection methods (McMaster technique...

  5. Assessment of hand blood flow: a modified technique

    International Nuclear Information System (INIS)

    Kirsh, J.C.; Tepperman, P.S.

    1985-01-01

    A blood flow artifact has been identified with the conventional bolus-injection technique in radionuclide studies of hand disorders. The artifact, consisting of increased blood flow on the injected side, was demonstrated in 22 of 25 subjects. Using a modified injection technique to allow time for local blood flow to return to the basal state, the artifact could be eliminated in 19 of 23 additional subjects. Use of this simple protocol should help avoid misinterpretation of blood flow asymmetry in the assessment of hand disorders

  6. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

    Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

    2001-01-01

    This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

  7. SPECAL ISSUE Assessing the Assessment Procedures and ...

    African Journals Online (AJOL)

    Community Based Education/CBE Courses at Jimma. University .... Develop policies and strategies for the CBE courses with high levels of ... practices to enhance successful performance and sustainability of the philosophy in ... Thus, descriptive method was used in this study to assess and describe the existing condition of ...

  8. Digital tomosynthesis of hand joints for arthritis assessment

    International Nuclear Information System (INIS)

    Duryea, J.; Dobbins, J.T. III; Lynch, J.A.

    2003-01-01

    The two principal forms of hand arthritis, rheumatoid arthritis (RA) and osteoarthritis (OA) have large clinical and economic costs. Radiography has been shown to be a useful tool to assess the condition of the disease. A hand radiograph, however, is a two-dimensional projection of a three-dimensional object. In this report we present the results of a study that applied digital tomosynthesis to hand radiography in order to extract three-dimensional outcome measures that should be more sensitive to arthritis progression. The study was performed using simulated projection radiographs created using micro computed tomography (μCT) and a set of five dry-bone hand skeletons. These simulated projection images were then reconstructed into tomographic slices using the matrix inversion tomosynthesis (MITS) algorithm. The accuracy of the tomosynthesis reconstruction was evaluated by comparing the reconstructed images to a gold standard created using the μCT data. A parameter from image registration science, normalized mutual information, provided a quantifiable figure of merit. This study examined the effects of source displacement, number of reconstructed planes, number of acquisitions, noise added to the gray scale images, and errors in the location of a fiducial marker. We also optimized the reconstruction as a function of two variables k and α, that controlled the mixing of MITS with conventional shift-and-add tomosynthesis. A study using hand delineated joint margins demonstrated that MITS images provided a better measurement of average joint space width. We found good agreement between the MITS slices and the true planes. Both joint margins and trabecular structure were visible and the reconstructed slices showed additional structures not visible with the standard projection image. Using hand-delineated joint margins we compared the average joint space width of the gold standard slices to the MITS and projection images. A root-mean square deviation (RMSD), calculated

  9. Hand-assisted laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension.

    Science.gov (United States)

    Kobayashi, Takashi; Miura, Kohei; Ishikawa, Hirosuke; Soma, Daiki; Zhang, Zhengkun; Ando, Takuya; Yuza, Kizuki; Hirose, Yuki; Katada, Tomohiro; Takizawa, Kazuyasu; Nagahashi, Masayuki; Sakata, Jun; Kameyama, Hitoshi; Wakai, Toshifumi

    2017-10-23

    Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension. From 2009 to 2016, seven patients with esophagogastric varices with portal hypertension were treated with hand-assisted laparoscopic devascularization and splenectomy in our institute. Four men and three women with a median age of 61 years (range 35-71) were enrolled in this series. We retrospectively reviewed the medical records for the perioperative variables, postoperative mortality and morbidity, and postoperative outcomes of esophagogastric varices. The median operative time was 455 (range 310-671) min. The median intraoperative blood loss was 695 (range 15-2395) ml. The median weight of removed spleen was 507 (range 242-1835) g. The conversion rate to open surgery was 0%. The median postoperative hospital stay was 21 (range 13-81) days. During a median 21 (range 3-43) months of follow-up, the mortality rate was 0%. Four postoperative complications (massive ascites, enteritis, intra-abdominal abscess, and intestinal ulcer) were observed in two patients. Those complications were treated successfully without re-operation. Esophagogastric varices in all patients disappeared or improved. Bleeding from esophagogastric varices was not observed during the follow-up period. Although our data are preliminary, hand-assisted laparoscopic devascularization and splenectomy proved an effective procedure for treating esophagogastric varices in patients with portal hypertension.

  10. Assessment of Competence in EVAR Procedures

    DEFF Research Database (Denmark)

    Strøm, M; Lönn, L; Bech, B

    2017-01-01

    OBJECTIVE/BACKGROUND: To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR). METHODS: A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200...... suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable......, and superior performance on a 5 point Likert scale. CONCLUSION: The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE...

  11. Defect assessment procedures at high temperature

    International Nuclear Information System (INIS)

    Ainsworth, R.A.

    1991-01-01

    A comprehensive assessment procedure for the high-temperature response of structures is being produced. The procedure is referred to as R5 and is written as a series of step-by-step instructions in a number of volumes. This paper considers in detail those parts of R5 which address the behaviour of defects. The defect assessment procedures may be applied to defects found in service, postulated defects, or defects formed during operation as a result of creep-fatigue loading. In the last case, a method is described for deducing from endurance data the number of cycles to initiate a crack of a specified size. Under steady loading, the creep crack tip parameter C * is used to assess crack growth. Under cyclic loading, the creep crack growth during dwell periods is stiell governed by C * but crack growth due to cyclic excursions must also be included. This cyclic crack growth is described by an effective stress intensity factor range. A feature of the R5 defect assessment procedures in that they are based on simplified methods and approximate reference stress methods are described which enable C * in a component to be evaluated. It is shown by comparison with theoretical calculations and experimental data that reliable estimates of C * and the associated crack growth are obtained provided realistic creep strain rate date are used in the reference stress approximation. (orig./HP)

  12. Simulation of beta radiator handling procedures in nuclear medicine by means of a movable hand phantom.

    Science.gov (United States)

    Blunck, Ch; Becker, F; Urban, M

    2011-03-01

    In nuclear medicine therapies, people working with beta radiators such as (90)Y may be exposed to non-negligible partial body doses. For radiation protection, it is important to know the characteristics of the radiation field and possible dose exposures at relevant positions in the working area. Besides extensive measurements, simulations can provide these data. For this purpose, a movable hand phantom for Monte Carlo simulations was developed. Specific beta radiator handling scenarios can be modelled interactively with forward kinematics or automatically with an inverse kinematics procedure. As a first investigation, the dose distribution on a medical doctor's hand injecting a (90)Y solution was measured and simulated with the phantom. Modelling was done with the interactive method based on five consecutive frames from a video recorded during the injection. Owing to the use of only one camera, not each detail of the radiation scenario is visible in the video. In spite of systematic uncertainties, the measured and simulated dose values are in good agreement.

  13. Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae?

    Science.gov (United States)

    Lai, Eddie Hsiang-Hua; Liu, Jen-Pei; Chang, Jenny Zwei-Chieng; Tsai, Shih-Jaw; Yao, Chung-Chen Jane; Chen, Mu-Hsiung; Chen, Yi-Jane; Lin, Chun-Pin

    2008-04-01

    The skeletal maturation status of a growing patient can influence the selection of orthodontic treatment procedures. Either lateral cephalometric or hand-wrist radiography can be used to assess skeletal development. In this study, we examined the correlation between the maturation stages of cervical vertebrae and hand-wrist bones in Taiwanese individuals. The study group consisted of 330 male and 379 female subjects ranging in age from 8 to 18 years. A total of 709 hand-wrist and 709 lateral cephalometric radiographs were analyzed. Hand-wrist maturation stages were assessed using National Taiwan University Hospital Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages were determined by the latest Cervical Vertebral Maturation Stage (CVMS) Index. Spearman's rank correlation was used to correlate the respective maturation stages assessed from the hand-wrist bones and the cervical vertebrae. The values of Spearman's rank correlation were 0.910 for males and 0.937 for females, respectively. These data confirmed a strong and significant correlation between CVMS and NTUH-SMI systems (p less than 0.001). After comparison of the mean ages of subjects in different stages of CVMS and NTU-SMI systems, we found that CVMS I corresponded to NTUH-SMI stages 1 and 2, CVMS II to NTUH-SMI stage 3, CVMS III to NTUHSMI stage 4, CVMS IV to NTUH-SMI stage 5, CVMS V to NTUH-SMI stages 6, 7 and 8, and CVMS VI to NTUH-SMI stage 9. Our results indicate that cervical vertebral maturation stages can be used to replace hand-wrist bone maturation stages for evaluation of skeletal maturity in Taiwanese individuals.

  14. Unique Assessment of Hand Surgery Knowledge by Specialty.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Chang, Benjamin; Levin, L Scott

    2016-03-01

    Orthopedic and plastic surgery residents receive unique training yet often compete for similar hand surgery fellowships. This study compared didactic hand surgery training during orthopedic and plastic surgery residency. The Plastic Surgery In-Service Training Exam and Orthopaedic In-Training Examination were analyzed for hand content for the years 2009 to 2013. Topics were categorized with the content outline for the Surgery of the Hand Examination. Differences were elucidated by means of Fisher's exact test. Relative to the Orthopaedic In-Training Examination, the Plastic Surgery In-Service Training Exam had greater hand representation (20.3 percent versus 8.1 percent; p < 0.001) with more annual hand questions (40 ± 3 versus 24 ± 2; p < 0.001). The Plastic Surgery Exam questions had more words, were less often level I-recall type, and were less often image-based. The questions focused more on finger and hand/palm anatomy, whereas the Orthopaedic examination was more wrist-focused. The Plastic Surgery Exam emphasized wound management and muscle/tendon injuries, but underemphasized fractures/dislocations. References differed, but Journal of Hand Surgery (American Volume) and Green's Operative Hand Surgery were common on both examinations. The Plastic Surgery Exam had a greater publication lag for journal references (10.7 ± 0.5 years versus 9.0 ± 0.6; p = 0.035). Differences in didactic hand surgery training are elucidated for plastic surgery and orthopedic residents. Deficiencies in the Plastic Surgery In-Service Training Exam hand curriculum relative to the Orthopaedic In-Training Examination may underprepare plastic surgeons for the Surgery of the Hand Examination. These data may assist future modifications to hand surgery training in the United States.

  15. Hand assessment with the E-Cone in rheumatoid arthritis and hand osteoarthritis

    NARCIS (Netherlands)

    van Merendonk, N.; van Alebeek, V.; Spreeuwers, Lieuwe Jan; Spreeuwers, D.; Kroon, P.J.; Roorda, L.; Dekker, J.; Hoeksma, A.F.

    2013-01-01

    Background: Rheumatoid arthritis (RA) is a systemic inflammatory, progressive disease resulting in deformities of the hand. Besides synovitis, tenosynovitis of the extrinsic flexor tendons is one of the initial features of RA, leading to friction and consequently to an imbalanced coordination of the

  16. Contextualized personality: traditional and new assessment procedures.

    Science.gov (United States)

    Heller, Daniel; Watson, David; Komar, Jennifer; Min, Ji-A; Perunovic, Wei Qi Elaine

    2007-12-01

    We describe our ongoing program of research related to the assessment of contextualized personality, focusing on social roles and cultural cues as contextual factors. First, we present our research employing the traditional assessment approach, wherein participants are asked to rate explicitly their personality across several different roles. We argue that this hypothetical approach is potentially susceptible to the influence of stereotypes, social desirability, and demand characteristics. We therefore describe the development of three novel and subtle assessment procedures that are based on obtaining online self-representations that are activated while occupying a specific context. Finally, the strengths and limitations of all four approaches, as well as directions for future research in the study of contextualized personality, are discussed.

  17. A CAD system and quality assurance protocol for bone age assessment utilizing digital hand atlas

    Science.gov (United States)

    Gertych, Arakadiusz; Zhang, Aifeng; Ferrara, Benjamin; Liu, Brent J.

    2007-03-01

    Determination of bone age assessment (BAA) in pediatric radiology is a task based on detailed analysis of patient's left hand X-ray. The current standard utilized in clinical practice relies on a subjective comparison of the hand with patterns in the book atlas. The computerized approach to BAA (CBAA) utilizes automatic analysis of the regions of interest in the hand image. This procedure is followed by extraction of quantitative features sensitive to skeletal development that are further converted to a bone age value utilizing knowledge from the digital hand atlas (DHA). This also allows providing BAA results resembling current clinical approach. All developed methodologies have been combined into one CAD module with a graphical user interface (GUI). CBAA can also improve the statistical and analytical accuracy based on a clinical work-flow analysis. For this purpose a quality assurance protocol (QAP) has been developed. Implementation of the QAP helped to make the CAD more robust and find images that cannot meet conditions required by DHA standards. Moreover, the entire CAD-DHA system may gain further benefits if clinical acquisition protocol is modified. The goal of this study is to present the performance improvement of the overall CAD-DHA system with QAP and the comparison of the CAD results with chronological age of 1390 normal subjects from the DHA. The CAD workstation can process images from local image database or from a PACS server.

  18. [Hand hygiene technique assessment using electronic equipment in 26 Hungarian healthcare institutions].

    Science.gov (United States)

    Lehotsky, Ákos; Morvai, Júlia; Szilágyi, László; Bánsághi, Száva; Benkó, Alíz; Haidegger, Tamás

    2017-07-01

    Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants' hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143-1148.

  19. Advanced structural integrity assessment procedures. Working material

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of the meeting was to provide an international forum for discussion on recent results in research and utility practice in the field of methodology for the structural integrity assessment of components including relevant non-codified procedures. The scope of the meeting included deterministic and probabilistic approaches. The papers covered the following topics: Leak-before-break concepts; non-destructive examination (NDE) and surveillance results; statistical evaluation of non-destructive examination data; pressurized thermal shock evaluation; fatigue effects (including vibration); and verification qualification. The meeting was attended by 32 specialists from 8 countries. Refs, figs and tabs

  20. A unified framework for developing effective hygiene procedures for hands, environmental surfaces and laundry in healthcare, domestic, food handling and other settings

    Science.gov (United States)

    Bloomfield, Sally F.; Carling, Philip C.; Exner, Martin

    2017-01-01

    Hygiene procedures for hands, surfaces and fabrics are central to preventing spread of infection in settings including healthcare, food production, catering, agriculture, public settings, and home and everyday life. They are used in situations including hand hygiene, clinical procedures, decontamination of environmental surfaces, respiratory hygiene, food handling, laundry hygiene, toilet hygiene and so on. Although the principles are common to all, approaches currently used in different settings are inconsistent. A concern is the use of inconsistent terminology which is misleading, especially to people we need to communicate with such as the public or cleaning professionals. This paper reviews the data on current approaches, alongside new insights to developing hygiene procedures. Using this data, we propose a more scientifically-grounded framework for developing procedures that maximize protection against infection, based on consistent principles and terminology, and applicable across all settings. A key feature is use of test models which assess the state of surfaces after treatment rather than product performance alone. This allows procedures that rely on removal of microbes to be compared with those employing chemical or thermal inactivation. This makes it possible to ensure that a consistent “safety target level” is achieved regardless of the type of procedure used, and allows us deliver maximum health benefit whilst ensuring prudent usage of antimicrobial agents, detergents, water and energy. PMID:28670508

  1. High-temperature flaw assessment procedure

    International Nuclear Information System (INIS)

    Ruggles, M.B.; Takahashi, Y.; Ainsworth, R.A.

    1991-08-01

    Described is the background work performed jointly by the Electric Power Research Institute in the United States, the Central Research Institute of Electric Power Industry in Japan and Nuclear Electric plc in the United Kingdom with the purpose of developing a high-temperature flaw assessment procedure for reactor components. Existing creep-fatigue crack-growth models are reviewed, and the most promising methods are identified. Sources of material data are outlined, and results of the fundamental deformation and crack-growth tests are discussed. Results of subcritical crack-growth exploratory tests, creep-fatigue crack-growth tests under repeated thermal transient conditions, and exploratory failure tests are presented and contrasted with the analytical modeling. Crack-growth assessment methods are presented and applied to a typical liquid-metal reactor component. The research activities presented herein served as a foundation for the Flaw Assessment Guide for High-Temperature Reactor Components Subjected to Creep-Fatigue Loading published separately. 30 refs., 108 figs., 13 tabs

  2. Hand-Arm vibration assessment among tiller operator

    Directory of Open Access Journals (Sweden)

    P. Nassiri

    2013-08-01

    Result: Results of the present study indicated that in all measured situations, exposure to hand arm vibration was higher than the standard limit suggested by Iranian occupational health committee and there was risk of vibration-induced disorders. The maximum exposure to vibration is in plowing ground. Exposure to hand arm vibration in three modes of plowing, transmission and natural, were respectively 16.95, 14.16 and 8.65 meters per second squared. Additionally, in all situations, vibration exposure was highest in the X-axis in comparison with Z- and Y-axes. .Conclusion: This study emphasizes on the need to provide intervention and controlling and managing strategies in order to eliminate or reduce vibration transmitted from tiller to operators hand and arm and also prevent to serious problems including neurovascular disorders, discomfort and white finger syndrome. Meanwhile, more studies are necessary to identify the sources of vibration on different models of tiller.

  3. Design and preliminary assessment of Vanderbilt hand exoskeleton.

    Science.gov (United States)

    Gasser, Benjamin W; Bennett, Daniel A; Durrough, Christina M; Goldfarb, Michael

    2017-07-01

    This paper presents the design of a hand exoskeleton intended to enable or facilitate bimanual activities of daily living (ADLs) for individuals with chronic upper extremity hemiparesis resulting from stroke. The paper describes design of the battery-powered, self-contained exoskeleton and presents the results of initial testing with a single subject with hemiparesis from stroke. Specifically, an experiment was conducted requiring the subject to repeatedly remove the lid from a water bottle both with and without the hand exoskeleton. The relative times required to remove the lid from the bottles was considerably lower when using the exoskeleton. Specifically, the average amount of time required to grasp the bottle with the paretic hand without the exoskeleton was 25.9 s, with a standard deviation of 33.5 s, while the corresponding average amount of time required to grasp the bottle with the exoskeleton was 5.1 s, with a standard deviation of 1.9 s. Thus, the task time involving the paretic hand was reduced by a factor of five, while the standard deviation was reduced by a factor of 16.

  4. Assessment of knowledge of hand washing among health care ...

    African Journals Online (AJOL)

    Introduction. Nosocomial infection is a global public health problem with an estimated 1.5 million suffering consequences at any given time [1, 2] noted that at least 25% of all hospital infections in the developing world are nosocomially acquired. The hands of health care providers are major agents of infection transmission ...

  5. High-temperature flaw assessment procedure

    International Nuclear Information System (INIS)

    Ruggles, M.B.; Takahashi, Y.; Ainsworth, R.A.

    1989-08-01

    The current program represents a joint effort between the Electric Power Research Institute (EPRI) in the USA, the Central Research Institute of Electric Power Industry (CRIEPI) in Japan, and the Central Electricity Generating Board (CEGB) in the UK. The goal is to develop an interim high-temperature flaw assessment procedure for high-temperature reactor components. This is to be accomplished through exploratory experimental and analytical studies of high-temperature crack growth. The state-of-the-art assessment and the fracture mechanics database for both types 304 and 316 stainless steels, completed in 1988, serve as a foundation for the present work. Work in the three participating organizations is progressing roughly on schedule. Results to-date are presented in this document. Fundamental tests results are discussed in Section 2. Section 3 focuses on results of exploratory subcritical crack growth tests. Progress in subcritical crack growth modeling is reported in Section 4. Exploratory failure tests are outlined in Section 5. 21 refs., 70 figs., 7 tabs

  6. Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study

    OpenAIRE

    Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K.; Mali, Gaurao Vasant

    2016-01-01

    Background: To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. Materials and Methods: The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical i...

  7. Assessment procedures results of training in biology

    Directory of Open Access Journals (Sweden)

    Elena A. Galkina

    2018-04-01

    Full Text Available The article describes the procedures for evaluating the results of training in biology. The mechanisms for monitoring the learning outcomes of a biology teacher are presented. Examples of algorithms for procedures for evaluating learning outcomes in biology are demonstrated.

  8. Do hospital visitors wash their hands? Assessing the use of alcohol-based hand sanitizer in a hospital lobby.

    Science.gov (United States)

    Birnbach, David J; Nevo, Igal; Barnes, Susan; Fitzpatrick, Maureen; Rosen, Lisa F; Everett-Thomas, Ruth; Sanko, Jill S; Arheart, Kristopher L

    2012-05-01

    Reports regarding hand hygiene compliance (HHC) among hospital visitors are limited. Although there is an implicit assumption that the availability of alcohol-based hand sanitizer (AHS) promotes visitor HHC, the degree of AHS use by visitors remains unclear. To assess AHS use, we observed visitor HHC and how it is affected by visual cues in a private university hospital. Using an observational controlled study, we tested 3 interventions: a desk sign mandating all visitors to use AHS, a free-standing AHS dispenser directly in front of a security desk, and a combination of a freestanding AHS dispenser and a sign. HHC was 0.52% at baseline and did not improve significantly when the desk sign was provided as a cue 0.67% (P = .753). However, HHC did improve significantly with use of the freestanding AHS dispenser (9.33%) and the sign and dispenser combination (11.67%) (P hand hygiene behavior. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. 15 CFR 990.27 - Use of assessment procedures.

    Science.gov (United States)

    2010-01-01

    ...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OIL POLLUTION ACT REGULATIONS NATURAL RESOURCE DAMAGE ASSESSMENTS Authorities § 990.27 Use of assessment procedures. (a) Standards for... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Use of assessment procedures. 990.27...

  10. Neural network based automated algorithm to identify joint locations on hand/wrist radiographs for arthritis assessment

    International Nuclear Information System (INIS)

    Duryea, J.; Zaim, S.; Wolfe, F.

    2002-01-01

    Arthritis is a significant and costly healthcare problem that requires objective and quantifiable methods to evaluate its progression. Here we describe software that can automatically determine the locations of seven joints in the proximal hand and wrist that demonstrate arthritic changes. These are the five carpometacarpal (CMC1, CMC2, CMC3, CMC4, CMC5), radiocarpal (RC), and the scaphocapitate (SC) joints. The algorithm was based on an artificial neural network (ANN) that was trained using independent sets of digitized hand radiographs and manually identified joint locations. The algorithm used landmarks determined automatically by software developed in our previous work as starting points. Other than requiring user input of the location of nonanatomical structures and the orientation of the hand on the film, the procedure was fully automated. The software was tested on two datasets: 50 digitized hand radiographs from patients participating in a large clinical study, and 60 from subjects participating in arthritis research studies and who had mild to moderate rheumatoid arthritis (RA). It was evaluated by a comparison to joint locations determined by a trained radiologist using manual tracing. The success rate for determining the CMC, RC, and SC joints was 87%-99%, for normal hands and 81%-99% for RA hands. This is a first step in performing an automated computer-aided assessment of wrist joints for arthritis progression. The software provides landmarks that will be used by subsequent image processing routines to analyze each joint individually for structural changes such as erosions and joint space narrowing

  11. Procedure-Oriented Torsional Anatomy of the Hand for Spasticity Injection.

    Science.gov (United States)

    John, Joslyn; Cianca, John; Chiou-Tan, Faye; Pandit, Sindhu; Furr-Stimming, Erin; Taber, Katherine H

    To provide musculoskeletal ultrasound (MSKUS) images of hand anatomy in the position of hemiparetic flexion as a reference for spasticity injections. After a stroke, spasticity can result in anatomic distortion of the hand. Spasticity may require treatment with botulinum toxin or phenol injections. Anatomic distortion may decrease the accuracy of injections. Standard anatomic references are of limited utility because they are not in this spastic hemiparetic position. There presently is no anatomic reference in the literature for these spastic postures. This study is part three of a series examining torsional anatomy of the body. Ultrasound (US) images were obtained in a healthy subject. The muscles examined included the lumbricals and the flexor pollicis brevis. A marker dot was placed at each dorsal and palmar anatomic injection site for these muscles. The US probe was placed on these dots to obtain a cross-sectional view. A pair of US images was recorded with and without power Doppler imaging: the first in anatomic neutral and second in hemiparetic spastic positions. In addition, a video recording of the movement of the muscles during this rotation was made at each site. On the palmar view, the lumbricals rotated medially. On dorsal view, the lumbricals can be seen deep to the dorsal interossei muscles, with spastic position, and they become difficult to identify. The flexor pollicis brevis (FPB) muscle contracts with torsion, making abductor pollicis brevis (APB) predominately in view. The anatomic location of the lumbrical muscles makes them difficult to inject even with ultrasound guidance. However, recognizing the nearby digital vasculature allows for improved identification of the musculature for injection purposes. The FPB muscle also can be identified by its adjacent radial artery lateral to the flexor pollicus longus tendon. Normal anatomy of hand can become distorted in spastic hemiparesis. Diagnostic ultrasound is able to discern these anatomic

  12. Comparative assessment of local tolerance of alcohols commonly used in alcohol-based hand rubs for hand hygiene.

    Science.gov (United States)

    Manche, Monique; Foligné, Benoît; Sauty, Mathieu; Platel, Anne; Vercauteren, Eric; Rauwel, Gaétan; Catoire, Sophie; Ficheux, Hervé; Criquelion, Jacques; Nesslany, Fabrice

    2017-10-01

    Hand hygiene plays a key role in nosocomial infection prevention. To achieve users' adherence, products' dermal tolerance is essential. We aimed at making a comparative assessment of skin irritation and phototoxicity of the 3 alcohols commonly used in alcohol-based hand rubs (Ethanol, Propan-2-ol, Propan-1-ol) at 60, 70, 80 or 85% w/w in water or with co-formulates (hydrating, emollient and skin protective agents). In vitro validated OECD methods 439 and 432 were used. For irritation, EpiSkin™ Small Model was the chosen Reconstructed Human Epidermis (RhE). For phototoxicity, co-formulates alone or in mixture with and without alcohol were tested using BALB/c 3T3 cell cultures. Whilst Ethanol and Propan-2-ol could not be differentiated and displayed good skin tolerance profiles, Propan-1-ol based products lead to significant viability impairments of RhE at 60, 70 or 80% and at 60% in the presence of co-formulates. However, these results could not be reproduced in another RhE model. Taking also into account bibliographic data on Propan-1-ol, this suggests that our results are probably related to a lack of specificity of the used RhE. Therefore, it can be relevant in case of significant results to use two different RhE models before performing any classification and/or performing any complementary tests. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. developing and implementing assessment moderation procedures

    African Journals Online (AJOL)

    Temechegn

    Written laboratory reports are among the different types of assessment tasks. ... Carefully designed assessment tasks allow students to demonstrate achievement of clearly .... efficient and have a better understanding of how the lab connects to theory ... the mean values of the various marks students received in this study.

  14. Setting technical standards for visual assessment procedures

    Science.gov (United States)

    Kenneth H. Craik; Nickolaus R. Feimer

    1979-01-01

    Under the impetus of recent legislative and administrative mandates concerning analysis and management of the landscape, governmental agencies are being called upon to adopt or develop visual resource and impact assessment (VRIA) systems. A variety of techniques that combine methods of psychological assessment and landscape analysis to serve these purposes is being...

  15. Developing and implementing assessment moderation procedures ...

    African Journals Online (AJOL)

    In evaluating laboratory reports, assessment criteria must be clearly established and made explicit to students before the lab activities so students can focus their efforts and the instructors will concentrate on major learning outcomes during marking the laboratory reports. This paper is intended to help draw assessment ...

  16. Hand X-ray in pediatric endocrinology: Skeletal age assessment and beyond

    Directory of Open Access Journals (Sweden)

    Vincenzo De Sanctis

    2014-01-01

    Full Text Available Skeletal age assessment (SAA is a clinical procedure which is used in determining the SA of children and adolescents. Bone development is influenced by a number of factors, including nutrition, hormonal secretions, and genetics. There are several factors to be borne in mind when using methods of assessing skeletal maturity. These include: Variability among methods, degree of variability in the estimation of skeletal maturation, sources of low accuracy, and dispersion of the values of skeletal maturation. Currently, the main clinical methods for SAA are the Greulich and Pyle (GP and Tanner and Whitehouse (TW methods. The GP method has the advantage of being quick and easy to use. A well-trained radiologist takes few minutes to determine the bone age (BA from a single hand radiograph. The method of TW, however, seems to be more reliable than the GP method. In recent years, the increasing speed in computer sciences and reduction of their cost has given the opportunity to create and use computerized BA estimation system. Despite the fact that the number of automated systems for BAA have increased, most are still within the experimental phase. The use of automated BA determination system, cleared for clinical use in Europe (BoneXpert, has been validated for various ethnicities and children with endocrine disorders. Ultrasound imaging has some limitations that include operator dependence, lower intra-rater and inter-rater reliability of assessment and difficulties with standardization of documentation and imaging transfer. Magnetic resonance imaging (MRI is noninvasive alternative tool for SA assessment in children. However, few studies have been reported on this topic, and further research is needed to evaluate the reliability and validity of MRI BAAs. In conclusion, at present radiographic methods for the assessment of BA remain the gold standards. Whatever method one adopts, it is essential to minimize the causes of imprecision by taking care to

  17. Development of a non-expert risk assessment method for hand-arm related tasks (HARM)

    NARCIS (Netherlands)

    Douwes, M.; Kraker, H. de

    2014-01-01

    To support health and safety practitioners in their obligation of risk assessment the 'Hand Arm Risk Assessment Method' (HARM) was developed. This tool can be used by any type of company for risk assessment of developing arm, neck or shoulders symptoms (pain) resulting from light manual tasks.This

  18. A procedure for the assessment of low frequency noise complaints.

    Science.gov (United States)

    Moorhouse, Andy T; Waddington, David C; Adams, Mags D

    2009-09-01

    The development and application of a procedure for the assessment of low frequency noise (LFN) complaints are described. The development of the assessment method included laboratory tests addressing low frequency hearing threshold and the effect on acceptability of fluctuation, and field measurements complemented with interview-based questionnaires. Environmental health departments then conducted a series of six trials with genuine "live" LFN complaints to test the workability and usefulness of the procedure. The procedure includes guidance notes and a pro-forma report with step-by-step instructions. It does not provide a prescriptive indicator of nuisance but rather gives a systematic procedure to help environmental health practitioners to form their own opinion. Examples of field measurements and application of the procedure are presented. The procedure and examples are likely to be of particular interest to environmental health practitioners involved in the assessment of LFN complaints.

  19. Work experience and seniority in health care vs. medical students’ knowledge of selected hand hygiene procedures

    Directory of Open Access Journals (Sweden)

    Anna Różańska

    2016-10-01

    Full Text Available Background: Hand hygiene (HH is the most important element of infection prevention. The aim of the study was to analyze the level of HH knowledge among medical students of Jagiellonian University Medical College in correlation with their clinical experience and the presence and extent of trainings in hospital hygiene prior to internships, as well as with HH practice among medical staff perceived by students. Material and Methods: The study was carried out in a group of 414 students from October to December, 2014. The questionnaire built of 14 questions was used as a study tool. Results: Absolutely correct answers to questions about HH were given by 52.9%, and about HH technique by 6.5% of respondents. The degree of accuracy of answers to questions concerning HH did not correlate with the gender of the respondents or with the fact that work placement had been preceded by training in the field of HH or with its scope. A statistically significant correlation was found between the year, the field, and the type of the study. Students with greater professional practice, significantly less often claimed that medical workers comply with HH. Professional practice of 22.9% of students was not preceded by any training in the field of hospital hygiene and in 28% of cases training did not cover HH. Nearly half of the respondents declared that pre-internship training had not addressed the problem of occupational exposure to biological agents. Conclusions: The results of the study shows that knowledge gained by students participating in the study was not satisfactory. Moreover, there is a need for improving the educational scheme in the discussed subject at all levels of basic and clinical subjects as well as during internships. Med Pr 2016;67(5:623–633

  20. [Work experience and seniority in health care vs. medical students' knowledge of selected hand hygiene procedures].

    Science.gov (United States)

    Różańska, Anna; Wójkowska-Mach, Jadwiga; Bulanda, Małgorzata

    Hand hygiene (HH) is the most important element of infection prevention. The aim of the study was to analyze the level of HH knowledge among medical students of Jagiellonian University Medical College in correlation with their clinical experience and the presence and extent of trainings in hospital hygiene prior to internships, as well as with HH practice among medical staff perceived by students. The study was carried out in a group of 414 students from October to December, 2014. The questionnaire built of 14 questions was used as a study tool. Absolutely correct answers to questions about HH were given by 52.9%, and about HH technique by 6.5% of respondents. The degree of accuracy of answers to questions concerning HH did not correlate with the gender of the respondents or with the fact that work placement had been preceded by training in the field of HH or with its scope. A statistically significant correlation was found between the year, the field, and the type of the study. Students with greater professional practice, significantly less often claimed that medical workers comply with HH. Professional practice of 22.9% of students was not preceded by any training in the field of hospital hygiene and in 28% of cases training did not cover HH. Nearly half of the respondents declared that pre-internship training had not addressed the problem of occupational exposure to biological agents. The results of the study shows that knowledge gained by students participating in the study was not satisfactory. Moreover, there is a need for improving the educational scheme in the discussed subject at all levels of basic and clinical subjects as well as during internships. Med Pr 2016;67(5):623-633. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. Improving L2 Reading Comprehension through Emotionalized Dynamic Assessment Procedures.

    Science.gov (United States)

    Abdolrezapour, Parisa

    2017-06-01

    The paper reports a study on an emotionally-loaded dynamic assessment procedure used with Iranian EFL learners. It focuses on the effect of using emotional intelligence characteristics (based on Goleman's framework) as a tool for motivating learners while performing reading tasks. The study with 50 intermediate learners aged 12-15 used three modalities: a control group, which was taught under institute's normal procedures; a comparison group, which received dynamic assessment (DA); and an experimental group, which received emotionalized dynamic assessment (EDA) procedures, in the form of an intervention focusing on characteristics of Goleman's emotional intelligence framework with the express purpose of inducing them to work with their emotions. Results showed that applying EDA procedures to reading assessment tasks made a difference in learners' level of performance in comparison to those who went through pure DA procedures who in turn performed significantly better than those who did not received DA in any form.

  2. Patients exposure assessment for radiographic procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

    2007-01-01

    In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

  3. TADS Needs Assessment Procedures Manual, Summer 1980.

    Science.gov (United States)

    Black, Talbot; And Others

    The TADS (Technical Assistance Development System) Needs Assessment Manual is designed to guide the comprehensive review of Handicapped Children's Early Education Program (HCEEP) demonstration projects in identifying technical assistance needs. An introduction reviews the TADS technical assistance model which includes program planning, needs…

  4. Self-assessment procedure using fuzzy sets

    Science.gov (United States)

    Mimi, Fotini

    2000-10-01

    Self-Assessment processes, initiated by a company itself and carried out by its own people, are considered to be the starting point for a regular strategic or operative planning process to ensure a continuous quality improvement. Their importance has increased by the growing relevance and acceptance of international quality awards such as the Malcolm Baldrige National Quality Award, the European Quality Award and the Deming Prize. Especially award winners use the instrument of a systematic and regular Self-Assessment and not only because they have to verify their quality and business results for at least three years. The Total Quality Model of the European Foundation for Quality Management (EFQM), used for the European Quality Award, is the basis for Self-Assessment in Europe. This paper presents a self-assessment supporting method based on a methodology of fuzzy control systems providing an effective means of converting the linguistic approximation into an automatic control strategy. In particular, the elements of the Quality Model mentioned above are interpreted as linguistic variables. The LR-type of a fuzzy interval is used for their representation. The input data has a qualitative character based on empirical investigation and expert knowledge and therefore the base- variables are ordinal scaled. The aggregation process takes place on the basis of a hierarchical structure. Finally, in order to render the use of the method more practical a software system on PC basis is developed and implemented.

  5. Assessment of LANL transportation policies and procedures

    International Nuclear Information System (INIS)

    Danna, J.G.; Jennrich, E.A.; Lund, D.M.; Davis, K.D.; Hoevemeyer, S.S.

    1991-04-01

    In order to determine whether activities related to the transportation of waste at Los Alamos National Laboratory (LANL) were being conducted in accordance with DOE policy, requirements stated in applicable DOE Orders were reviewed and compared with LANL policies and procedures described in the Administrative Requirements and the On-Site Transportation Manual. The following DOE Orders were determined to pertain to waste transportation and thus reviewed to identify requirements for which LANL is responsible for satisfying: Order 5820.2A Radioactive Waste Management; Order 1540.1 Materials Transportation and Traffic Management; and Order 5480.3 Safety Requirements for the Packaging and Transportation of Hazardous Materials, Hazardous Substances, and Hazardous Wastes. The LANL On-Site Transportation Manual and the Administrative Requirements contained in the LANL Environment, Safety, and Health Manual were reviewed to verify that each of the requirements identified through the review of the Orders and 10 CFR Part 71 were being satisfied. The following Administrative Requirements were considered in this task: Shipment of Radioactive Materials; Radioactive Liquid Waste; Low-Level Radioactive Solid Waste; Chemical, Hazardous, and Mixed Waste; Polychlorinated Biphenyls; and Transuranic (TRU) Solid Waste

  6. The Clinical Assessment Study of the Hand (CAS-HA: a prospective study of musculoskeletal hand problems in the general population

    Directory of Open Access Journals (Sweden)

    Marshall Michelle

    2007-08-01

    Full Text Available Abstract Background Pain in the hand affects an estimated 12–21% of the population, and at older ages the hand is one of the most common sites of pain and osteoarthritis. The association between symptomatic hand osteoarthritis and disability in everyday life has not been studied in detail, although there is evidence that older people with hand problems suffer significant pain and disability. Despite the high prevalence of hand problems and the limitations they cause in older adults, little attention has been paid to the hand by health planners and policy makers. We plan to conduct a prospective, population-based, observational cohort study designed in parallel with our previously reported cohort study of knee pain, to describe the course of musculoskeletal hand problems in older adults and investigate the relative merits of different approaches to classification and defining prognosis. Methods/Design All adults aged 50 years and over registered with two general practices in North Staffordshire will be invited to take part in a two-stage postal survey. Respondents to the survey who indicate that they have experienced hand pain or problems within the previous 12 months will be invited to attend a research clinic for a detailed assessment. This will consist of clinical interview, hand assessment, screening test of lower limb function, digital photography, plain x-rays, anthropometric measurement and brief self-complete questionnaire. All consenting clinic attenders will be followed up by (i general practice medical record review, (ii repeat postal questionnaire at 18-months, and (iii repeat postal questionnaire at 3 years. Discussion This paper describes the protocol for the Clinical Assessment Study of the Hand (CAS-HA, a prospective, population-based, observational cohort study of community-dwelling older adults with hand pain and hand problems based in North Staffordshire.

  7. An instrumented object for hand exercise and assessment using a pneumatic pressure sensor

    Science.gov (United States)

    Mohan, A.; Tharion, G.; Kumar, R. K.; Devasahayam, S. R.

    2018-05-01

    Measurement of grip force is important for both exercise training and assessment of the hand during physical rehabilitation. The standard method uses a grip dynamometer which measures the force between the fingers and opposing thumb. The primary limitation of the grip dynamometer is the restriction of measurement to cylindrical grasps. Any deformation of the hand due to muscular or skeletal disease makes the grip dynamometer difficult or impossible to use. An alternative to the grip dynamometer is a sealed pneumatic object that can be gripped by the hand. Measurement of the internal pressure in the object can be related to the grip force. In this paper, we analyze such a pneumatic pressure sensing object for hand grip assessment and also describe an easy fabrication of the grip sensor. The instrumented object presented in this paper is designed to assess both the maximal voluntary grip forces and continuous grip force to monitor control of hand function during exercise under instruction from a therapist. Potential uses of such a pneumatic pressure sensing object for hand grip are in physical rehabilitation of patients following paralysing illnesses like stroke and spinal cord injury.

  8. Software quality assurance procedures for radioactive waste risk assessment codes

    International Nuclear Information System (INIS)

    Hill, I.; Mayer, J.

    1990-01-01

    This support study for the evaluation of the safety of geological disposal systems is aimed at identifying the requirements for software quality assurance procedures for radioactive waste risk assessment codes, and to recommend appropriate procedures. The research covers: (i) the analysis of existing procedures and definition of requirements; (ii) a case study of the use of some existing procedures; (iii) the definition and the implementation of procedures. The report is supported by appendices that give more detail on the procedures recommended. It is intended to provide ideas on the steps that should be taken to ensure the quality of the programs used for assessment of the safety case for radioactive waste repositories, and does not represent the introduction of wholly new ideas or techniques. The emphasis throughout is on procedures that will be easily implemented, rather than on the fully rigorous procedures that are required for some application areas. The study has concentrated on measures that will increase the confidence in repository performance assessments among the wider scientific/engineering community, and the lay public

  9. Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland.

    Science.gov (United States)

    Staines, Anthony; Amherdt, Isabelle; Lécureux, Estelle; Petignat, Christiane; Eggimann, Philippe; Schwab, Marcos; Pittet, Didier

    2017-12-01

    OBJECTIVE To assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative. DESIGN Multicenter analysis of hand hygiene compliance through direct observation by trained observers. SETTING A total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland. PARTICIPANTS Clinical staff. INTERVENTIONS In total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449-6,852). An 18-month Hand Hygiene Breakthrough Collaborative was conducted to implement the WHO multimodal promotional strategy including improved access to alcohol-based hand rub, education, performance measurement and feedback, reminders and communication, leadership engagement, and safety culture. RESULTS Overall hand hygiene compliance improved from 61.9% to 88.3% (Pstrategy for content and measurement was associated with significant and substantial improvement in compliance across all professions, all hand hygiene indications, and all participating hospitals. Infect Control Hosp Epidemiol 2017;38:1420-1427.

  10. Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study.

    Science.gov (United States)

    Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K; Mali, Gaurao Vasant

    2016-09-01

    To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus , Staphylococcus epidermidis , Pseudomonas aeruginosa , Escherichia coli , and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical isolates of the aforementioned test organisms. The well variant of agar disk diffusion test using Mueller-Hinton agar was used for evaluating the antimicrobial efficacy of hand sanitizers. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. Fifty microliters of the hand sanitizer was introduced into each of the 4 wells while the 5 th well incorporated with sterile water served as a control. This was done for all the test organisms and plates were incubated in an incubator for 24 h at 37΀C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring the zone of inhibition. The mean diameters of zones of inhibition (in mm) observed in Group A (Sterillium), Group B (PureHands), Group C (Lifebuoy), and Group D (Dettol) were 22 ± 6, 7.5 ± 0.5, 9.5 ± 1.5, and 8 ± 1, respectively. Maximum inhibition was found with Group A against all the tested organisms. Data were statistically analyzed using analysis of variance, followed by post hoc test for group-wise comparisons. The difference in the values of different sanitizers was statistically significant at P hand sanitizer to maintain the hand hygiene.

  11. A procedure for safety assessment of components with cracks - Handbook

    International Nuclear Information System (INIS)

    Andersson, P.; Bergman, M.; Brickstad, B.; Dahlberg, L.; Nilsson, F.; Sattari-Far, I.

    1996-01-01

    In this handbook a procedure is described which can be used both for assessment of detected cracks or crack like defects or for defect tolerance analysis. The procedure can be used to calculate possible crack growth due to fatigue or stress corrosion and to calculate the reserve margin for failure due to fracture and plastic collapse. For ductile materials, the procedure gives the reserve margin for initiation of stable crack growth. Thus, an extra reserve margin, unknown to size, exists for failure in components made of ductile materials. The procedure was developed for operative use with the following objectives in mind: The procedure should be able to handle both linear and non-linear problems without any a priori division; The procedure shall ensure uniqueness of the safety assessment; The procedure should be well defined and easy to use; The conservatism of the procedure should be well validated; The handbook that documents the procedure should be so complete that for most assessments access to any other fracture mechanics literature should not be necessary. The method utilized is based on the R6-method developed at Nuclear Electric plc. This method can in principle be used for all metallic materials. It is, however, more extensively verified for steel alloys only. The method is not intended for use in temperatures where creep deformation is of importance. The first edition of the handbook was released in 1990 and the second in 1991. This third edition has been extensively revised. A Windows-based program (SACC) has been developed which can perform the assessments described in the book including calculation of crack growth due to stress corrosion and fatigue. 52 refs., 27 figs., 35 tabs

  12. Procedure for the assessment of material control and accounting systems

    International Nuclear Information System (INIS)

    Parziale, A.A.; Sacks, I.J.

    1979-01-01

    For the United States Nuclear Regulatory Commission, a procedure was developed and tested for the evaluation of Material Control and Accounting (MC and A) Systems at nuclear fuel facilities. This procedure, called the Structured Assessment Approach, SAA, subjects the MC and A system at a facility to a series of increasingly sophisticated adversaries and strategies. A fully integrated version of the computer codes which assist the analyst in this assessment will become available in October 1979. The concepts of the SAA and the results of the assessment of a hypothetical but typical facility are presented

  13. DMM assessments of attachment and adaptation: Procedures, validity and utility.

    Science.gov (United States)

    Farnfield, Steve; Hautamäki, Airi; Nørbech, Peder; Sahhar, Nicola

    2010-07-01

    This article gives a brief over view of the Dynamic-Maturational Model of attachment and adaptation (DMM; Crittenden, 2008) together with the various DMM assessments of attachment that have been developed for specific stages of development. Each assessment is discussed in terms of procedure, outcomes, validity, advantages and limitations, comparable procedures and areas for further research and validation. The aims are twofold: to provide an introduction to DMM theory and its application that underlie the articles in this issue of CCPP; and to provide researchers and clinicians with a guide to DMM assessments.

  14. Favorable Responsiveness of the Hand10 Questionnaire to Assess Treatment Outcomes for Lateral Epicondylitis.

    Science.gov (United States)

    Nishizuka, Takanobu; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Yamamoto, Michiro; Onishi, Tetsuro; Hirata, Hitoshi

    2018-06-01

    The aim of our study was to compare the responsiveness of the Hand10 questionnaire and the Pain visual analogue scale (VAS) for the assessment of lateral epicondylitis. The standardized response mean and effect size were used as indicators of responsiveness, measured at baseline and after 6 months of treatment. Among the 54 patients enrolled, 28 were treated using a forearm band, compress and stretching, with the other 26 patients treated using compress and stretching. The standardized response mean and the effect size were 1.18 and 1.38, respectively, of the Hand10 and 1.39 and 1.75, respectively, for the Pain VAS. The responsiveness of both tests was considered to be large, based on Cohen's classification of effect size, supporting the use of the Hand10 questionnaire to assess treatment outcomes for lateral epicondylitis.

  15. Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment.

    Science.gov (United States)

    Jensen, Peter; Thyssen, Jacob P; Johansen, Jeanne D; Skare, Lizbet; Menné, Torkil; Lidén, Carola

    2011-01-01

    EU legislation has reduced the epidemic of nickel contact allergy affecting the consumer, and shifted the focus towards occupational exposure. The acid wipe sampling technique was developed to quantitatively determine skin exposure to metals. To assess the clinical usefulness of the acid wipe sampling technique as part of the diagnostic investigation for occupational nickel allergy-associated hand dermatitis. Six patients with vesicular dermatitis on the hands were included. Acid wipe sampling of skin and patch testing with a nickel sulfate dilution series were performed. Nickel was detected in all samples from the hands. In all patients, the nickel content on the hands was higher than on the non-exposed control area. Occupational exposure to nickel-releasing items raised the nickel content on exposed skin as compared with a non-exposed control site. Nickel-reducing measures led to complete symptom relief in all cases. In cases of a positive nickel patch test reaction and hand eczema, patients should perform the dimethylglyoxime (DMG) test on metallic items at home and at work. The acid wipe sampling technique is useful for the diagnosis of occupational hand eczema following screening with the inexpensive DMG test. © 2010 John Wiley & Sons A/S.

  16. Validity and inter-observer reliability of subjective hand-arm vibration assessments

    NARCIS (Netherlands)

    Coenen, P.; Formanoy, M.; Douwes, M.; Bosch, T.; Kraker, H. de

    2014-01-01

    Exposure to mechanical vibrations at work (e.g., due to handling powered tools) is a potential occupational risk as it may cause upper extremity complaints. However, reliable and valid assessment methods for vibration exposure at work are lacking. Measuring hand-arm vibration objectively is often

  17. Response shift in severity assessment of hand eczema with visual analogue scales

    DEFF Research Database (Denmark)

    Mollerup, Annette; Johansen, Jeanne D

    2015-01-01

    BACKGROUND: Hand eczema is a common and fluctuating disease. Visual analogue scales (VASs) are used to assess disease severity, both currently and when at its worst. However, such patient-reported outcomes may be at risk of being flawed owing to recall bias or response shifts. OBJECTIVE: To explore...

  18. Impact assessment procedures for sustainable development: A complexity theory perspective

    International Nuclear Information System (INIS)

    Nooteboom, Sibout

    2007-01-01

    The author assumes that effective Impact Assessment procedures should somehow contribute to sustainable development. There is no widely agreed framework for evaluating such effectiveness. The author suggests that complexity theories may offer criteria. The relevant question is 'do Impact Assessment Procedures contribute to the 'requisite variety' of a social system for it to deal with changing circumstances?' Requisite variety theoretically relates to the capability of a system to deal with changes in its environment. The author reconstructs how thinking about achieving sustainable development has developed in a sequence of discourses in The Netherlands since the 1970s. Each new discourse built on the previous ones, and is supposed to have added to 'requisite variety'. The author asserts that Impact Assessment procedures may be a necessary component in such sequences and derives possible criteria for effectiveness

  19. Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment

    DEFF Research Database (Denmark)

    Jensen, Peter; Thyssen, Jacob Pontoppidan; Johansen, Jeanne D

    2011-01-01

    Background. EU legislation has reduced the epidemic of nickel contact allergy affecting the consumer, and shifted the focus towards occupational exposure. The acid wipe sampling technique was developed to quantitatively determine skin exposure to metals. Objectives. To assess the clinical...... dilution series were performed. Results. Nickel was detected in all samples from the hands. In all patients, the nickel content on the hands was higher than on the non-exposed control area. Conclusions. Occupational exposure to nickel-releasing items raised the nickel content on exposed skin as compared...

  20. Procedure for the assessment of material control and accounting systems

    International Nuclear Information System (INIS)

    Maimoni, A.; Sacks, I.; Cleland, L.

    1978-01-01

    The current status of the LLL program for MC and A system assessment is reviewed. Particular emphasis is given to the assessment procedure and results. The integrated approach we have taken includes many of the functions normally assigned to physical security. Deceit and tampering are explicitly considered. The results of such a detailed assessment include a systematic identification of adversary targets; the most vulnerable portions of the safeguards system; the number and type of adversaries required, in collusion, to fail the system; and the conditional probabilities of safeguard system failure for a variety of assumptions. The assessment procedure was demonstrated by analyzing a prototype fuel cycle facility, the Test Bed. We believe our methodology will be useful to the NRC as a means of performing detailed, objective assessments. The nuclear industry also should find it valuable as a design tool

  1. Crowd-sourced assessment of surgical skills in cricothyrotomy procedure.

    Science.gov (United States)

    Aghdasi, Nava; Bly, Randall; White, Lee W; Hannaford, Blake; Moe, Kris; Lendvay, Thomas S

    2015-06-15

    Objective assessment of surgical skills is resource intensive and requires valuable time of expert surgeons. The goal of this study was to assess the ability of a large group of laypersons using a crowd-sourcing tool to grade a surgical procedure (cricothyrotomy) performed on a simulator. The grading included an assessment of the entire procedure by completing an objective assessment of technical skills survey. Two groups of graders were recruited as follows: (1) Amazon Mechanical Turk users and (2) three expert surgeons from University of Washington Department of Otolaryngology. Graders were presented with a video of participants performing the procedure on the simulator and were asked to grade the video using the objective assessment of technical skills questions. Mechanical Turk users were paid $0.50 for each completed survey. It took 10 h to obtain all responses from 30 Mechanical Turk users for 26 training participants (26 videos/tasks), whereas it took 60 d for three expert surgeons to complete the same 26 tasks. The assessment of surgical performance by a group (n = 30) of laypersons matched the assessment by a group (n = 3) of expert surgeons with a good level of agreement determined by Cronbach alpha coefficient = 0.83. We found crowd sourcing was an efficient, accurate, and inexpensive method for skills assessment with a good level of agreement to experts' grading. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Elimination of hand-wrist radiographs for maturity assessment in children needing orthodontic therapy

    International Nuclear Information System (INIS)

    Al Khal, Hessa A.; Wong, Ricky W.K.; Rabie, A.B.M.

    2008-01-01

    Our aim was to evaluate the validity of the cervical vertebra maturation (CVM) method as an indicator of skeletal age during the circumpubertal period by correlating the CVM method with the hand-wrist maturation (HWM) method in an attempt to eliminate the need for hand-wrist radiographs for maturity assessment. Hand-wrist and lateral cephalometric radiographs of 400 Chinese were randomly selected. The age for girls was between 10 years and 15 years and for boys it was between 12 years and 17 years, so that they were within the circumpubertal period. The CVM was assessed by a method developed by Baccetti and co-workers, whereas hand-wrist maturation was assessed by Fishman's method. The CVM was significantly correlated with HWM skeletal age. (Spearman's r boys 0.9206, girls = 0.9363). All the patients in cervical vertebra stage 3 (CVS3) of CVM corresponded to skeletal maturation indicator 2 (SMI2) or SMI3 stages of HWM (around the peak of the growth spurt). The method error was insignificant. CVM is a valid indicator of skeletal growth during the circumpubertal period. This work will provide dental practitioners with information on jaw growth modification therapy. (orig.)

  3. Elimination of hand-wrist radiographs for maturity assessment in children needing orthodontic therapy

    Energy Technology Data Exchange (ETDEWEB)

    Al Khal, Hessa A.; Wong, Ricky W.K.; Rabie, A.B.M. [University of Hong Kong, Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, Hong Kong (China)

    2008-03-15

    Our aim was to evaluate the validity of the cervical vertebra maturation (CVM) method as an indicator of skeletal age during the circumpubertal period by correlating the CVM method with the hand-wrist maturation (HWM) method in an attempt to eliminate the need for hand-wrist radiographs for maturity assessment. Hand-wrist and lateral cephalometric radiographs of 400 Chinese were randomly selected. The age for girls was between 10 years and 15 years and for boys it was between 12 years and 17 years, so that they were within the circumpubertal period. The CVM was assessed by a method developed by Baccetti and co-workers, whereas hand-wrist maturation was assessed by Fishman's method. The CVM was significantly correlated with HWM skeletal age. (Spearman's r boys = 0.9206, girls = 0.9363). All the patients in cervical vertebra stage 3 (CVS3) of CVM corresponded to skeletal maturation indicator 2 (SMI2) or SMI3 stages of HWM (around the peak of the growth spurt). The method error was insignificant. CVM is a valid indicator of skeletal growth during the circumpubertal period. This work will provide dental practitioners with information on jaw growth modification therapy. (orig.)

  4. Assessment of the environmental microbiological cross contamination following hand drying with paper hand towels or an air blade dryer.

    Science.gov (United States)

    Margas, E; Maguire, E; Berland, C R; Welander, F; Holah, J T

    2013-08-01

    This study compared the potential for cross contamination of the surrounding environment resulting from two different hand-drying methods: paper towels and the use of an air blade dryer. One hundred volunteers for each method washed their hands and dried them using one of the two methods. Bacterial contamination of the surrounding environment was measured using settle plates placed on the floor in a grid pattern, air sampling and surface swabs. Both drying methods produced ballistic droplets in the immediate vicinity of the hand-drying process. The air blade dryer produced a larger number of droplets which were dispersed over a larger area. Settle plates showed increased microbial contamination in the grid squares which were affected by ballistic droplets. Using the settle plates counts, it was estimated that approx. 1.7 × 10(5) cfu more micro-organisms were left on the laboratory floor (total area approx. 17.15 m(2)) after 100 volunteers used an air blade dryer compared to when paper towels were used. The two drying methods led to different patterns of ballistic droplets and levels of microbial contamination under heavy use conditions. Whilst the increase in microbial levels in the environment is not significant if only nonpathogenic micro-organisms are spread, it may increase the risk of pathogen contamination of the environment when pathogens are occasionally present on people's hands. The study suggests that the risk of cross contamination from the washroom users to the environment and subsequent users should be considered when choosing a hand-drying method. The data could potentially give guidance following the selection of drying methods on implementing measures to minimise the risk of cross contamination. © 2013 The Society for Applied Microbiology.

  5. Clinical and Radiographic Evaluation of Procedural Errors during Preparation of Curved Root Canals with Hand and Rotary Instruments: A Randomized Clinical Study

    Science.gov (United States)

    Khanna, Rajesh; Handa, Aashish; Virk, Rupam Kaur; Ghai, Deepika; Handa, Rajni Sharma; Goel, Asim

    2017-01-01

    Background: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. Aim: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Materials and Methods: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Statistical Analysis: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). Results: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Conclusion: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex. PMID:29042727

  6. Assessment of radiological properties of wastes from urban decontamination procedures

    International Nuclear Information System (INIS)

    Da Silva, D.N.G.; Guimarães, J.R.D.; Rochedo, E.R.R.; Rochedo, P.R.R.; De Luca, C.

    2015-01-01

    One important activity associated to urban areas contaminated from accidental releases to the atmosphere of nuclear power plants is the management of radioactive wastes generated from decontamination procedures. This include the collection, conditioning, packing, transport and temporary/final disposition. The final destination is defined usually through a political decision. Thus, transport of packed radioactive wastes shall depend on decisions not just under the scope of radiological protection issues. However, the simulations performed to assess doses for the public and decontamination workers allows the estimate of radiological aspects related to the waste generated and these characteristics may be included in a multi-criteria decision tool aiming to support, under the radiological protection point of view, the decision-making process on post-emergency procedures. Important information to decision makers are the type, amount and activity concentration of wastes. This work describes the procedures to be included in the urban area model to account for the assessment of qualitative and quantitative description of wastes. The results will allow the classification of different procedures according to predefined criteria that shall then feed the multi-criteria assessment tool, currently under development, considering basic radiological protection aspects of wastes generated by the different available cleanup procedures on typical tropical urban environments. (authors)

  7. Assessment of the MPACT Resonance Data Generation Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Williams, Mark L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-12-26

    Currently, heterogeneous models are being used to generate resonance self-shielded cross-section tables as a function of background cross sections for important nuclides such as 235U and 238U by performing the CENTRM (Continuous Energy Transport Model) slowing down calculation with the MOC (Method of Characteristics) spatial discretization and ESSM (Embedded Self-Shielding Method) calculations to obtain background cross sections. And then the resonance self-shielded cross section tables are converted into subgroup data which are to be used in estimating problem-dependent self-shielded cross sections in MPACT (Michigan Parallel Characteristics Transport Code). Although this procedure has been developed and thus resonance data have been generated and validated by benchmark calculations, assessment has never been performed to review if the resonance data are properly generated by the procedure and utilized in MPACT. This study focuses on assessing the procedure and a proper use in MPACT.

  8. Assessment of Fidelity in Interventions to Improve Hand Hygiene of Healthcare Workers: A Systematic Review

    Science.gov (United States)

    Musuuza, Jackson S.; Barker, Anna; Ngam, Caitlyn; Vellardita, Lia; Safdar, Nasia

    2016-01-01

    OBJECTIVE Compliance with hand hygiene in healthcare workers is fundamental to infection prevention yet remains a challenge to sustain. We examined fidelity reporting in interventions to improve hand hygiene compliance, and we assessed 5 measures of intervention fidelity: (1) adherence, (2) exposure or dose, (3) quality of intervention delivery, (4) participant responsiveness, and (5) program differentiation. DESIGN Systematic review METHODS A librarian performed searches of the literature in PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, and Web of Science of material published prior to June 19, 2015. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews, and assessment of study quality was conducted for each study reviewed. RESULTS A total of 100 studies met the inclusion criteria. Only 8 of these 100 studies reported all 5 measures of intervention fidelity. In addition, 39 of 100 (39%) failed to include at least 3 fidelity measures; 20 of 100 (20%) failed to include 4 measures; 17 of 100 (17%) failed to include 2 measures, while 16 of 100 (16%) of the studies failed to include at least 1 measure of fidelity. Participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. CONCLUSIONS Almost all hand hygiene intervention studies failed to report at least 1 fidelity measurement. To facilitate replication and effective implementation, reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene. PMID:26861117

  9. Assessment of Conventional Teaching Procedures: Implications for Gifted Learners

    Science.gov (United States)

    Alenizi, Mogbel Aid K.

    2016-01-01

    The present research aims to assess the conventional teaching procedures in the development of mathematical skills of the students with learning difficulties. The study group was made up of all the children with academic learning disorders in KSA. The research questions have been scrutinized from the averages and the standard deviation of the…

  10. Youth Reactions to Participation in Psychological Assessment Procedures

    Science.gov (United States)

    Saldana, Lisa; DuBois, David L.

    2006-01-01

    This study investigates self-reported positive and negative reactions of youth to psychological assessment procedures. A community sample (COM) reported reactions to completing a self-report questionnaire of negative emotional states. A clinical sample (CL) reported reactions both to completion of the questionnaire and to a clinical intake.…

  11. Innovative Approaches to Increasing the Student Assessment Procedures Effectiveness

    Science.gov (United States)

    Dorozhkin, Evgenij M.; Chelyshkova, Marina B.; Malygin, Alexey A.; Toymentseva, Irina A.; Anopchenko, Tatiana Y.

    2016-01-01

    The relevance of the investigated problem is determined by the need to improving the evaluation procedures in education and the student assessment in the age of the context of education widening, new modes of study developing (such as blending learning, e-learning, massive open online courses), immediate feedback necessity, reliable and valid…

  12. Composite Tissue Transplant of Hand or Arm: A Health Technology Assessment.

    Science.gov (United States)

    2016-01-01

    Injuries to arms and legs following severe trauma can result in the loss of large regions of tissue, disrupting healing and function and sometimes leading to amputation of the damaged limb. People experiencing amputations of the hand or arm could potentially benefit from composite tissue transplant, which is being performed in some countries. Currently, there are no composite tissue transplant programs in Canada. We conducted a systematic review of the literature, with no restriction on study design, examining the effectiveness and cost-effectiveness of hand and arm transplant. We assessed the overall quality of the clinical evidence with GRADE. We developed a Markov decision analytic model to determine the cost-effectiveness of transplant versus standard care for a healthy adult with a hand amputation. Incremental cost-effectiveness ratios (ICERs) were calculated using a 30-year time horizon. We also estimated the impact on provincial health care costs if these transplants were publicly funded in Ontario. Compared to pre-transplant function, patients' post-transplant function was significantly better. For various reasons, 17% of transplanted limbs were amputated, 6.4% of patients died within the first year after the transplant, and 10.6% of patients experienced chronic rejections. GRADE quality of evidence for all outcomes was very low. In the cost-effectiveness analysis, single-hand transplant was dominated by standard care, with increased costs ($735,647 CAD vs. $61,429) and reduced quality-adjusted life-years (QALYs) (10.96 vs. 11.82). Double-hand transplant also had higher costs compared with standard care ($633,780), but it had an increased effectiveness of 0.17 QALYs, translating to an ICER of $3.8 million per QALY gained. In most sensitivity analyses, ICERs for bilateral hand transplant were greater than $1 million per QALY gained. A hand transplant program would lead to an estimated annual budget impact of $0.9 million to $1.2 million in the next 3 years

  13. Assessment in Counseling: A Guide to the Use of Psychological Assessment Procedures. Third Edition.

    Science.gov (United States)

    Hood, Albert B.; Johnson, Richard W.

    This book presents information about various psychological assessment procedures that are specifically relevant for practicing counselors. It deals with the use of assessment procedures in the counseling process and emphasizes the selection, interpretation, and communication of psychological test results. The importance of integrating test results…

  14. Comparison of 3 in vivo methods for assessment of alcohol-based hand rubs.

    Science.gov (United States)

    Edmonds-Wilson, Sarah; Campbell, Esther; Fox, Kyle; Macinga, David

    2015-05-01

    Alcohol-based hand rubs (ABHRs) are the primary method of hand hygiene in health-care settings. ICPs increasingly are assessing ABHR product efficacy data as improved products and test methods are developed. As a result, ICPs need better tools and recommendations for how to assess and compare ABHRs. Two ABHRs (70% ethanol) were tested according to 3 in vivo methods approved by ASTM International: E1174, E2755, and E2784. Log10 reductions were measured after a single test product use and after 10 consecutive uses at an application volume of 2 mL. The test method used had a significant influence on ABHR efficacy; however, in this study the test product (gel or foam) did not significantly influence efficacy. In addition, for all test methods, log10 reductions obtained after a single application were not predictive of results after 10 applications. Choice of test method can significantly influence efficacy results. Therefore, when assessing antimicrobial efficacy data of hand hygiene products, ICPs should pay close attention to the test method used, and ensure that product comparisons are made head to head in the same study using the same test methodology. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology.

    Science.gov (United States)

    Anderson, Roger T; Keating, Karen N; Doll, Helen A; Camacho, Fabian

    2015-07-01

    Skin toxicity (hand-foot syndrome/hand-foot skin reaction, HFS/R) related to antineoplastic therapy is a significant issue in oncology practice, with potentially large impacts on health-related quality of life (HRQL). A patient-reported questionnaire, the hand-foot skin reaction and quality of life (HF-QoL) questionnaire was developed to measure the HFS/R symptoms associated with cancer therapeutic agents and their effect on daily activities. The validity and reliability of the HF-QoL questionnaire was tested in a randomized trial of capecitabine with sorafenib/placebo in 223 patients with locally advanced/metastatic breast cancer. Other measures completed included patient ratings of condition severity, the Functional Assessment of Cancer Therapy-Breast cancer (FACT-B), and the clinician-rated National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, hand-foot skin reaction grade. The psychometric properties of the HF-QoL tested included structural validity, internal consistency, construct validity, discriminant validity, and responsiveness. Finally, the minimal clinically important difference (MCID) was estimated. The HF-QoL instrument comprises a 20-item symptom scale and an 18-item daily activity scale. Each scale demonstrated excellent measurement properties and discriminated between NCI-CTCAE grade and patient-rated condition severity with large effect sizes. The daily activity scale had excellent internal consistency and correlated with the FACT-B and HF-QoL symptom scores. Both HF-QoL scale scores increased linearly with increasing patient-rated condition severity. The MCIDs were estimated as 5 units for daily activities and 8 units for symptoms mean scores. The HF-QoL was sensitive to symptoms and HRQL issues associated with HFS/R among participants treated with capecitabine with and without sorafenib. The HF-QoL appears suitable for assessing the HRQL impairment associated with HFS/R to cancer therapies. Skin

  16. Examining construct validity of a new naturalistic observational assessment of hand skills for preschool- and school-age children.

    Science.gov (United States)

    Chien, Chi-Wen; Brown, Ted; McDonald, Rachael

    2012-04-01

    The Assessment of Children's Hand Skills is a new assessment that utilises a naturalistic observational method to capture children's real-life hand skill performance when engaged at various types of daily activities in everyday living contexts. The Assessment of Children's Hand Skills is designed for use with 2- to 12-year-old children with a range of disabilities or health conditions. The study aimed to investigate construct validity of the Assessment of Children's Hand Skills in Australian children. Rasch analysis was used to examine internal construct validity of the Assessment of Children's Hand Skills in a mixed sample of 53 children with disabilities (including autism spectrum disorder, developmental/genetic disorders and physical disabilities) and 85 typically developing children. External construct validity was examined by correlating with three questionnaires evaluating daily living skills and hand skills. Rasch goodness-of-fit analysis suggested that all 22 activity items and 19 of 20 hand skill items in the Assessment of Children's Hand Skills measured a single construct. The Assessment of Children's Hand Skills items were placed in a clinically meaningful hierarchy from easy to hard, and the difficulty range of the items also matched the majority of children with disabilities and typically developing preschool-aged children. Moderate to high correlations (0.59 ≤ Spearman's ρ coefficients ≤ 0.89, P assessments of daily living and fine motor skills. This study provided preliminary evidence supporting the construct validity of the Assessment of Children's Hand Skills for its clinical application in assessing children's real-life hand skill performance in Australian contexts. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

  17. Relation between patients' and physicians' severity assessment of occupational hand eczema

    DEFF Research Database (Denmark)

    Cvetkovski, Rikke Skoet; Jensen, H; Olsen, J

    2005-01-01

    BACKGROUND: Severity assessment of occupational hand eczema (OHE) is important not only in clinical settings but also in research. Questionnaires with self-rated assessment of severity may be an attractive tool for assessing severity because of their cost efficiency in comparison with expensive...... clinical examinations. OBJECTIVES: To evaluate the relation between self-rated severity and severity assessment based on standardized medical certificates issued by dermatologists in a population of patients with OHE. METHODS: Between October 2001 and November 2002 (58 weeks) we identified all new cases...... of recognized OHE from the Danish National Board of Industrial Injuries (DNBII) registry. Each patient was examined by a dermatologist, who issued a standardized medical certificate. The severity assessment in the DNBII registry was based on this medical certificate, which comprised information on morphology...

  18. All in: expansion of the acquisition of data for outcomes and procedure transfer (ADOPT) program to an entire SAGES annual meeting hands-on hernia course.

    Science.gov (United States)

    Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Cecil, Tom; Coleman, Mark; Dunkin, Brian

    2018-05-01

    Continuing professional development (CPD) for the surgeon has been challenging because of a lack of standardized approaches of hands-on courses, resulting in poor post-course outcomes. To remedy this situation, SAGES has introduced the ADOPT program, implementing a standardized, long-term mentoring program as part of its hernia hands-on course. Previous work evaluating the pilot program showed increased adoption of learned procedures as well as increased confidence of the mentored surgeons. This manuscript describes the impact of such a program when it is instituted across an entire hands-on course. Following collection of pre-course benchmark data, all participants in the 2016 SAGES hands-on hernia course underwent structured, learner-focused instruction during the cadaveric lab. All faculty had completed a standardized teaching course in the Lapco TT format. Subsequently, course participants were enrolled in a year-long program involving longitudinal mentorship, webinars, conference calls, and coaching. Information about participant demographics, training, experience, self-reported case volumes, and confidence levels related to procedures were collected via survey 3 months prior to 9 months after the course. Twenty surgeons participated in the SAGES ADOPT 2016 hands-on hernia program. Of these, seventeen completed pre-course questionnaires (85%), ten completed the 3-month questionnaire (50%), and four completed the 9-month questionnaire (20%). Nine of ten respondents of the 3-month survey (90%) reported changes in their practice. In the 9-month survey, significant increases in the annualized procedural volumes were reported for open primary ventral hernia repair, open components separation, and mesh insertion for ventral hernia repair (p ADOPT program to an entire hands-on hernia course is both feasible and beneficial, with evidence of Kirkpatrick Levels 1-4a training effectiveness. This expanded success suggests that it is a useful blueprint for the CPD of

  19. A treatment for a chronic stroke patient with a plegic hand combining CI therapy with conventional rehabilitation procedures: case report.

    Science.gov (United States)

    Bowman, Mary H; Taub, Edward; Uswatte, Gitendra; Delgado, Adriana; Bryson, Camille; Morris, David M; McKay, Staci; Mark, Victor W

    2006-01-01

    Constraint-Induced Movement therapy (CI therapy) is a recognized rehabilitation approach for persons having stroke with mild to moderately severe motor upper extremity deficits. To date, no rehabilitation treatment protocol has been proven effective that addresses both motor performance and spontaneous upper extremity use in the life situation for chronic stroke participants having severe upper extremity impairment with no active finger extension or thumb abduction. This case report describes treatment of a chronic stroke participant with a plegic hand using a CI therapy protocol that combines CI therapy with selected occupational and physical therapy techniques. Treatment consisted of six sessions of adaptive equipment and upper extremity orthotics training followed by a three-week, six-hour daily intervention of CI therapy plus neurodevelopmental treatment. Outcome measures included the Motor Activity Log for very low functioning patients (Grade 5 MAL), upper extremity portion of the Fugl-Meyer Motor Assessment, Graded Wolf Motor Function Test - for very low functioning patients (gWMFT- Grade 5), and Modified Ashworth Scale. The participant showed improvement on each outcome measure with the largest improvement on the Grade 5 MAL. In follow-up, the participant had good retention of his gains in motor performance and use of his more affected arm for real world activities after 3 months; after a one-week brush-up at 3 months, and at one year post-treatment.

  20. Development and initial validity of the in-hand manipulation assessment.

    Science.gov (United States)

    Klymenko, Gabrielle; Liu, Karen P Y; Bissett, Michelle; Fong, Kenneth N K; Welage, Nandana; Wong, Rebecca S M

    2018-04-01

    A review of the literature related to in-hand manipulation (IHM) revealed that there is no assessment which specifically measures this construct in the adult population. This study reports the face and content validity of an IHM assessment for adults with impaired hand function based on expert opinion. The definition of IHM skills, assessment tasks and scoring methods identified from literature was discussed in a focus group (n = 4) to establish face validity. An expert panel (n = 16) reviewed the content validity of the proposed assessment; evaluating the representativeness and relevance of encompassing the IHM skills in the proposed assessment tasks, the clarity and importance to daily life of the task and the clarity and applicability to clinical environment of the scoring method. The content validity was calculated using the content validity index for both the individual task and all tasks together (I-CVI and S-CVI). Feedback was incorporated to create the assessment. The focus group members agreed to include 10 assessment tasks that covered all IHM skills. In the expert panel review, all tasks received an I-CVI above 0.78 and S-CVI above 0.80 in representativeness and relevance ratings, representing good content validity. With the comments from the expert panel, tasks were modified to improve the clarity and importance to daily life. A four-point Likert scale was identified for assessing both the completion of the assessment tasks and the quality of IHM skills within the task performance. Face and content validity were established in this new IHM assessment. Further studies to examine psychometric properties and use within clinical practice are recommended. © 2018 Occupational Therapy Australia.

  1. Residual stress effects in LMFBR fracture assessment procedures

    International Nuclear Information System (INIS)

    Hooton, D.G.

    1984-01-01

    Two post-yield fracture mechanics methods, which have been developed into fully detailed failure assessment procedures for ferritic structures, have been reviewed from the point of view of the manner in which as-welded residual stress effects are incorporated, and comparisons then made with finite element and theoretical models of centre-cracked plates containing residual/thermal stresses in the form of crack-driving force curves. Applying the procedures to austenitic structures, comparisons are made in terms of failure assessment curves and it is recommended that the preferred method for the prediction of critical crack sizes in LMFBR austenitic structures containing as-welded residual stresses is the CEGB-R6 procedure based on a flow stress defined at 3% strain in the parent plate. When the prediction of failure loads in such structures is required, it is suggested that the CEGB-R6 procedure be used with residual/thermal stresses factored to give a maximum total stress of flow stress magnitude

  2. Generic procedures for assessment and response during a radiological emergency

    International Nuclear Information System (INIS)

    2000-08-01

    One of the most important aspects of managing a radiological emergency is the ability to promptly and adequately determine and take actions to protect members of the public and emergency workers. Radiological accident assessment must take account of all critical information available at any time and must be an iterative and dynamic process aimed at reviewing the response as more detailed and complete information becomes available. This manual provides the tools, generic procedures and data needed for an initial response to a non-reactor radiological accident. This manual is one out of a set of IAEA publications on emergency preparedness and response, including Method for the Development of Emergency Response Preparedness for Nuclear or Radiological Accidents (IAEA-TECDOC-953), Generic Assessment Procedures for Determining Protective Actions During a Reactor Accident (IAEA-TECDOC-955) and Intervention Criteria in a Nuclear or Radiation Emergency (Safety Series No. 109)

  3. Psychomotor skills assessment in practicing surgeons experienced in performing advanced laparoscopic procedures.

    Science.gov (United States)

    Gallagher, Anthony G; Smith, C Daniel; Bowers, Steven P; Seymour, Neal E; Pearson, Adam; McNatt, Steven; Hananel, David; Satava, Richard M

    2003-09-01

    Minimally invasive surgery (MIS) has introduced a new and unique set of psychomotor skills for a surgeon to acquire and master. Although assessment technologies have been proposed, precise and objective psychomotor skills assessment of surgeons performing laparoscopic procedures has not been detailed. Two hundred ten surgeons attending the 2001 annual meeting of the American College of Surgeons in New Orleans who reported having completed more than 50 laparoscopic procedures participated. Subjects were required to complete one box-trainer laparoscopic cutting task and a similar virtual reality task. These tasks were specifically designed to test only psychomotor and not cognitive skills. Both tasks were completed twice. Performance of tasks was assessed and analyzed. Demographic and laparoscopic experience data were also collected. Complete data were available on 195 surgeons. In this group, surgeons performed the box-trainer task better with their dominant hand (p psychomotor skills is now possible. Surgeons who had performed more than 50 laparoscopic procedures showed considerable variability in their performance on a simple laparoscopic and virtual reality task. Approximately 10% of surgeons tested performed the task significantly worse than the group's average performance. Studies such as this may form the methodology for establishing criteria levels and performance objectives in objective assessment of the technical skills component of determining surgical competence.

  4. An operational procedure for rapid flood risk assessment in Europe

    Science.gov (United States)

    Dottori, Francesco; Kalas, Milan; Salamon, Peter; Bianchi, Alessandra; Alfieri, Lorenzo; Feyen, Luc

    2017-07-01

    The development of methods for rapid flood mapping and risk assessment is a key step to increase the usefulness of flood early warning systems and is crucial for effective emergency response and flood impact mitigation. Currently, flood early warning systems rarely include real-time components to assess potential impacts generated by forecasted flood events. To overcome this limitation, this study describes the benchmarking of an operational procedure for rapid flood risk assessment based on predictions issued by the European Flood Awareness System (EFAS). Daily streamflow forecasts produced for major European river networks are translated into event-based flood hazard maps using a large map catalogue derived from high-resolution hydrodynamic simulations. Flood hazard maps are then combined with exposure and vulnerability information, and the impacts of the forecasted flood events are evaluated in terms of flood-prone areas, economic damage and affected population, infrastructures and cities.An extensive testing of the operational procedure has been carried out by analysing the catastrophic floods of May 2014 in Bosnia-Herzegovina, Croatia and Serbia. The reliability of the flood mapping methodology is tested against satellite-based and report-based flood extent data, while modelled estimates of economic damage and affected population are compared against ground-based estimations. Finally, we evaluate the skill of risk estimates derived from EFAS flood forecasts with different lead times and combinations of probabilistic forecasts. Results highlight the potential of the real-time operational procedure in helping emergency response and management.

  5. Synovitis maps for the assessment of inflammatory diseases of the hand

    International Nuclear Information System (INIS)

    Karlo, Christoph; Zanetti, Marco; Stolzmann, Paul; Hodler, Juerg; Pfirrmann, Christian W.A.; Steurer-Dober, Isabelle; Brunner, Florian

    2011-01-01

    To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand. 80 hands in 40 patients (mean age, 48 years; range, 15-72 years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1 = least, 5 = most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference. Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis. Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement. (orig.)

  6. Synovitis maps for the assessment of inflammatory diseases of the hand

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, Christoph [Kantonsspital Luzern, Department of Radiology, Luzern (Switzerland); University Hospital Zurich, Department of Radiology, Zurich (Switzerland); Zanetti, Marco; Stolzmann, Paul; Hodler, Juerg; Pfirrmann, Christian W.A. [University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Steurer-Dober, Isabelle [University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Kantonsspital Luzern, Department of Radiology, Luzern (Switzerland); Brunner, Florian [University Hospital Balgrist, Department of Rheumatology, Zurich (Switzerland)

    2011-07-15

    To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand. 80 hands in 40 patients (mean age, 48 years; range, 15-72 years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1 = least, 5 = most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference. Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis. Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement. (orig.)

  7. Assessment of comparative skills between hand-assisted and straight laparoscopic colorectal training on an augmented reality simulator.

    Science.gov (United States)

    Leblanc, F; Delaney, C P; Neary, P C; Rose, J; Augestad, K M; Senagore, A J; Ellis, C N; Champagne, B J

    2010-09-01

    The aim of this study was to compare skills sets during a hand-assisted and straight laparoscopic colectomy on an augmented reality simulator. Twenty-nine surgeons, assigned randomly in 2 groups, performed laparoscopic sigmoid colectomies on a simulator: group A (n = 15) performed hand-assisted then straight procedures; group B (n = 14) performed straight then hand-assisted procedures. Groups were compared according to prior laparoscopic colorectal experience, performance (time, instrument path length, and instrument velocity changes), technical skills, and operative error. Prior laparoscopic colorectal experience was similar in both groups. Both groups had better performances with the hand-assisted approach, although technical skill scores were similar between approaches. The error rate was higher with the hand-assisted approach in group A, but similar between both approaches in group B. These data define the metrics of performance for hand-assisted and straight laparoscopic colectomy on an augmented reality simulator. The improved scores with the hand-assisted approach suggest that with this simulator a hand-assisted model may be technically easier to perform, although it is associated with increased intraoperative errors.

  8. A comparative assessment of alternative waste management procedures for selected reprocessing wastes

    International Nuclear Information System (INIS)

    Hickford, G.E.; Plews, M.J.

    1983-07-01

    This report, which has been prepared by Associated Nuclear Services for the Department of the Environment, presents the results of a study and comparative assessment of management procedures for low and intermediate level solid waste streams arising from current and future fuel reprocessing operations on the Sellafield site. The characteristics and origins of the wastes under study are discussed and a reference waste inventory is presented, based on published information. Waste management strategy in the UK and its implications for waste conditioning, packaging and disposal are discussed. Wastes currently arising which are not suitable for Drigg burial or sea dumping are stored in an untreated form. Work is in hand to provide additional and improved disposal facilities which will accommodate all the waste streams under study. For each waste stream viable procedures are identified for further assessment. The procedures comprise a series of on-site operations-recovery from storage, pre-treatment, treatment, encapsulation, and packaging, prior to storage or disposal of the conditioned waste form. Assessments and comparisons of each procedure for each waste are presented. These address various process, operational, economic, radiological and general safety factors. The results are presented in a series of tables with supporting text. For the majority of wastes direct encapsulation with minimal treatment appears to be a viable procedure. Occupational exposure and general safety are not identified as significant factors governing the choice of procedures. The conditioned wastes meet the general requirements for safe handling during storage and transportation. The less active wastes suitable for disposal by currently available routes meet the appropriate disposal criteria. It is not possible to consider in detail the suitability for disposal of the more active wastes for which disposal facilities are not yet available. (Author)

  9. A Cyber Security Risk Assessment Procedure for Digital I and C Systems in NPPs

    International Nuclear Information System (INIS)

    Song, J. G.; Lee, J. W.; Lee, C. K.; Kwon, K. C.; Lee, D. Y.

    2011-01-01

    Digital Instrumentation and Control (I and C) systems in nuclear power plants (NPPs) use general digital technologies similar to those used in IT systems. However, one of significant differences between the two systems resides in the duration of their service life. The I and C systems in NPPs operate for more than 20 years. IT systems, on the other hand, are in service for about 3 to 5 years. Hence, a one-time risk assessment for IT systems is normally acceptable. In contrast, the risk assessment for the I and C systems in NPPs should be recursively performed during their longer operation life. A recursive procedure for cyber security risk assessment of the I and C systems in NPPs is studied and proposed in this paper

  10. A Cyber Security Risk Assessment Procedure for Digital I and C Systems in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Song, J. G.; Lee, J. W.; Lee, C. K.; Kwon, K. C.; Lee, D. Y. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    Digital Instrumentation and Control (I and C) systems in nuclear power plants (NPPs) use general digital technologies similar to those used in IT systems. However, one of significant differences between the two systems resides in the duration of their service life. The I and C systems in NPPs operate for more than 20 years. IT systems, on the other hand, are in service for about 3 to 5 years. Hence, a one-time risk assessment for IT systems is normally acceptable. In contrast, the risk assessment for the I and C systems in NPPs should be recursively performed during their longer operation life. A recursive procedure for cyber security risk assessment of the I and C systems in NPPs is studied and proposed in this paper

  11. Clinical assessment of hip strength using a hand-held dynamometer is reliable

    DEFF Research Database (Denmark)

    Thorborg, K; Petersen, J; Magnusson, S P

    2010-01-01

    Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external...... tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level....

  12. A new methodology for the assessment of hand protection from ultraviolet exposure.

    Science.gov (United States)

    Khazova, M; O'Hagan, J B; Grainger, K J-L

    2006-01-01

    A number of industrial applications and public services involve occupational exposure to ultraviolet radiation (UVR) from a variety of lamps and lasers. The aim of this study was to develop a methodology for the assessment of the UV protection level for disposable gloves. Glove UV protection factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. Our study showed that for all tested gloves a change in UVR attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of UVR protection. Glove material has a bigger effect on UVR protection level than variations in the glove thickness or its colour. Examples of assessment of the 'worst case scenario' are compared with the protection level against a number of sources, together with the guidance on a simplified evaluation protocol. An application-specific assessment, illustrated for 'SmartWater' forensic examinations and biological trans-illuminators, demonstrates that some gloves provide inadequate protection against occupational UV exposure.

  13. Procedures and methods of benefit assessments for medicines in Germany.

    Science.gov (United States)

    Bekkering, Geertruida E; Kleijnen, Jos

    2008-11-01

    The Federal Joint Committee (FJC; Gemeinsamer Bundesausschuss, G-BA) defines the health-care elements that are to be reimbursed by sickness funds. To define a directive, the FJC can commission benefit assessments, which provide an overview of the scientific evidence regarding the efficacy and benefits of an intervention. This paper describes the operational implementation of the legal requirements with regard to the benefit assessments of medicines. Such benefit assessments are sometimes referred to as "isolated benefit assessments," to distinguish them from benefit assessments as part of a full economic evaluation.The FJC has the freedom to commission these assessments from any agency; however, to date the majority have commissioned the Institute for Quality and Efficiency in Health Care (IQWiG). Nevertheless, the content of this paper applies integrally to any institute commissioned for such assessments. In this report, 'the institute' is used when the text refers to any of these institutes.The legal framework for benefit assessments is laid out in the German Social Code Book version V ( http://www.sozialgesetzbuch.de ), Sects. 35b ( section 1), 139a ( section 4-6) and Sect. 139b ( section 3). It is specified that: The institute must guarantee high transparency. The institute must provide appropriate participation of relevant parties for the commission-related development of assessments, and opportunity for comment on all important segments of the assessment procedure. The institute has to report on the progress and results of the work at regular intervals. The institute is held to giving the commission to external experts. Based on the legal framework, the institute must guarantee a high procedural transparency. Transparency of the whole process should be achieved, which is evidenced by clear reporting of procedures and criteria in all phases undertaken in the benefit assessment. The most important means of enhancing transparency are: 1. To implement a scoping

  14. [Procedures and methods of benefit assessments for medicines in Germany].

    Science.gov (United States)

    Bekkering, G E; Kleijnen, J

    2008-12-01

    The Federal Joint Committee (FJC; Gemeinsamer Bundesausschuss, G-BA) defines the health-care elements that are to be reimbursed by sickness funds. To define a directive, the FJC can commission benefit assessments, which provide an overview of the scientific evidence regarding the efficacy and benefits of an intervention. This paper describes the operational implementation of the legal requirements with regard to the benefit assessments of medicines. Such benefit assessments are sometimes referred to as "isolated benefit assessments," to distinguish them from benefit assessments as part of a full economic evaluation. The FJC has the freedom to commission these assessments from any agency; however, to date the majority have commissioned the Institute for Quality and Efficiency in Health Care (IQWiG). Nevertheless, the content of this paper applies integrally to any institute commissioned for such assessments. In this report, "the institute"' is used when the text refers to any of these institutes. The legal framework for benefit assessments is laid out in the German Social Code Book version V (http://www. sozialgesetzbuch.de), Sects. 35b ( section sign 1), 139a ( section sign 4-6) and Sect. 139b ( section sign 3). It is specified that: The institute must guarantee high transparency. The institute must provide appropriate participation of relevant parties for the commission-related development of assessments, and opportunity for comment on all important segments of the assessment procedure. The institute has to report on the progress and results of the work at regular intervals. The institute is held to giving the commission to external experts. Based on the legal framework, the institute must guarantee a high procedural transparency. Transparency of the whole process should be achieved, which is evidenced by clear reporting of procedures and criteria in all phases undertaken in the benefit assessment. The most important means of enhancing transparency are: 1. To

  15. Assessment of Conventional Teaching Procedures: Implications for Gifted Learners

    Directory of Open Access Journals (Sweden)

    Mogbel Aid K Alenizi

    2016-07-01

    Full Text Available The present research aims to assess the conventional teaching procedures in the development of mathematical skills of the students with learning difficulties. The study group was made up of all the children with academic learning disorders in KSA. The research questions have been scrutinized from the averages and the standard deviation of the marks scored by the participants in the test and control group. The outcomes of the study show that the conventional teaching procedures have effects on mathematical skill development of the female pupils with learning disorders. The results of the study show that the test group outperformed the control group. Based on the data and the evidences, various recommendations have been proposed for the stakeholders in the area of teaching the gifted children so as to ascertain better training for them. Keywords: Maths skills, Learning difficulties, Saudi Arabia

  16. Probabilistic assessment of flaw evaluation procedures for pressure vessel integrity

    International Nuclear Information System (INIS)

    Shaffer, D.H.; Bamford, W.H.; Jouris, G.M.

    1980-01-01

    Prudent design procedures, in order to err in the direction of conservative over-strength rather than risky under-strength, have taken bounding values rather than best estimates for material parameters, and wherever possible, used conservative input for the calculations. The growing data base for this work is now beginning to allow an assessment of the conservatism that has been incorporated into the design procedure. Quantitative estimates of the variability associated with crack growth rates and fracture toughness have been generated in connection with other studies, and it would be useful to incorporate such information into an overall assessment of the design margins that are prescribed. In addition to getting an estimate of the conservatism in the current procedure, this study should provide a useful insight into the relative degree of margin that is introduced at each stage of the flaw evaluation process. Identification of the step by step margins should lead to more effective data collection programs from which information for adequately controlling the design conservatism can be obtained. The study will also provide valuable guidance in fixing revised design reference curves and safety factors so that adequate overall margins can be maintained without excess conservatism. This study is limited to vessel rupture in a brittle mode, and examples for illustration are particularly related to the beltline region of a reactor pressure vessel. The methodology, however, is applicable to all regions for which the required stress analyses, operating history, and material parameters are available. The work being carried out here is in consonance with ASME Section XI on Flaw Evaluation Procedures. It is concerned both with flaws under normal operating conditions and flaws under faulted conditions. (author)

  17. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology

    Science.gov (United States)

    Keating, Karen N.; Doll, Helen A.; Camacho, Fabian

    2015-01-01

    Background. Skin toxicity (hand-foot syndrome/hand-foot skin reaction, HFS/R) related to antineoplastic therapy is a significant issue in oncology practice, with potentially large impacts on health-related quality of life (HRQL). Materials and Methods. A patient-reported questionnaire, the hand-foot skin reaction and quality of life (HF-QoL) questionnaire was developed to measure the HFS/R symptoms associated with cancer therapeutic agents and their effect on daily activities. The validity and reliability of the HF-QoL questionnaire was tested in a randomized trial of capecitabine with sorafenib/placebo in 223 patients with locally advanced/metastatic breast cancer. Other measures completed included patient ratings of condition severity, the Functional Assessment of Cancer Therapy-Breast cancer (FACT-B), and the clinician-rated National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, hand-foot skin reaction grade. The psychometric properties of the HF-QoL tested included structural validity, internal consistency, construct validity, discriminant validity, and responsiveness. Finally, the minimal clinically important difference (MCID) was estimated. Results. The HF-QoL instrument comprises a 20-item symptom scale and an 18-item daily activity scale. Each scale demonstrated excellent measurement properties and discriminated between NCI-CTCAE grade and patient-rated condition severity with large effect sizes. The daily activity scale had excellent internal consistency and correlated with the FACT-B and HF-QoL symptom scores. Both HF-QoL scale scores increased linearly with increasing patient-rated condition severity. The MCIDs were estimated as 5 units for daily activities and 8 units for symptoms mean scores. Conclusion. The HF-QoL was sensitive to symptoms and HRQL issues associated with HFS/R among participants treated with capecitabine with and without sorafenib. The HF-QoL appears suitable for assessing the HRQL

  18. Nonspecialist Raters Can Provide Reliable Assessments of Procedural Skills

    DEFF Research Database (Denmark)

    Mahmood, Oria; Dagnæs, Julia; Bube, Sarah

    2018-01-01

    was significant (p Pearson's correlation of 0.77 for the nonspecialists and 0.75 for the specialists. The test-retest reliability showed the biggest difference between the 2 groups, 0.59 and 0.38 for the nonspecialist raters and the specialist raters, respectively (p ... was chosen as it is a simple procedural skill that is crucial to master in a resident urology program. RESULTS: The internal consistency of assessments was high, Cronbach's α = 0.93 and 0.95 for nonspecialist and specialist raters, respectively (p correlations). The interrater reliability...

  19. Clinical assessment of hip strength using a hand-held dynamometer is reliable

    DEFF Research Database (Denmark)

    Thorborg, K; Petersen, J; Magnusson, S P

    2010-01-01

    rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between......Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external...... by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12...

  20. Two hands are better than one: a new assessment method and a new interpretation of the non-visual illusion of self-touch.

    Science.gov (United States)

    White, Rebekah C; Aimola Davies, Anne M; Davies, Martin

    2011-09-01

    A simple experimental paradigm creates the powerful illusion that one is touching one's own hand even when the two hands are separated by 15 cm. The participant uses her right hand to administer stimulation to a prosthetic hand while the Examiner provides identical stimulation to the participant's receptive left hand. Change in felt position of the receptive hand toward the prosthetic hand has previously led to the interpretation that the participant experiences self-touch at the location of the prosthetic hand, and experiences a sense of ownership of the prosthetic hand. Our results argue against this interpretation. We assessed change in felt position of the participant's receptive hand but we also assessed change in felt position of the participant's administering hand. Change in felt position of the administering hand was significantly greater than change in felt position of the receptive hand. Implications for theories of ownership are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Flaw assessment procedure for high temperature reactor components

    International Nuclear Information System (INIS)

    Ainsworth, R.A.; Takahashi, Y.

    1990-01-01

    An interim high-temperature flaw assessment procedure is described. This is a result of a collaborative effort between Electric Power Research Institute in the USA, Central Research Institute of Electric Power Industry in Japan, and Nuclear Electric plc in the UK. The procedure addresses preexisting defects subject to creep-fatigue loading conditions. Laws employed to calculate the crack growth per cycle are defined in terms of fracture mechanics parameters and constants related to the component material. The crack growth laws may be integrated to calculate the remaining life of a component or to predict the amount of crack extension in a given period. Fatigue and creep crack growth per cycle are calculated separately, and the total crack extension is taken as the simple sum of the two contributions. An interaction between the two propagation modes is accounted for in the material properties in the separate calculations. In producing the procedure, limitations of the approach have been identified. Some of these limitations are to be addressed in an extension of the current collaborative program. 20 refs

  2. Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

    Directory of Open Access Journals (Sweden)

    Florian Fischer

    2016-01-01

    Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

  3. Structured Assessment Approach: a procedure for the assessment of fuel cycle safeguard systems

    International Nuclear Information System (INIS)

    Parziale, A.A.; Patenaude, C.J.; Renard, P.A.; Sacks, I.J.

    1980-01-01

    Lawrence Livermore National Laboratory has developed and tested for the United States Nuclear Regulatory Commission a procedure for the evaluation of Material Control and Accounting (MC and A) Systems at Nuclear Fuel Facilities. This procedure, called the Structured Assessment Approach, SAA, subjects the MC and A system at a facility to a series of increasingly sophisticated adversaries and strategies. A fully integrated version of the computer codes which assist the analyst in this assessment was made available in October, 1979. The concepts of the SAA and the results of the assessment of a hypothetical but typical facility are presented

  4. Design of a robotic device for assessment and rehabilitation of hand sensory function.

    Science.gov (United States)

    Lambercy, Olivier; Robles, Alejandro Juárez; Kim, Yeongmi; Gassert, Roger

    2011-01-01

    This paper presents the design and implementation of the Robotic Sensory Trainer, a robotic interface for assessment and therapy of hand sensory function. The device can provide three types of well controlled stimuli: (i) angular displacement at the metacarpophalangeal (MCP) joint using a remote-center-of-motion double-parallelogram structure, (ii) vibration stimuli at the fingertip, proximal phalange and palm, and (iii) pressure at the fingertip, while recording position, interaction force and feedback from the user over a touch screen. These stimuli offer a novel platform to investigate sensory perception in healthy subjects and patients with sensory impairments, with the potential to assess deficits and actively train detection of specific sensory cues in a standardized manner. A preliminary study with eight healthy subjects demonstrates the feasibility of using the Robotic Sensory Trainer to assess the sensory perception threshold in MCP angular position. An average just noticeable difference (JND) in the MCP joint angle of 2.46° (14.47%) was found, which is in agreement with previous perception studies. © 2011 IEEE

  5. Uncovering Procedural Knowledge in Craft, Design, and Technology Education: A Case of Hands-On Activities in Electronics

    Science.gov (United States)

    Pirttimaa, Matti; Husu, Jukka; Metsärinne, Mika

    2017-01-01

    Different knowledge types have their own specific features and tasks in the learning process. Procedural knowledge is used in craft and technology education when students solve problems individually and share their working knowledge with others. This study presents a detailed analysis of a one student's learning process in technology education and…

  6. Development of internal dose assessment procedure for workers in industries using raw materials containing naturally occurring radioactive materials

    International Nuclear Information System (INIS)

    Choi, Cheol Kyu; KIm, Yong Geon; Ji, Seung Woo; Kim, Kwang Pyo; Koo, Bon Cheol; Chang, Byung Uck

    2016-01-01

    It is necessary to assess radiation dose to workers due to inhalation of airborne particulates containing naturally occurring radioactive materials (NORM) to ensure radiological safety required by the Natural Radiation Safety Management Act. The objective of this study is to develop an internal dose assessment procedure for workers at industries using raw materials containing natural radionuclides. The dose assessment procedure was developed based on harmonization, accuracy, and proportionality. The procedure includes determination of dose assessment necessity, preliminary dose estimation, airborne particulate sampling and characterization, and detailed assessment of radiation dose. The developed dose assessment procedure is as follows. Radioactivity concentration criteria to determine dose assessment necessity are 10 Bq·g-1 for 40K and 1 Bq·g-1 for the other natural radionuclides. The preliminary dose estimation is performed using annual limit on intake (ALI). The estimated doses are classified into 3 groups (<0.1 mSv, 0.1-0.3 mSv, and >0.3 mSv). Air sampling methods are determined based on the dose estimates. Detailed dose assessment is performed using air sampling and particulate characterization. The final dose results are classified into 4 different levels (<0.1 mSv, 0.1-0.3 mSv, 0.3-1 mSv, and >1 mSv). Proper radiation protection measures are suggested according to the dose level. The developed dose assessment procedure was applied for NORM industries in Korea, including coal combustion, phosphate processing, and monazite handing facilities. The developed procedure provides consistent dose assessment results and contributes to the establishment of optimization of radiological protection in NORM industries

  7. Development of internal dose assessment procedure for workers in industries using raw materials containing naturally occurring radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Cheol Kyu; KIm, Yong Geon; Ji, Seung Woo; Kim, Kwang Pyo [College of Engineering, Kyung Hee University, Yongin (Korea, Republic of); Koo, Bon Cheol; Chang, Byung Uck [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-09-15

    It is necessary to assess radiation dose to workers due to inhalation of airborne particulates containing naturally occurring radioactive materials (NORM) to ensure radiological safety required by the Natural Radiation Safety Management Act. The objective of this study is to develop an internal dose assessment procedure for workers at industries using raw materials containing natural radionuclides. The dose assessment procedure was developed based on harmonization, accuracy, and proportionality. The procedure includes determination of dose assessment necessity, preliminary dose estimation, airborne particulate sampling and characterization, and detailed assessment of radiation dose. The developed dose assessment procedure is as follows. Radioactivity concentration criteria to determine dose assessment necessity are 10 Bq·g-1 for 40K and 1 Bq·g-1 for the other natural radionuclides. The preliminary dose estimation is performed using annual limit on intake (ALI). The estimated doses are classified into 3 groups (<0.1 mSv, 0.1-0.3 mSv, and >0.3 mSv). Air sampling methods are determined based on the dose estimates. Detailed dose assessment is performed using air sampling and particulate characterization. The final dose results are classified into 4 different levels (<0.1 mSv, 0.1-0.3 mSv, 0.3-1 mSv, and >1 mSv). Proper radiation protection measures are suggested according to the dose level. The developed dose assessment procedure was applied for NORM industries in Korea, including coal combustion, phosphate processing, and monazite handing facilities. The developed procedure provides consistent dose assessment results and contributes to the establishment of optimization of radiological protection in NORM industries.

  8. Measuring the validation of assessing the non-dominant-hand function by ALSFRS-r in Chinese ALS patients.

    Science.gov (United States)

    Hu, Fangfang; Jin, Jiaoting; Jia, Rui; Xiang, Li; Qi, Huaguang; Zhao, Xing; Dang, Jingxia

    2017-12-01

    ALSFRS-r is a widely accepted rating scale for measuring the global function of Amyotrophic Lateral Sclerosis (ALS) patients, but we found some limitations of ALSFRS-r in assessing the function of non-dominant hand in Chinese ALS patients. We reviewed 95 ALS patients who expressed upper-limb symptoms at first visit and analyzed the ALSFRS-r score and subscale. In both upper limb involved patients, the ALSFRS-r had no difference between dominant-hand and non-dominant-hand onset groups (39.15±5.55 vs 38.0±5.91, p=0.477). But in only one upper limb involved patients, the ALSFRS-r score in non-dominant-hand onset patients was higher than dominant-hand onset patients (43.94±3.44 vs 40.87±4.42, pr score was significantly lower than original ALSFRS-r (43.94±3.44 vs 42.88±3.07 p=0.001), the progression rate was slower (0.81±0.63 vs 0.64±0.63, p=0.001). So, for Chinese ALS patients, using food bowl and chopsticks should replace the item of cutting food and handling utensils to assess the non-dominant-hand function, especially in non-dominant-hand onset patients. Copyright © 2017. Published by Elsevier Ltd.

  9. Noise-induced hearing loss in construction workers being assessed for hand-arm vibration syndrome.

    Science.gov (United States)

    House, Ronald A; Sauvé, John T; Jiang, Depeng

    2010-01-01

    Construction workers are at risk of noise-induced hearing loss (NIHL) but often have no periodic audiometric testing. The participants were construction workers assessed for Hand-Arm Vibration Syndrome (HAVS) at the Occupational Health Clinic, St. Michael's Hospital, Toronto, Ontario. Audiometry was offered and 169 of the 191 workers assessed for HAVS agreed to have the audiometric test. The objective was to examine the prevalence of hearing loss in these 169 workers and to determine the effect on hearing of duration of work in construction (as a proxy for noise exposure) and the severity of vibration white finger (VWF) which previous studies have suggested is a marker for increased individual susceptibility for NIHL. VWF was measured by the Stockholm vascular scale. All participants were men, median age of 57 (range: 28-75), median number of years worked in construction of 35 (range: 4-52). All of the Spearman rank correlations between years worked in construction and the hearing levels at each audiometric frequency were statistically significant (p hearing loss at or above the level at which a workers' compensation pension would be granted in Ontario and the prevalence of this auditory outcome had a statistically significant increase as years worked in construction increased. Multivariate linear regression indicated that VWF also had a statistically significant effect on hearing loss for all audiometric frequencies combined after controlling for years worked in construction. Improved prevention of hearing loss in construction workers is needed.

  10. Assessment of workers' exposure to hand-arm and whole body vibration in one of the furniture industries in east of Tehran

    Directory of Open Access Journals (Sweden)

    Ramazan Mirzaei

    2015-01-01

    Full Text Available Workers in wood industry are exposed to vibration and its damages. The purpose of this study was to evaluate exposure to hand-arm and whole body vibration in the wood industry. In this study, the parameters of whole body and hand-arm vibrations such as effective acceleration, overall equivalent acceleration, Vibration Dose Value and crest factor were studied on two Thicknessing planes, two sliding panel saw machines, two orbital sander, and three operators of perforate procedure. Assessments were done by the use of an oscillator and an analyzer of Svantak Co. Evaluating Hand-arm and whole body vibrations were conducted based on ISO 5349-1, ISO 5349-2 and ISO 2631-1 standards, respectively, and the findings/ the evaluated data were analyzed. The mean amount of daily exposure to hand-arm vibration (RMS in Thicknessing plane, Orbital Sander and Sliding panel saw machine operators are respectively 5.56, 5.49 and 3.37 m/s2 . In addition, the average crest factor of the 3 jobs is higher than 6. Mean of daily Exposure to whole body vibration in 3 machine operators of Thicknessing plane, perforate procedure and Sliding panel saw is respectively, 0.28, 0.24 and 0.17 meters per square second. The crest factor for all the exposures was to be less than 6 and the mean of the calculated daily vibration dose equaled 5.83 with the standard deviation of 0.87( m⁄s^1.75 . In further measured situations, exposure to hand-arm vibration is more than the standard level, so engineering and management measures are required to reduce the amount of exposure and support the health of the operators and the equipment.

  11. The Vienna psychosocial assessment procedure for bionic reconstruction in patients with global brachial plexus injuries.

    Directory of Open Access Journals (Sweden)

    Laura Antonia Hruby

    Full Text Available Global brachial plexopathies cause major sensory and motor deficits in the affected arm and hand. Many patients report of psychosocial consequences including chronic pain, decreased self-sufficiency, and poor body image. Bionic reconstruction, which includes the amputation and prosthetic replacement of the functionless limb, has been shown to restore hand function in patients where classic reconstructions have failed. Patient selection and psychological evaluation before such a life-changing procedure are crucial for optimal functional outcomes. In this paper we describe a psychosocial assessment procedure for bionic reconstruction in patients with complete brachial plexopathies and present psychosocial outcome variables associated with bionic reconstruction.Between 2013 and 2017 psychosocial assessments were performed in eight patients with global brachial plexopathies. We conducted semi-structured interviews exploring the psychosocial adjustment related to the accident, the overall psychosocial status, as well as motivational aspects related to an anticipated amputation and expectations of functional prosthetic outcome. During the interview patients were asked to respond freely. Their answers were transcribed verbatim by the interviewer and analyzed afterwards on the basis of a pre-defined item scoring system. The interview was augmented by quantitative evaluation of self-reported mental health and social functioning (SF-36 Health Survey, body image (FKB-20 and deafferentation pain (VAS. Additionally, psychosocial outcome variables were presented for seven patients before and after bionic reconstruction.Qualitative data revealed several psychological stressors with long-term negative effects on patients with complete brachial plexopathies. 88% of patients felt functionally limited to a great extent due to their disability, and all of them reported constant, debilitating pain in the deafferented hand. After bionic reconstruction the physical

  12. The Vienna psychosocial assessment procedure for bionic reconstruction in patients with global brachial plexus injuries.

    Science.gov (United States)

    Hruby, Laura Antonia; Pittermann, Anna; Sturma, Agnes; Aszmann, Oskar Christian

    2018-01-01

    Global brachial plexopathies cause major sensory and motor deficits in the affected arm and hand. Many patients report of psychosocial consequences including chronic pain, decreased self-sufficiency, and poor body image. Bionic reconstruction, which includes the amputation and prosthetic replacement of the functionless limb, has been shown to restore hand function in patients where classic reconstructions have failed. Patient selection and psychological evaluation before such a life-changing procedure are crucial for optimal functional outcomes. In this paper we describe a psychosocial assessment procedure for bionic reconstruction in patients with complete brachial plexopathies and present psychosocial outcome variables associated with bionic reconstruction. Between 2013 and 2017 psychosocial assessments were performed in eight patients with global brachial plexopathies. We conducted semi-structured interviews exploring the psychosocial adjustment related to the accident, the overall psychosocial status, as well as motivational aspects related to an anticipated amputation and expectations of functional prosthetic outcome. During the interview patients were asked to respond freely. Their answers were transcribed verbatim by the interviewer and analyzed afterwards on the basis of a pre-defined item scoring system. The interview was augmented by quantitative evaluation of self-reported mental health and social functioning (SF-36 Health Survey), body image (FKB-20) and deafferentation pain (VAS). Additionally, psychosocial outcome variables were presented for seven patients before and after bionic reconstruction. Qualitative data revealed several psychological stressors with long-term negative effects on patients with complete brachial plexopathies. 88% of patients felt functionally limited to a great extent due to their disability, and all of them reported constant, debilitating pain in the deafferented hand. After bionic reconstruction the physical component summary

  13. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology

    OpenAIRE

    Anderson, Roger T.; Keating, Karen N.; Doll, Helen A.; Camacho, Fabian

    2015-01-01

    This study describes the development and validation of a brief, patient self-reported questionnaire (the hand-foot skin reaction and quality of life questionnaire) supporting its suitability for use in clinical research to aid in early recognition of symptoms, to evaluate the effectiveness of agents for hand-foot skin reaction (HFSR) or hand-foot syndrome (HFS) treatment within clinical trials, and to evaluate the impact of these treatments on HFS/R-associated patients’ health-related quality...

  14. Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

    Directory of Open Access Journals (Sweden)

    Bianca Pinto Cunha

    Full Text Available Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax, maximal pinch grip strength (PGSMax, Jebsen-Taylor Hand Function Test (JTHFT and Nine Hole Peg Test (9-HPT. All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50 and between JTHFT and 9-HPT (r = 0.55. Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

  15. Assessment of hand hygiene techniques using the World Health Organization's six steps.

    Science.gov (United States)

    Arias, Ariadna V; Garcell, Humberto G; Ochoa, Yagdeline R; Arias, Katiana F; Miranda, Fernando R

    2016-01-01

    The quality of hand hygiene was evaluated via direct observation for compliance with the six recommended World Health Organization steps. A total of 2497 HH opportunities, of which 1573 (63.0%) were hand rubs, were monitored over a five month period. Compliance was higher in nurses compared with physicians and auxiliaries and in steps 1 and 2 for hand rubs as well as the first three steps of hand washing, with lower rates after these steps. Rubbing of the thumbs and fingertips achieved the lowest rates of compliance in both HH types. A combination of the five recommended moments and six steps and staff education is recommended to improve the quality of hand hygiene. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  16. Assessment of transpulmonary absorption of ethanol from alcohol-based hand rub.

    Science.gov (United States)

    Hautemanière, Alexis; Ahmed-Lecheheb, Djihane; Cunat, Lisiane; Hartemann, Philippe

    2013-03-01

    Alcohol-based hand rubs (ABHRs) have been associated with a reduction of nosocomial infections. Despite the worldwide introduction of these products in health care settings, the aim of this study was to assess the transpulmonary absorption of ethanol contains in ABHRs used by health care workers (HCWs) in real conditions of work shift. Twenty-six HCWs of Nancy University Hospital were included. Research consisted in monitoring participants during 4 hours of work shift to assess their exposure to ethanol. The measurement of ethanol vapors in exhaled breath was performed using a class B ethylometer (Alco-Sensor FST). Ethanol concentration in inhaled breath was measured using Gilian pump LFS-113. Concentration of ethanol, acetaldehyde, and acetate in blood and urine samples were determined using gas chromatography with flame ionization detector. Participants were 12% male and 88% female. The mean age was 40 ± 8 years. None of the employees included in the study presented any traces of ethanol or its metabolites in the blood or urine. Ethanol (0.08 ± 0.07 mg/L) was detected in the breath of 10 HCWs at 1 to 2 minutes postexposure. The mean concentration of ethanol in the inhaled air was 46.2 mg/m. Absorption of ethanol vapor from ABHRs among HCWs during their care activities was not detected. Quantification of ethanol fumes inhaled during 4 hours of work shift was below the regulatory limitations of exposure to ethanol. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  17. Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

    Science.gov (United States)

    Elhoseeny, Taghareed A; Mourad, Juidan K

    2014-08-01

    The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to

  18. Procedure for conducting probabilistic safety assessment: level 1 full power internal event analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Dae; Lee, Y. H.; Hwang, M. J. [and others

    2003-07-01

    This report provides guidance on conducting a Level I PSA for internal events in NPPs, which is based on the method and procedure that was used in the PSA for the design of Korea Standard Nuclear Plants (KSNPs). Level I PSA is to delineate the accident sequences leading to core damage and to estimate their frequencies. It has been directly used for assessing and modifying the system safety and reliability as a key and base part of PSA. Also, Level I PSA provides insights into design weakness and into ways of preventing core damage, which in most cases is the precursor to accidents leading to major accidents. So Level I PSA has been used as the essential technical bases for risk-informed application in NPPs. The report consists six major procedural steps for Level I PSA; familiarization of plant, initiating event analysis, event tree analysis, system fault tree analysis, reliability data analysis, and accident sequence quantification. The report is intended to assist technical persons performing Level I PSA for NPPs. A particular aim is to promote a standardized framework, terminology and form of documentation for PSAs. On the other hand, this report would be useful for the managers or regulatory persons related to risk-informed regulation, and also for conducting PSA for other industries.

  19. Validity, reliability and support for implementation of independence-scaled procedural assessment in laparoscopic surgery.

    Science.gov (United States)

    Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

    2016-06-01

    There is no widely used method to evaluate procedure-specific laparoscopic skills. The first aim of this study was to develop a procedure-based assessment method. The second aim was to compare its validity, reliability and feasibility with currently available global rating scales (GRSs). An independence-scaled procedural assessment was created by linking the procedural key steps of the laparoscopic cholecystectomy to an independence scale. Subtitled and blinded videos of a novice, an intermediate and an almost competent trainee, were evaluated with GRSs (OSATS and GOALS) and the independence-scaled procedural assessment by seven surgeons, three senior trainees and six scrub nurses. Participants received a short introduction to the GRSs and independence-scaled procedural assessment before assessment. The validity was estimated with the Friedman and Wilcoxon test and the reliability with the intra-class correlation coefficient (ICC). A questionnaire was used to evaluate user opinion. Independence-scaled procedural assessment and GRS scores improved significantly with surgical experience (OSATS p = 0.001, GOALS p < 0.001, independence-scaled procedural assessment p < 0.001). The ICCs of the OSATS, GOALS and independence-scaled procedural assessment were 0.78, 0.74 and 0.84, respectively, among surgeons. The ICCs increased when the ratings of scrub nurses were added to those of the surgeons. The independence-scaled procedural assessment was not considered more of an administrative burden than the GRSs (p = 0.692). A procedural assessment created by combining procedural key steps to an independence scale is a valid, reliable and acceptable assessment instrument in surgery. In contrast to the GRSs, the reliability of the independence-scaled procedural assessment exceeded the threshold of 0.8, indicating that it can also be used for summative assessment. It furthermore seems that scrub nurses can assess the operative competence of surgical trainees.

  20. Assessment of the Quality of Water from Hand-Dug Wells in Ghana

    Directory of Open Access Journals (Sweden)

    Marian Asantewah Nkansah

    2010-01-01

    Full Text Available This study focused upon the determination of physicochemical and microbial properties, including metals, selected anions and coliform bacteria in drinking water samples from hand-dug wells in the Kumasi metropolis of the Republic of Ghana. The purpose was to assess the quality of water from these sources. Ten different water samples were taken from different parts of Kumasi, the capital of the Ashanti region of Ghana and analyzed for physicochemical parameters including pH, electrical conductivity, total dissolved solids, alkalinity total hardness and coliform bacteria. Metals and anions analyzed were Ca, Mg, Fe, Mn, NO 3 – , NO 2 – , SO 4 2- , PO 4 2- , F – and Cl – . Bacteria analysed were total coliform and Escherichia coli. The data showed variation of the investigated parameters in samples as follows: pH, 6.30-0.70; conductivity (EC, 46-682 μS/cm; PO 4 3- , 0.67-76.00 mg/L; F – , 0.20-0.80 mg/L; NO 3 – , 0-0.968 mg/L; NO 2 – , 0-0.063 mg/L; SO 4 2- , 3.0-07.0 mg/L; Fe, 0-1.2 mg/L; Mn, 0-0.018 mg/L. Total coliform and Escherichia coli were below the minimum detection limit (MDL of 20 MPN per 100 ml in all the samples. The concentrations of most of the investigated parameters in the drinking water samples from Ashanti region were within the permissible limits of the World Health Organization drinking water quality guidelines.

  1. Assessment of the bacterial contamination of hand air dryer in washrooms

    OpenAIRE

    Alharbi, Sulaiman Ali; Salmen, Saleh Hussein; Chinnathambi, Arunachalam; Alharbi, Naiyf S.; Zayed, M.E.; Al-Johny, Bassam O.; Wainwright, Milton

    2016-01-01

    The present study was carried out, using standard techniques, to identify and count the bacterial contamination of hand air dryers, used in washrooms. Bacteria were isolated from the air flow, outlet nozzle of warm air dryers in fifteen air dryers used in these washrooms. Bacteria were found to be relatively numerous in the air flows. Bacterially contaminated air was found to be emitted whenever a warm air dryer was running, even when not being used for hand drying. Our investigation shows th...

  2. Assessing the gaming experience of an applied game for rehabilitation of the arm and hand function : A feasibility study

    NARCIS (Netherlands)

    Kottink, Anke I.R.; Prange-Lasonder, Gerdienke B.; Rietman, Johan S.; Buurke, Jaap H.; Ibánez, Jaíme; González-Vargas, José; Azorín, José María; Akay, Metin; Pons, José Luis

    2017-01-01

    The present pilot study assessed the feasibility, in terms of gaming experience, of using a first prototype of a self-developed mixed-reality system for rehabilitation of the arm and hand function. Results showed that the hybrid game approach is well accepted by Cerebral Palsy children and adults

  3. Using the Hand Laterality Judgement Task to assess motor imagery : a study of practice effects in repeated measurements

    NARCIS (Netherlands)

    Boonstra, Anne M.; de Vries, Sjoerd J.; Veenstra, Evelien; Tepper, Marga; Feenstra, Wya; Otten, Egbert

    The aim of this study was to determine whether there is a practice effect on the Hand Laterality Judgement Task (HLJT). The HLJT task is a mental rotation task that can be used to assess motor imagery ability in stroke patients. Thirty-three healthy individuals performed the HLJT and two control

  4. Using the Hand Laterality Judgement Task to Assess Motor Imagery: A Study of Practice Effects in Repeated Measurements

    Science.gov (United States)

    Boonstra, Anne M.; de Vries, Sjoerd J.; Veenstra, Evelien; Tepper, Marga; Feenstra, Wya; Otten, Egbert

    2012-01-01

    The aim of this study was to determine whether there is a practice effect on the Hand Laterality Judgement Task (HLJT). The HLJT task is a mental rotation task that can be used to assess motor imagery ability in stroke patients. Thirty-three healthy individuals performed the HLJT and two control tasks twice at a 3-week interval. Differences in the…

  5. Assessment of Food Safety Knowledge, Attitude, Self-Reported Practices, and Microbiological Hand Hygiene of Food Handlers

    Science.gov (United States)

    Lee, Hui Key; Abdul Halim, Hishamuddin; Thong, Kwai Lin; Chai, Lay Ching

    2017-01-01

    Institutional foodborne illness outbreaks continue to hit the headlines in the country, indicating the failure of food handlers to adhere to safe practices during food preparation. Thus, this study aimed to compare the knowledge, attitude, and self-reported practices (KAP) of food safety assessment and microbiological assessment of food handlers’ hands as an indicator of hygiene practices in food premises. This study involved 85 food handlers working in a university located in Kuala Lumpur, Malaysia. The food safety KAP among food handlers (n = 67) was assessed using a questionnaire; while the hand swabs (n = 85) were tested for the total aerobic count, coliforms, and Escherichia coli, Staphylococcus aureus, Salmonella, Vibrio cholerae and Vibrio parahaemolyticus. The food handlers had moderate levels of food safety knowledge (61.7%) with good attitude (51.9/60) and self-reported practices (53.2/60). It is noteworthy that the good self-reported practices were not reflected in the microbiological assessment of food handlers’ hands, in which 65% of the food handlers examined had a total aerobic count ≥20 CFU/cm2 and Salmonella was detected on 48% of the food handlers’ hands. In conclusion, the suggestion of this study was that the food handlers had adequate food safety knowledge, but perceived knowledge failed to be translated into practices at work.

  6. Assessment of Food Safety Knowledge, Attitude, Self-Reported Practices, and Microbiological Hand Hygiene of Food Handlers

    Directory of Open Access Journals (Sweden)

    Hui Key Lee

    2017-01-01

    Full Text Available Institutional foodborne illness outbreaks continue to hit the headlines in the country, indicating the failure of food handlers to adhere to safe practices during food preparation. Thus, this study aimed to compare the knowledge, attitude, and self-reported practices (KAP of food safety assessment and microbiological assessment of food handlers’ hands as an indicator of hygiene practices in food premises. This study involved 85 food handlers working in a university located in Kuala Lumpur, Malaysia. The food safety KAP among food handlers (n = 67 was assessed using a questionnaire; while the hand swabs (n = 85 were tested for the total aerobic count, coliforms, and Escherichia coli, Staphylococcus aureus, Salmonella, Vibrio cholerae and Vibrio parahaemolyticus. The food handlers had moderate levels of food safety knowledge (61.7% with good attitude (51.9/60 and self-reported practices (53.2/60. It is noteworthy that the good self-reported practices were not reflected in the microbiological assessment of food handlers’ hands, in which 65% of the food handlers examined had a total aerobic count ≥20 CFU/cm2 and Salmonella was detected on 48% of the food handlers’ hands. In conclusion, the suggestion of this study was that the food handlers had adequate food safety knowledge, but perceived knowledge failed to be translated into practices at work.

  7. Weld Design, Testing, and Assessment Procedures for High Strength Pipelines

    Science.gov (United States)

    2011-12-20

    Long-distance high-strength pipelines are increasingly being constructed for the efficient transportation of energy products. While the high-strength linepipe steels and high productivity welding processes are being applied, the procedures employed f...

  8. Qualitative Evaluation of Digital Hand X-rays is Not a Reliable Method to Assess Bone Mineral Density

    Directory of Open Access Journals (Sweden)

    AndrewJ. Miller

    2017-01-01

    Full Text Available Object: The gold standard for evaluating bone mineral density is dual energy x-ray absorptiometry (DEXA.  Prior studies have shown poor reliability using analog wrist X-rays in diagnosing osteoporosis. Our goal was to investigate if there was improved diagnostic value to visual assessment of digital hand X-rays in osteoporosis screening. We hypothesized that similar to analog counterparts, digital hand X-rays have poor correlation and reliability in determining bone mineral density (BMD relative to DEXA.Methods: We prospectively evaluated female patients older than 65 years who presented to our hand clinic with digital hand and wrist X-rays as part of their evaluation over six months. Patients who had a fracture and were without DEXA scans within the past two years were excluded. Five fellowship-trained hand surgeons, blinded to DEXA T-scores, evaluated the x-rays over two assessments separated by four weeks and classified them as osteoporotic, osteopenic, or normal BMD.  Accuracy relative to DEXA T-score, interobserver and intraobserver rates were calculated.Results: Thirty four patients met the inclusion criteria and a total of 340 x-rays reviews were performed.  The assessments were correct in 169 cases (49% as compared to the DEXA T-scores. A mean weighted kappa coefficient of agreement between observers was 0.29 (range 0.02-0.41 reflecting a fair agreement. The first and second assessment for all five physicians was 0.46 (range 0.19-0.78 reflecting a moderate agreement.  Grouping osteoporosis and osteopenia together compared to normal, the accuracy, interobserver and intraobserver rates increased to 63%, 0.42 and 0.54 respectively.Conclusion: Abnormally low BMD is a common occurrence in patients treated for upper extremity disorders. There is poor accuracy relative to DEXA scan and only fair agreement in diagnosing osteoporosis using visual assessments of digital x-rays.

  9. Assessment of patients' skin dose during interventional cardiology procedures

    International Nuclear Information System (INIS)

    Tsapaki, V.; Vardalaki, E.; Kottou, S.; Molfetas, M.; Neofotistou, V.

    2002-01-01

    During the last 30 years the use of Interventional Cardiology (IC) procedures has increased significantly, mainly due to the benefits and advantages of the method that offers more accurate diagnosis and treatment along with less complications and hospitalization. However, IC procedures are based on the use of x-ray radiation, mostly localized at certain areas of patient's body and for extended periods of time. Consequently, patient may receive high radiation dose and deterministic effects, such as erythema, epilation or even dermal necrosis may be observed. Therefore, the need for reducing radiation dose is highly important. In order to achieve this, good knowledge of the dose levels delivered to the patient during IC procedures is essential since radiation effects are known to increase with dose. It is of great interest to know the point where the maximum skin dose (MSD) is noted since individual sensitivity may vary. MSDs greater than 1 Gy should be recorded. Patient dosimetry during IC procedures is a complex task since these type of procedures depend on various factors, such as complexity and severity of case, different specifications of x-ray equipment and patient's physical characteristics. Moreover, cardiologist's experience plays an important role. For these reasons, Food and Drug Administration (FDA), the International Commission on Radiological Protection (ICRP) as well as the World Health Organization (WHO), have published documents on radiation safety and ways to reduce skin injuries during IC procedures. Various methods have been proposed for measuring MSD such as the use of slow radiotherapy films, thermoluminescent detectors (TLD), scintillation detectors, Dose-Area Product (DAP) meter, as well as a combination of DAP and air kerma. A literature review on MSDs measured during IC procedures showed that doses ranged from 300 to 43000 mGy

  10. Preliminary evaluation of SensHand V1 in assessing motor skills performance in Parkinson disease.

    Science.gov (United States)

    Cavallo, Filippo; Esposito, Dario; Rovini, Erika; Aquilano, Michela; Carrozza, Maria Chiara; Dario, Paolo; Maremmani, Carlo; Bongioanni, Paolo

    2013-06-01

    Nowadays, the increasing old population 65+ as well as the pace imposed by work activities lead to a high number of people that have particular injuries for limbs. In addition to persistent or temporary disabilities related to accidental injuries we must take into account that part of the population suffers from motor deficits of the hands due to stroke or diseases of various clinical nature. The most recurrent technological solutions to measure the rehabilitation or skill motor performance of the hand are glove-based devices, able to faithfully capture the movements of the hand and fingers. This paper presents a system for hand motion analysis based on 9-axis complete inertial modules and dedicated microcontroller which are fixed on fingers and forearm. The technological solution presented is able to track the patients' hand motions in real-time and then to send data through wireless communication reducing the clutter and the disadvantages of a glove equipped with sensors through a different technological structure. The device proposed has been tested in the study of Parkinson's disease.

  11. X-ray findings in the skeleton of the hand to prove renal osteopathy. Soft ray immersions radiography versus standard procedures

    International Nuclear Information System (INIS)

    Pollack, T.; Friedberg, R.; Heinicke, H.J.

    1994-01-01

    In examinations of the hand skeleton, findings typical of renal osteopathy are much more readily revealed by soft ray immersions radiography than by images obtained using conventional techniques. In combination with microradioscopy the method is highly suitable for the primary diagnosis and follow-up of renal osteopathy. The information provided eliminates the need for examinations of other skeletal sections and thus justifies the slightly increased dose requirements. The fact that unchanged parathormone can be determined simultaneously adds to the sensitivity of this non-invasive technique. Histological assessments of the skeleton can, however, not always be avoided. (orig.) [de

  12. Improved reliability in skeletal age assessment using a pediatric hand MR scanner with a 0.3T permanent magnet.

    Science.gov (United States)

    Terada, Yasuhiko; Kono, Saki; Uchiumi, Tomomi; Kose, Katsumi; Miyagi, Ryo; Yamabe, Eiko; Fujinaga, Yasunari; Yoshioka, Hiroshi

    2014-01-01

    The purpose of this study was to improve the reliability and validity of skeletal age assessment using an open and compact pediatric hand magnetic resonance (MR) imaging scanner. We used such a scanner with 0.3-tesla permanent magnet to image the left hands of 88 healthy children (aged 3.4 to 15.7 years, mean 8.8 years), and 3 raters (2 orthopedic specialists and a radiologist) assessed skeletal age using those images. We measured the strength of agreement in ratings by values of weighted Cohen's κ and the proportion of cases excluded from rating because of motion artifact and inappropriate positioning. We compared the current results with those of a previous study in which 93 healthy children (aged 4.1 to 16.4 years, mean 9.7 years) were examined with an adult hand scanner. The κ values between raters exceeded 0.80, which indicates almost perfect agreement, and most were higher than those of the previous study. The proportion of cases excluded from rating because of motion artifact or inappropriate positioning was also reduced. The results indicate that use of the compact pediatric hand scanner improved the reliability and validity of skeletal age assessments.

  13. Quantitative Assessment of the Arm/Hand Movements in Parkinson’s Disease Using a Wireless Armband Device

    Directory of Open Access Journals (Sweden)

    Sofija Spasojević

    2017-08-01

    Full Text Available We present an approach for quantitative assessment of the arm/hand movements in patients with Parkinson’s disease (PD, from sensor data acquired with a wearable, wireless armband device (Myo sensor. We propose new Movement Performance Indicators that can be adopted by practitioners for the quantitative evaluation of motor performance and support their clinical evaluations. In addition, specific Movement Performance Indicators can indicate the presence of the bradykinesia symptom. The study includes seventeen PD patients and sixteen age-matched controls. A set of representative arm/hand movements is defined under the supervision of movement disorder specialist. In order to assist the evaluations, and for progress monitoring purposes, as well as for assessing the amount of bradykinesia in PD, a total set of 84 Movement Performance Indicators are computed from the sensor readings. Subsequently, we investigate whether wireless armband device, with the use of the proposed Movement Performance Indicators can be utilized: (1 for objective and precise quantitative evaluation of the arm/hand movements of Parkinson’s patients, (2 for assessment of the bradykinesia motor symptom, and (3 as an adequate low-cost alternative for the sensor glove. We conducted extensive analysis of proposed Movement Performance Indicators and results are indicating following clinically relevant characteristics: (i adequate reliability as measured by ICC; (ii high accuracy in discrimination between the patients and controls, and between the disease stages (support to disease diagnosis and progress monitoring, respectively; (iii substantial difference in comparison between the left-hand and the right-hand movements across controls and patients, as well as between disease stage groups; (iv statistically significant correlation with clinical scales (tapping test and UPDRS-III Motor Score; and (v quantitative evaluation of bradykinesia symptom. Results suggest that the proposed

  14. Development of a new assessment tool for cervical myelopathy using hand-tracking sensor: Part 1: validity and reliability.

    Science.gov (United States)

    Alagha, M Abdulhadi; Alagha, Mahmoud A; Dunstan, Eleanor; Sperwer, Olaf; Timmins, Kate A; Boszczyk, Bronek M

    2017-04-01

    To assess the reliability and validity of a hand motion sensor, Leap Motion Controller (LMC), in the 15-s hand grip-and-release test, as compared against human inspection of an external digital camera recording. Fifty healthy participants were asked to fully grip-and-release their dominant hand as rapidly as possible for two trials with a 10-min rest in-between, while wearing a non-metal wrist splint. Each test lasted for 15 s, and a digital camera was used to film the anterolateral side of the hand on the first test. Three assessors counted the frequency of grip-and-release (G-R) cycles independently and in a blinded fashion. The average mean of the three was compared with that measured by LMC using the Bland-Altman method. Test-retest reliability was examined by comparing the two 15-s tests. The mean number of G-R cycles recorded was: 47.8 ± 6.4 (test 1, video observer); 47.7 ± 6.5 (test 1, LMC); and 50.2 ± 6.5 (test 2, LMC). Bland-Altman indicated good agreement, with a low bias (0.15 cycles) and narrow limits of agreement. The ICC showed high inter-rater agreement and the coefficient of repeatability for the number of cycles was ±5.393, with a mean bias of 3.63. LMC appears to be valid and reliable in the 15-s grip-and-release test. This serves as a first step towards the development of an objective myelopathy assessment device and platform for the assessment of neuromotor hand function in general. Further assessment in a clinical setting and to gauge healthy benchmark values is warranted.

  15. A method of assessing the efficacy of hand sanitizers: use of real soil encountered in the food service industry.

    Science.gov (United States)

    Charbonneau, D L; Ponte, J M; Kochanowski, B A

    2000-04-01

    In many outbreaks of foodborne illness, the food worker has been implicated as the source of the infection. To decrease the likelihood of cross-contamination, food workers must clean and disinfect their hands frequently. To ensure their effectiveness, hand disinfectants should be tested using rigorous conditions that mimic normal use. Currently, several different methods are used to assess the efficacy of hand disinfectants. However, most of these methods were designed with the health care worker in mind and do not model the specific contamination situations encountered by the food worker. To fill this void, we developed a model that uses soil from fresh meat and a means of quantifying bacteria that is encountered and transferred during food preparation activities. Results of studies using various doses of para-chloro-meta-xylenol and triclosan confirm that the method is reproducible and predictable in measuring the efficacy of sanitizers. Consistent, dose-dependent results were obtained with relatively few subjects. Other studies showed that washing hands with a mild soap and water for 20 s was more effective than applying a 70% alcohol hand sanitizer.

  16. Cognitive Styles in Admission Procedures for Assessing Candidates of Architecture

    Science.gov (United States)

    Casakin, Hernan; Gigi, Ariela

    2016-01-01

    Cognitive style has a strong predictive power in academic and professional success. This study investigated the cognitive profile of candidates studying architecture. Specifically, it explored the relation between visual and verbal cognitive styles, and the performance of candidates in admission procedures. The cognitive styles of candidates who…

  17. Assessment of the bacterial contamination of hand air dryer in washrooms.

    Science.gov (United States)

    Alharbi, Sulaiman Ali; Salmen, Saleh Hussein; Chinnathambi, Arunachalam; Alharbi, Naiyf S; Zayed, M E; Al-Johny, Bassam O; Wainwright, Milton

    2016-03-01

    The present study was carried out, using standard techniques, to identify and count the bacterial contamination of hand air dryers, used in washrooms. Bacteria were isolated from the air flow, outlet nozzle of warm air dryers in fifteen air dryers used in these washrooms. Bacteria were found to be relatively numerous in the air flows. Bacterially contaminated air was found to be emitted whenever a warm air dryer was running, even when not being used for hand drying. Our investigation shows that Staphylococcus haemolyticus, Micrococcus luteus, Pseudomonas alcaligenes, Bacillus cereus and Brevundimonad diminuta/vesicularis were emitted from all of the dryers sampled, with 95% showing evidence of the presence of the potential pathogen S. haemolyticus. It is concluded that hot air dryers can deposit pathogenic bacteria onto the hands and body of users. Bacteria are distributed into the general environment whenever dryers are running and could be inhaled by users and none-users alike. The results provide an evidence base for the development and enhancement of hygienic hand drying practices.

  18. Comparative evaluation between cervical vertebral morphology and hand-wrist morphology for skeletal maturation assessment.

    Science.gov (United States)

    Grippaudo, C; Garcovich, D; Volpe, G; Lajolo, C

    2006-05-01

    The aim of the study was to find a correlation between the evaluation of skeletal maturation performed by the study of cervical vertebrae maturation indicators and the evaluation obtained by the hand and wrist maturation indicators. Left hand wrist radiographs and the corresponding lateral cephalograms of 90 patients (48 males and 42 females; aged 6 to 14 years) were paired and a study group of 128 pair of radiographs was obtained, having some patients 2 or more radiographs at different times. Hand and wrist radiographs were evaluated according to the protocol proposed by Grave (scores 0 to 9); corresponding lateral cephalograms were evaluated according to the method reported by Baccetti (scores 1 to 5). Values obtained with the 2 methods were analyzed by Spearman's correlation test. When the values were compared globally in the 2 genders a good correlation was obtained (r=0.795; Pmaturation evaluation by the analysis of cervical vertebrae in laterolateral cephalograms which can substitute the hand and wrist radiograph for the skeletal maturation evaluation in orthodontic diagnosis.

  19. Construct validation of teacher portfolio assessment : Procedures for improving teacher competence assessment illustrated by teaching students research skills

    NARCIS (Netherlands)

    Schaaf, M.F. van der

    2005-01-01

    The study aims to design and test procedures for teacher portfolio assessments. What are suitable procedures to assess teachers' competencies in developing students' research skills? We first searched into the tasks teachers have in teaching students research skills and the competencies needed to

  20. Patient dose assessment in different diagnostic procedures in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sena, E de; Bejar, M J; Berenguer, R [Servicio de Radiofisica y Proteccion Radiologica, Salamanca (Spain); Ruano, R; Tamayo, P [Servicio de Medicina Nuclear, Hospital Universitario de Salamanca (Spain)

    2001-03-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  1. Patient dose assessment in different diagnostic procedures in nuclear medicine

    International Nuclear Information System (INIS)

    Sena, E. de; Bejar, M.J.; Berenguer, R.; Ruano, R.; Tamayo, P.

    2001-01-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  2. Evaluating strategic environmental assessment in the Netherlands: Content, process and procedure as indissoluble criteria for effectiveness

    NARCIS (Netherlands)

    M.W. van Buuren (Arwin); S.G. Nooteboom (Sibout)

    2009-01-01

    textabstractTo assess the effectiveness of strategic environmental assessment (SEA) we distinguish between its contribution to the quality of the ultimate policy choice (usefulness, applicability), the procedural quality of the planning process (transparency, timeliness) and the quality of

  3. Assessment of different concentrations of ketofol in procedural operations

    International Nuclear Information System (INIS)

    Daabiss, Mohamed; Elsherbiny, Medhat; Al Otaibi, Rashed

    2009-01-01

    Propofol is an intravenous anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol. One hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or propofol: ketamine (4:1) (Group II). Subsequent infusion rates to a predetermined sedation level using Ramsay Sedation Scale. Heart rate, noninvasive arterial blood pressure (NIBP), oxygen saturation (SpO2), end tidal carbon dioxide (Etco 2 ) and incidence of any side effects were recorded. There were no significant hemodynamic changes in both groups after induction. However, there was an increase in postoperative nausea, psychomimetic side effects, and delay in discharge times in group I compared to group II. The adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the time of hospital discharge. (author)

  4. Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system.

    Science.gov (United States)

    Mittal, Neelam; Jain, Jyoti

    2014-01-01

    The purpose of this study was to evaluate the efficacy of nickel-titanium rotary retreatment systems versus stainless steel hand retreatment system with or without solvent for gutta-percha removal during retreatment. Sixty extracted human mandibular molar teeth with single canal in a distal root was prepared with ProTaper rotary nickel-titanium files and obturated with gutta-percha and sealer. The teeth were randomly divided into six groups of 10 specimens in each groups. The volume of filling material before and after retreatment were evaluated in cm(3) using the computed tomography (CT) scanner proprietary software. Maximum amount of filling material removed during retreatment with ProTaper retreatment system with solvent and minimum with hand retreatment system with solvent. None of the technique was 100% effective in removing the filling materials, but the ProTaper retreatment system with solvent was better.

  5. Reliability of the "Ten Test" for assessment of discriminative sensation in hand trauma.

    Science.gov (United States)

    Berger, Michael J; Regan, William R; Seal, Alex; Bristol, Sean G

    2016-10-01

    "Ten Test" (TT) is a bedside measure of discriminative sensation, whereby the magnitude of abnormal sensation to moving light touch is normalized to an area of normal sensation on an 11-point Likert scale (0-10). The purposes of this study were to determine reliability parameters of the TT in a cohort of patients presenting to a hand trauma clinic with subjectively altered sensation post-injury and to compare the reliability of TT to that of the Weinstein Enhanced Sensory Test (WEST). Study participants (n = 29, mean age = 37 ± 12) comprised patients presenting to an outpatient hand trauma clinic with recent hand trauma and self reported abnormal sensation. Participants underwent TT and WEST by two separate raters on the same day. Interrater reliability, response stability and responsiveness of each test were determined by the intraclass correlation coefficient (ICC: 2, 1), standard error of measurement (SEM) with 95% confidence intervals (CI) and minimal detectable difference score, with 95% CI (MDD95), respectively. The TT displayed excellent interrater reliability (ICC = 0.95, 95% CI 0.89-0.97) compared to good reliability for WEST (ICC = 0.78, 95% CI 0.58-0.89). The range of true scores expected with 95% confidence based on the SEM (i.e. response stability), was ±1.1 for TT and ±1.1 for WEST. MDD95 scores reflecting test responsiveness were 1.5 and 1.6 for TT and WEST, respectively. The TT displayed excellent reliability parameters in this patient population. Reliability parameters were stronger for TT compared to WEST. These results provide support for the use of TT as a component of the sensory exam in hand trauma. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system

    OpenAIRE

    Neelam Mittal; Jyoti Jain

    2014-01-01

    Aims: The purpose of this study was to evaluate the efficacy of nickel-titanium rotary retreatment systems versus stainless steel hand retreatment system with or without solvent for gutta-percha removal during retreatment. Materials and Methods: Sixty extracted human mandibular molar teeth with single canal in a distal root was prepared with ProTaper rotary nickel-titanium files and obturated with gutta-percha and sealer. The teeth were randomly divided into six groups of 10 specimens in ...

  7. Critical Emergency Medicine Procedural Skills: A Comparative Study of Methods for Teaching and Assessment.

    Science.gov (United States)

    Chapman, Dane M.; And Others

    Three critical procedural skills in emergency medicine were evaluated using three assessment modalities--written, computer, and animal model. The effects of computer practice and previous procedure experience on skill competence were also examined in an experimental sequential assessment design. Subjects were six medical students, six residents,…

  8. Procedures for self-assessment of operational safety

    International Nuclear Information System (INIS)

    1997-08-01

    Self-assessment processes have been continuously developed by nuclear organizations, including nuclear power plants. Currently, the nuclear industry and governmental organizations are showing an increasing interest in the implementation of this process as an effective way for improving safety performance. Self-assessment involves the use of different types of tools and mechanisms to assist the organizations in assessing their own safety performance against given standards. This helps to enhance the understanding of the need for improvements, the feeling of ownership in achieving them and and the safety culture as a whole. The concepts developed in this report present the basic approach to self-assessment taking into consideration experience gained during Operational Safety Review Team (OSART) missions, from organizations and utilities which have successfully implemented parts of a self-assessment programme and from meetings organized to discuss the subject

  9. Assessing Online Patient Education Readability for Spine Surgery Procedures.

    Science.gov (United States)

    Long, William W; Modi, Krishna D; Haws, Brittany E; Khechen, Benjamin; Massel, Dustin H; Mayo, Benjamin C; Singh, Kern

    2018-03-01

    Increased patient reliance on Internet-based health information has amplified the need for comprehensible online patient education articles. As suggested by the American Medical Association and National Institute of Health, spine fusion articles should be written for a 4th-6th-grade reading level to increase patient comprehension, which may improve postoperative outcomes. The purpose of this study is to determine the readability of online health care education information relating to anterior cervical discectomy and fusion (ACDF) and lumbar fusion procedures. Online health-education resource qualitative analysis. Three search engines were utilized to access patient education articles for common cervical and lumbar spine procedures. Relevant articles were analyzed for readability using Readability Studio Professional Edition software (Oleander Software Ltd). Articles were stratified by organization type as follows: General Medical Websites (GMW), Healthcare Network/Academic Institutions (HNAI), and Private Practices (PP). Thirteen common readability tests were performed with the mean readability of each compared between subgroups using analysis of variance. ACDF and lumbar fusion articles were determined to have a mean readability of 10.7±1.5 and 11.3±1.6, respectively. GMW, HNAI, and PP subgroups had a mean readability of 10.9±2.9, 10.7±2.8, and 10.7±2.5 for ACDF and 10.9±3.0, 10.8±2.9, and 11.6±2.7 for lumbar fusion articles. Of 310 total articles, only 6 (3 ACDF and 3 lumbar fusion) were written for comprehension below a 7th-grade reading level. Current online literature from medical websites containing information regarding ACDF and lumbar fusion procedures are written at a grade level higher than the suggested guidelines. Therefore, current patient education articles should be revised to accommodate the average reading level in the United States and may result in improved patient comprehension and postoperative outcomes.

  10. Bone age assessment in Hispanic children: digital hand atlas compared with the Greulich and Pyle (G&P) atlas

    Science.gov (United States)

    Fernandez, James Reza; Zhang, Aifeng; Vachon, Linda; Tsao, Sinchai

    2008-03-01

    Bone age assessment is most commonly performed with the use of the Greulich and Pyle (G&P) book atlas, which was developed in the 1950s. The population of theUnited States is not as homogenous as the Caucasian population in the Greulich and Pyle in the 1950s, especially in the Los Angeles, California area. A digital hand atlas (DHA) based on 1,390 hand images of children of different racial backgrounds (Caucasian, African American, Hispanic, and Asian) aged 0-18 years was collected from Children's Hospital Los Angeles. Statistical analysis discovered significant discrepancies exist between Hispanic and the G&P atlas standard. To validate the usage of DHA as a clinical standard, diagnostic radiologists performed reads on Hispanic pediatric hand and wrist computed radiography images using either the G&P pediatric radiographic atlas or the Children's Hospital Los Angeles Digital Hand Atlas (DHA) as reference. The order in which the atlas is used (G&P followed by DHA or vice versa) for each image was prepared before actual reading begins. Statistical analysis of the results was then performed to determine if a discrepancy exists between the two readings.

  11. Staphylococcus aureusand Escherichia colilevels on the hands of ...

    African Journals Online (AJOL)

    and patients) owing to long exposures to biological agents. ... The objective of this study was to assess the efficacy of different handwashing ..... with skin damage because of hand hygiene procedures on the health care workers. Am J Infect ...

  12. GIS based procedure of cumulative environmental impact assessment.

    Science.gov (United States)

    Balakrishna Reddy, M; Blah, Baiantimon

    2009-07-01

    Scale and spatial limits of impact assessment study in a GIS platform are two very important factors that could have a bearing on the genuineness and quality of impact assessment. While effect of scale has been documented and well understood, no significant study has been carried out on spatial considerations in an impact assessment study employing GIS technique. A novel technique of impact assessment demonstrable through GIS approach termed hereby as 'spatial data integrated GIS impact assessment method (SGIAM)' is narrated in this paper. The technique makes a fundamental presumption that the importance of environmental impacts is dependent, among other things, on spatial distribution of the effects of the proposed action and of the affected receptors in a study area. For each environmental component considered (e.g., air quality), impact indices are calculated through aggregation of impact indicators which are measures of the severity of the impact. The presence and spread of environmental descriptors are suitably quantified through modeling techniques and depicted. The environmental impact index is calculated from data exported from ArcINFO, thus giving significant importance to spatial data in the impact assessment exercise.

  13. A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training

    DEFF Research Database (Denmark)

    Nayahangan, L J; Konge, L; Schroeder, T V

    2017-01-01

    to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved...... eliminated, resulting in a final prioritised list of 19 technical procedures. Conclusion A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons......Objectives and background Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of “learning by doing.” This change has established simulation...

  14. Development of assessment procedures at the CEGB's nuclear power training centre

    International Nuclear Information System (INIS)

    Chapman, C.R.; Harris, N.D.C.

    1986-01-01

    The work of a power station engineer can be considered under four aspects: technology, diagnosis action and communication. The development, validation and use of assessment procedures can successfully incorporate the same aspects. The purposes of assessment are reporting training achievement and giving feedback to course members and tutorial staff. The development of standardized procedures to produce, evaluate and mark assessments and to optimize feedback ensures objectivity and uniformity. This has been achieved at the Central Electricity Generating Board's Nuclear Power Training Centre by enlisting an educational consultant to provide guidance and assist in training the resident tutors in assessment procedures. (author)

  15. Motor assessment instruments and psychometric procedures: A systematic review

    Directory of Open Access Journals (Sweden)

    Pâmella de Medeiros

    2017-03-01

    Full Text Available It was our objective to identify the psychometric elements to an epistemological reflection through a systematic review of cross-cultural validation procedures of TGMD-2 batteries, MABC-2 and KTK. Searches were carried out by two evaluators independently without year and language restrictions in six databases: Web of Science, Science Direct, Lilacs, Scopus, Pubmed and The ScientificElectronic Library Online - SciELO. The key words used were: "MABC", "TGMD" and "KTK" all of them combined with the word "validity". There was a total of 734 articles, of which, after the exclusion criteria, remained only 11 studies. It was found that there are differences between the authors in relation to the psychometric factors taken into account in cross-cultural validation. So that there was a lack of unanimity of the validation criteria of all studies in this field.

  16. Research on advanced system safety assessment procedures (4)

    International Nuclear Information System (INIS)

    Suzuki, Kazuhiko; Shimada, Yukiyasu

    2001-03-01

    The past research reports in the area of safety engineering proposed the Computer-aided HAZOP system to be applied to Nuclear Reprocessing Facilities. Automated HAZOP system has great advantage compared with human analysts in terms of accuracy of the results, and time required to conduct HAZOP studies. This report surveys the literature on risk assessment and safety design based on the concept of independent protection layers (IPLs). Furthermore, to improve HAZOP System, tool is proposed to construct the basic model and the internal state model. Such HAZOP system is applied to analyze two kinds of processes, where the ability of the proposed system is verified. In addition, risk assessment support system is proposed to integrate safety design environment and assessment result to be used by other plants as well as to enable the underline plant to use other plants' information. This technique can be implemented using web-based safety information systems. (author)

  17. Stiff Hands

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Stiff Hands Email to a friend * required fields ...

  18. Hand Infections

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Hand Infections Email to a friend * required fields ...

  19. On the assessment of extremely low breakdown probabilities by an inverse sampling procedure [gaseous insulation

    DEFF Research Database (Denmark)

    Thyregod, Poul; Vibholm, Svend

    1991-01-01

    the flashover probability function and the corresponding distribution of first breakdown voltages under the inverse sampling procedure, and show how this relation may be utilized to assess the single-shot flashover probability corresponding to the observed average first breakdown voltage. Since the procedure......First breakdown voltages obtained under the inverse sampling procedure assuming a double exponential flashover probability function are discussed. An inverse sampling procedure commences the voltage application at a very low level, followed by applications at stepwise increased levels until...... is based on voltage applications in the neighbourhood of the quantile under investigation, the procedure is found to be insensitive to the underlying distributional assumptions...

  20. Assessing user acceptance towards automated and conventional sink use for hand decontamination using the technology acceptance model.

    Science.gov (United States)

    Dawson, Carolyn H; Mackrill, Jamie B; Cain, Rebecca

    2017-12-01

    Hand hygiene (HH) prevents harmful contaminants spreading in settings including domestic, health care and food handling. Strategies to improve HH range from behavioural techniques through to automated sinks that ensure hand surface cleaning. This study aimed to assess user experience and acceptance towards a new automated sink, compared to a normal sink. An adapted version of the technology acceptance model (TAM) assessed each mode of handwashing. A within-subjects design enabled N = 46 participants to evaluate both sinks. Perceived Ease of Use and Satisfaction of Use were significantly lower for the automated sink, compared to the conventional sink (p technology. We provide recommendations for future HH technology development to contribute a positive user experience, relevant to technology developers, ergonomists and those involved in HH across all sectors. Practitioner Summary: The need to facilitate timely, effective hand hygiene to prevent illness has led to a rise in automated handwashing systems across different contexts. User acceptance is a key factor in system uptake. This paper applies the technology acceptance model as a means to explore and optimise the design of such systems.

  1. 78 FR 46905 - Tobacco Transition Program; Final Assessment Procedures

    Science.gov (United States)

    2013-08-02

    ... communications (Braille, large print, audio tape, etc.) should contact the USDA Target Center at (202)720-2600... is also known as FETRA (7 U.S.C. 518-519a). FETRA repealed the tobacco marketing quota and related... adjusted market share for the 39th and 40th quarterly assessment payments due on September 30, 2014, will...

  2. Flood damage assessment – Literature review and recommended procedure

    DEFF Research Database (Denmark)

    Olesen, Lea; Löwe, Roland; Arnbjerg-Nielsen, Karsten

    The assessment of flood risk is an essential tool in evaluating the potential consequences of a flood. The analysis of the risk can be applied as part of the flood plain management, but can also be used in a cost-benefit analysis, when comparing different adaption strategies. This analysis is the...

  3. Assessment of washing procedure for determination some of ...

    African Journals Online (AJOL)

    This study was proposed to assess the suitability of washing technique to distinguish between airborne and soil borne several metal contaminants. For this reason, six plant species which grew under Mobarakeh Steel Company emissions were selected. Aluminum, iron, nickel, manganese, zinc, copper and lead ...

  4. Preliminary assessment of the dose to the interventional radiologist in fluoro-CT-guided procedures

    International Nuclear Information System (INIS)

    Pereira, M. F.; Alves, J. G.; Sarmento, S.; Santos, J. A. M.; Sousa, M. J.; Gouvea, M.; Oliveira, A. D.; Cardoso, J. V.; Santos, L. M.

    2011-01-01

    A preliminary assessment of the occupational dose to the intervention radiologist received in fluoroscopy computerised tomography (CT) used to guide the collection of lung and bone biopsies is presented. The main aim of this work was to evaluate the capability of the reading system as well as of the available whole-body (WB) and extremity dosemeters used in routine monthly monitoring periods to measure per procedure dose values. The intervention radiologist was allocated 10 WB detectors (LiF: Mg, Ti, TLD-100) placed at chest and abdomen levels above and below the lead apron, and at both right and left arms, knees and feet. A special glove was developed with casings for the insertion of 11 extremity detectors (LiF:Mg, Cu, P, TLD-100H) for the identification of the most highly exposed fingers. The H p (10) dose values received above the lead apron (ranged 0.20-0.02 mSv) depend mainly on the duration of the examination and on the placement of physician relative to the beam, while values below the apron are relatively low. The left arm seems to receive a higher dose value. H p (0.07) values to the hand (ranged 36.30-0.06 mSv) show that the index, middle and ring fingers are the most highly exposed. In this study, the wrist dose was negligible compared with the finger dose. These results are preliminary and further studies are needed to better characterise the dose assessment in CT fluoroscopy. (authors)

  5. Performance of a Deep-Learning Neural Network Model in Assessing Skeletal Maturity on Pediatric Hand Radiographs.

    Science.gov (United States)

    Larson, David B; Chen, Matthew C; Lungren, Matthew P; Halabi, Safwan S; Stence, Nicholas V; Langlotz, Curtis P

    2018-04-01

    Purpose To compare the performance of a deep-learning bone age assessment model based on hand radiographs with that of expert radiologists and that of existing automated models. Materials and Methods The institutional review board approved the study. A total of 14 036 clinical hand radiographs and corresponding reports were obtained from two children's hospitals to train and validate the model. For the first test set, composed of 200 examinations, the mean of bone age estimates from the clinical report and three additional human reviewers was used as the reference standard. Overall model performance was assessed by comparing the root mean square (RMS) and mean absolute difference (MAD) between the model estimates and the reference standard bone ages. Ninety-five percent limits of agreement were calculated in a pairwise fashion for all reviewers and the model. The RMS of a second test set composed of 913 examinations from the publicly available Digital Hand Atlas was compared with published reports of an existing automated model. Results The mean difference between bone age estimates of the model and of the reviewers was 0 years, with a mean RMS and MAD of 0.63 and 0.50 years, respectively. The estimates of the model, the clinical report, and the three reviewers were within the 95% limits of agreement. RMS for the Digital Hand Atlas data set was 0.73 years, compared with 0.61 years of a previously reported model. Conclusion A deep-learning convolutional neural network model can estimate skeletal maturity with accuracy similar to that of an expert radiologist and to that of existing automated models. © RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on January 19, 2018.

  6. New automated procedure to assess context recognition memory in mice.

    Science.gov (United States)

    Reiss, David; Walter, Ondine; Bourgoin, Lucie; Kieffer, Brigitte L; Ouagazzal, Abdel-Mouttalib

    2014-11-01

    Recognition memory is an important aspect of human declarative memory and is one of the routine memory abilities altered in patients with amnestic syndrome and Alzheimer's disease. In rodents, recognition memory has been most widely assessed using the novel object preference paradigm, which exploits the spontaneous preference that animals display for novel objects. Here, we used nose-poke units instead of objects to design a simple automated method for assessing context recognition memory in mice. In the acquisition trial, mice are exposed for the first time to an operant chamber with one blinking nose-poke unit. In the choice session, a novel nonblinking nose-poke unit is inserted into an empty spatial location and the number of nose poking dedicated to each set of nose-poke unit is used as an index of recognition memory. We report that recognition performance varies as a function of the length of the acquisition period and the retention delay and is sensitive to conventional amnestic treatments. By manipulating the features of the operant chamber during a brief retrieval episode (3-min long), we further demonstrate that reconsolidation of the original contextual memory depends on the magnitude and the type of environmental changes introduced into the familiar spatial environment. These results show that the nose-poke recognition task provides a rapid and reliable way for assessing context recognition memory in mice and offers new possibilities for the deciphering of the brain mechanisms governing the reconsolidation process.

  7. Assessment of eye, hand and male gonadal skin dose in radiotherapy

    International Nuclear Information System (INIS)

    Pushap, M.P.S.

    1979-01-01

    An attempt has been made to gauge the dose to (1) the eye, (2) the skin of the hands and (3) the gonads from radiotherapy of other parts of the body. The study has been done on actual male patients at the Jorjani Medical Centre, Tehran. The study, indicated high dose to the eye lid i.e. about 3% of the tumour dose in the case of head irradiation. The eyes and gonads lie at unequal distances from thorax, so are their doses. It is further emphasised that a minimum dose of 400 rad in three weeks to one month has been reported to be cataractogenic in man. A 50% incidence of progressive loss of vision with a dose of 750 rad to 1000 rad in three weeks to three months time has been observed. If appropriate techniques are not employed to shield the eye, even from stray radiation, such limits may easily be reached. (K.B.)

  8. Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge.

    Science.gov (United States)

    Balayla, Jacques; Bergman, Simon; Ghitulescu, Gabriela; Feldman, Liane S; Fraser, Shannon A

    2012-08-01

    What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of procedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use. We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 different common general surgery procedures: inguinal hernia repair with mesh in men, laparoscopic cholecystectomy and right hemicolectomy. The tools were developed as a step-wise assessment of specific surgical procedures based on techniques described in a current surgical text. We compared novice (medical student to postgraduate year [PGY]-2) and expert group (PGY-3 to program staff) scores using the Mann-Whitney U test. We calculated the total SPK score and defined a cut-off score using receiver operating characteristic analysis. In all, 5 participants in 7 different training groups (n = 35) underwent an interview. Median scores for each procedure and overall SPK scores increased with experience. The median SPK for novices was 54.9 (95% confidence interval [CI] 21.6-58.8) compared with 98.05 (95% CP 94.1-100.0) for experts (p = 0.012). The SPK cut-off score of 93.1 discriminates between novice and expert surgeons. Surgical procedural knowledge can reliably be assessed using our SPK assessment tool. It can discriminate between novice and expert surgeons for common general surgical procedures. Future studies are planned to evaluate its use for more complex procedures.

  9. Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers.

    Science.gov (United States)

    Sureda, Xisca; Bilal, Usama; Fernández, Esteve; Valiente, Roberto; Escobar, Francisco J; Navas-Acien, Ana; Franco, Manuel

    2018-08-01

    After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues. We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues in 2016 in the city of Madrid, Spain. We further measured airborne nicotine concentrations and particulate matter of less than 2.5 µm in diameter (PM2.5) in terraces with monitors by active sampling during 30 min. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and fitted multivariate models to characterize their determinants. We found 202 hospitality venues between May and September (summer), and 83 between October and December 2016 (fall) that were opened at the time of observation. We found signs of tobacco consumption on 78.2% of the outdoor main entrances and on 95.1% of outdoor terraces. We measured nicotine and PM2.5 concentrations in 92 outdoor terraces (out of the 123 terraces observed). Overall median nicotine concentration was 0.42 (IQR: 0.14-1.59) μg/m 3 , and overall PM2.5 concentration was 10.40 (IQR: 6.76-15.47) μg/m 3 (statistically significantly higher than the background levels). Multivariable analyses showed that nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when tobacco smell was noticed. Nicotine concentrations increased with the presence of cigarette butts, and when there were more than eight lit cigarettes at a time. Outdoor hospitality venues are areas where non-smokers, both employees and patrons, continue to be exposed to second-hand smoke. These spaces should be further studied and considered in future tobacco control interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills.

    Science.gov (United States)

    Pugh, Debra; Cavalcanti, Rodrigo B; Halman, Samantha; Ma, Irene W Y; Mylopoulos, Maria; Shanks, David; Stroud, Lynfa

    2017-04-01

    The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified. Using an EPA framework, our study sought to (1) define the essential skills required for entrustment for 7 bedside procedures expected of graduates of Canadian internal medicine (IM) residency programs, and (2) develop rubrics for the assessment of these procedural skills. An initial list of essential skills was defined for each procedural EPA by focus groups of experts at 4 academic centers using the nominal group technique. These lists were subsequently vetted by representatives from all Canadian IM training programs through a web-based survey. Consensus (more than 80% agreement) about inclusion of each item was sought using a modified Delphi exercise. Qualitative survey data were analyzed using a framework approach to inform final assessment rubrics for each procedure. Initial lists of essential skills for procedural EPAs ranged from 10 to 24 items. A total of 111 experts completed the national survey. After 2 iterations, consensus was reached on all items. Following qualitative analysis, final rubrics were created, which included 6 to 10 items per procedure. These EPA-based assessment rubrics represent a national consensus by Canadian IM clinician educators. They provide a practical guide for the assessment of procedural skills in a competency-based education model, and a robust foundation for future research on their implementation and evaluation.

  11. Standardization of figures and assessment procedures for DTM verticalaccuracy

    Directory of Open Access Journals (Sweden)

    Vittorio Casella

    2015-07-01

    Full Text Available Digital Terrain Models (DTMs are widely used in many sectors. They play a key role in hydrological risk prevention, risk mitigation and numeric simulations. This paper deals with two questions: (i when it is stated that a DTM has a given vertical accuracy, is this assertion univocal? (ii when DTM vertical accuracy is assessed by means of checkpoints, does their location influence results? First, the paper illustrates that two vertical accuracy definitions are conceivable: Vertical Accuracy at the Nodes (VAN, the average vertical distance between the model and the terrain, evaluated at the DTM's nodes and Vertical Accuracy at the interpolated Points (VAP, in which the vertical distance is evaluated at the generic points. These two quantities are not coincident and, when they are calculated for the same DTM, different numeric values are reached. Unfortunately, the two quantities are often interchanged, but this is misleading. Second, the paper shows a simulated example of a DTM vertical accuracy assessment, highlighting that the checkpoints’ location plays a key role: when checkpoints coincide with the DTM nodes, VAN is estimated; when checkpoints are randomly located, VAP is estimated, instead. Third, an in-depth, theoretical characterization of the two considered quantities is performed, based on symbolic computation, and suitable standardization coefficients are proposed. Finally, our discussion has a well-defined frame: it doesn't deal with all the items of the DTM vertical accuracy budget, which would require a much longer essay, but only with one, usually called fundamental vertical accuracy.

  12. Research on advanced system safety assessment procedures (III)

    International Nuclear Information System (INIS)

    Suzuki, Kazuhiko; Shimada, Yukiyasu

    2000-03-01

    Though HAZOP is recognized as the useful safety assessment method, it requires a labor-intensive and time-consuming process. So recently computer-aided HAZOP has been proposed. The research report in 1999 (PNC TJ1400 99-003) presented HAZOP system based on the plant component malfunctions basic models. By using this basic model, not only state malfunction of component but also the consequence to external circumstance can be assessed. G2, which is an excellent object-oriented developer tool in GUI (Graphical User Interface), was used as a tool for developing the system. By using the graphical editor in the system, the user can carry out HAZOP easily. The purpose of this research is to improve the ability of the HAZOP system to obtain a more detailed HAZOP results. HAZOP is carried out according to the fault propagation of component level and the one of plant level based on plant component malfunctions basic models. Furthermore, the HAZOP system which can do the cause and effect analysis in detail intended for the component which processes two or more materials is developed. It is possible to carry out HAZOP for various plants by newly adding material information to the knowledge base. We have applied this system to the Nuclear Reprocessing Facilities to demonstrate the utilities of developing system. (author)

  13. Fire risk assessment in Germany. Procedure, data, results

    International Nuclear Information System (INIS)

    Berg, H.P.

    2000-01-01

    The recommended approach for a quantitative fire risk assessment to be applied within periodic safety reviews of nuclear power plants in Germany starts with a screening process providing critical fire zones and is followed by a quantitative analysis using a standard event tree with elements for fire initiation, ventilation of the room, fire detection, fire suppression, and fire propagation. In a final step, the fire induced frequency of initiating events, the main contributors and the calculated hazard state frequency for the fire event are determined. For that purpose, a comprehensive data base is needed which has been developed in particular for active fire protection measures. As an example results of one fire PSA are reported. (author)

  14. Exposure assessment procedures in presence of wideband digital wireless networks

    International Nuclear Information System (INIS)

    Trinchero, D.

    2009-01-01

    The article analyses the applicability of traditional methods, as well as recently proposed techniques, to the exposure assessment of electromagnetic field generated by wireless transmitters. As is well known, a correct measurement of the electromagnetic field is conditioned by the complexity of the signal, which requires dedicated instruments or specifically developed extrapolation techniques. Nevertheless, it is also influenced by the typology of the deployment of the transmitting and receiving stations, which varies from network to network. These aspects have been intensively analysed in the literature and several cases of study are available for review. The present article collects the most recent analyses and discusses their applicability to different scenarios, typical of the main wireless networking applications: broadcasting services, mobile cellular networks and data access provisioning infrastructures. (authors)

  15. Research on advanced system safety assessment procedures (II)

    International Nuclear Information System (INIS)

    Suzuki, Kazuhiko; Shimada, Yukiyasu

    1999-03-01

    HAZOP (Hazard and operability study) is a systematic technique, which requires the involvement of an experienced, interdisciplinary team of engineers, to identify hazards or operability problems throughout an entire facility by brainstorming. Though HAZOP is recognized as the useful safety assessment method, it requires a labor-intensive and time-consuming process. So recently computer-aided HAZOP has been proposed. The research report in 1998 (PNC PJ1612 98-001) presented prototype system, which carries out HAZOP and FT synthesis, by making use of proposed method. Relationships between states of input and output variables, internal and external events of each component are represented using decision tables, and the system is implemented by C++. In this study, the causalities of plant component malfunctions are described as component malfunction basic model and are stored in the computer. Thus, we have developed safety evaluation support system by considering the fault propagation path. Component malfunction basic model is made based on the information on the causalities between the abnormal state and each malfunction in components. This component malfunction basic model provides the common frame to describe abnormal situation in components. By using this basic model, not only state malfunction of component but also the consequence to external circumstance is assessed. G2, which is an excellent object-oriented developer tool in GUI (Graphical User Interface), is used as a tool for developing the system. By using the graphical editor in the system, the user can carry out HAZOP easily. We have applied this system to the Nuclear Reprocessing Facilities to demonstrate the utilities of developing system. (author)

  16. A Procedural Skills OSCE: Assessing Technical and Non-Technical Skills of Internal Medicine Residents

    Science.gov (United States)

    Pugh, Debra; Hamstra, Stanley J.; Wood, Timothy J.; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

    2015-01-01

    Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal…

  17. Acceptability of Functional Behavioral Assessment Procedures to Special Educators and School Psychologists

    Science.gov (United States)

    O'Neill, Robert E.; Bundock, Kaitlin; Kladis, Kristin; Hawken, Leanne S.

    2015-01-01

    This survey study assessed the acceptability of a variety of functional behavioral assessment (FBA) procedures (i.e., functional assessment interviews, rating scales/questionnaires, systematic direct observations, functional analysis manipulations) to a national sample of 123 special educators and a state sample of 140 school psychologists.…

  18. Probabilistic safety assessment of Tehran Research Reactor using systems analysis programs for hands-on integrated reliability evaluations

    International Nuclear Information System (INIS)

    Hosseini, M.H.; Nematollahi, M.R.; Sepanloo, K.

    2004-01-01

    Probabilistic safety assessment application is found to be a practical tool for research reactor safety due to intense involvement of human interactions in an experimental facility. In this document the application of the probabilistic safety assessment to the Tehran Research Reactor is presented. The level 1 practicabilities safety assessment application involved: Familiarization with the plant, selection of accident initiators, mitigating functions and system definitions, event tree constructions and quantifications, fault tree constructions and quantification, human reliability, component failure data base development and dependent failure analysis. Each of the steps of the analysis given above is discussed with highlights from the selected results. Quantification of the constructed models is done using systems analysis programs for hands-on integrated reliability evaluations software

  19. Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

    Science.gov (United States)

    Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

    2018-01-09

    New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

  20. A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training.

    Science.gov (United States)

    Nayahangan, L J; Konge, L; Schroeder, T V; Paltved, C; Lindorff-Larsen, K G; Nielsen, B U; Eiberg, J P

    2017-04-01

    Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of "learning by doing." This change has established simulation as a cornerstone in providing trainees with the necessary skills and competences. However, the development of simulation based programs often evolves based on available resources and equipment, reflecting convenience rather than a systematic educational plan. The objective of the present study was to perform a national needs assessment to identify the technical procedures that should be integrated in a simulation based curriculum. A national needs assessment using a Delphi process was initiated by engaging 33 predefined key persons in vascular surgery. Round 1 was a brainstorming phase to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved elimination and ranking of procedures. The response rate for round 1 was 70%, with 36 procedures identified. Round 2 had a 76% response rate and resulted in a preliminary prioritised list after exploring the need for simulation based training. Round 3 had an 85% response rate; 17 procedures were eliminated, resulting in a final prioritised list of 19 technical procedures. A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Hand Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... DESCRIPTION The bones of the hand serve as a framework. This framework supports the muscles that make the wrist and fingers move. When ...

  2. Survey Procedures Manual for the Environmental Survey and Site Assessment Program (ESSAP). Revision 10

    International Nuclear Information System (INIS)

    2000-01-01

    The Environmental Survey and Site Assessment Program (ESSAP) of the Oak Ridge Institute for Science and Education (ORISE) conducts radiological survey activities under a contract with the U. S. Department of Energy (DOE) and for the U.S. Nuclear Regulatory Commission (NRC). ORISE and its programs are operated by Oak Ridge Associated Universities (ORAU) through a contract with DOE. The purpose of this Procedures Manual is to provide a standardized set of procedures that document activities of the program in an auditable manner. These procedures are applicable to both DOE and NRC operations. Procedures presented in this manual are limited to those associated with site survey activities

  3. Assessment of grammar optimizes language tasks for the intracarotid amobarbital procedure.

    Science.gov (United States)

    Połczyńska, Monika; Kuhn, Taylor; You, S Christine; Walshaw, Patricia; Curtiss, Susan; Bookheimer, Susan

    2017-11-01

    A previous study showed that assessment of language laterality could be improved by adding grammar tests to the recovery phase of the intracarotid amobarbital procedure (IAP) (Połczyńska et al. 2014). The aim of this study was to further investigate the extent to which grammar tests lateralize language function during the recovery phase of the IAP in a larger patient sample. Forty patients with drug-resistant epilepsy (14 females, thirty-two right-handed, mean age 38.5years, SD=10.6) participated in this study. On EEG, 24 patients had seizures originating in the left hemisphere (LH), 13 in the right hemisphere (RH), and 4 demonstrated mixed seizure origin. Thirty participants (75%) had bilateral injections, and ten (25%) had unilateral injections (five RH and five LH). Based on results from the encoding phase, we segregated our study participants to a LH language dominant and a mixed dominance group. In the recovery phase of the IAP, the participants were administered a new grammar test (the CYCLE-N) and a standard language test. We analyzed the laterality index measure and effect sizes in the two tests. In the LH-dominant group, the CYCLE-N generated more profound language deficits in the recovery phase than the standard after injection to either hemisphere (pgrammar tasks was still higher than for the standard tests. Critically, the CYCLE-N administered in the recovery phase was nearly as effective as the standard tests given during the encoding phase. The results may be significant for individuals with epilepsy undergoing IAP. The grammar tests may be a highly efficient measure for lateralizing language function in the recovery phase. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Development of a tool to support holistic generic assessment of clinical procedure skills.

    Science.gov (United States)

    McKinley, Robert K; Strand, Janice; Gray, Tracey; Schuwirth, Lambert; Alun-Jones, Tom; Miller, Helen

    2008-06-01

    The challenges of maintaining comprehensive banks of valid checklists make context-specific checklists for assessment of clinical procedural skills problematic. This paper reports the development of a tool which supports generic holistic assessment of clinical procedural skills. We carried out a literature review, focus groups and non-participant observation of assessments with interview of participants, participant evaluation of a pilot objective structured clinical examination (OSCE), a national modified Delphi study with prior definitions of consensus and an OSCE. Participants were volunteers from a large acute teaching trust, a teaching primary care trust and a national sample of National Health Service staff. Results In total, 86 students, trainees and staff took part in the focus groups, observation of assessments and pilot OSCE, 252 in the Delphi study and 46 candidates and 50 assessors in the final OSCE. We developed a prototype tool with 5 broad categories amongst which were distributed 38 component competencies. There was > 70% agreement (our prior definition of consensus) at the first round of the Delphi study for inclusion of all categories and themes and no consensus for inclusion of additional categories or themes. Generalisability was 0.76. An OSCE based on the instrument has a predicted reliability of 0.79 with 12 stations and 1 assessor per station or 10 stations and 2 assessors per station. This clinical procedural skills assessment tool enables reliable assessment and has content and face validity for the assessment of clinical procedural skills. We have designated it the Leicester Clinical Procedure Assessment Tool (LCAT).

  5. Development of an Assessment Procedure for Seawater Intrusion Mitigation

    Science.gov (United States)

    Hsi Ting, F.; Yih Chi, T.

    2017-12-01

    The Pingtung Plain is one of the areas with extremely plentiful groundwater resources in Taiwan. Due to that the application of the water resource is restricted by significant variation of precipitation between wet and dry seasons, groundwater must be used as a recharge source to implement the insufficient surface water resource during dry seasons. In recent years, the coastal aquaculture rises, and the over withdrawn of groundwater by private well results in fast drop of groundwater level. Then it causes imbalance of groundwater supply and leads to serious seawater intrusion in the coastal areas. The purpose of this study is to develop an integrated numerical model of groundwater resources and seawater intrusion. Soil and Water Assessment Tool (SWAT), MODFLOW and MT3D models were applied to analyze the variation of the groundwater levels and salinity concentration to investigate the correlation of parameters, which are used to the model applications in order to disposal saltwater intrusion. The data of groundwater levels, pumping capacity and hydrogeological data to were collected to build an integrated numerical model. Firstly, we will collect the information of layered aquifer and the data of hydrological parameters to build the groundwater numerical model at Pingtung Plain, and identify the amount of the groundwater which flow into the sea. In order to deal with the future climate change conditions or extreme weather conditions, we will consider the recharge with groundwater model to improve the seawater intrusion problem. The integrated numerical model which describes that seawater intrusion to deep confined aquifers and shallow unsaturated aquifers. Secondly, we will use the above model to investigate the weights influenced by different factors to the amount area of seawater intrusion, and predict the salinity concentration distribution of evaluation at coastal area of Pingtung Plain. Finally, we will simulate groundwater recharge/ injection at the coastal

  6. Bill project authorizing the ratification of association agreement between the European Union and the European Atomic Energy Community and their member states, on the one hand, and Georgia, on the other hand. (accelerated procedure). Nr 2791

    International Nuclear Information System (INIS)

    Valls, Manuel; Fabius, Laurent

    2015-01-01

    This bill project mainly contains the text of the association agreement between the EU and Euratom on the one hand, and Georgia on the other hand. This agreement contains a statement of objectives, a presentation of general principles, of issues of cooperation in the field of foreign policy and security, of issues related to freedom, security and justice, of issues related to trade and associated issues, to economic cooperation, to cooperation in other fields (transports, energy, environment, climate, industrial policy, and so on), to financial support and fraud prevention. Numerous appendices are related to these different topics

  7. A probabilistic seismic risk assessment procedure for nuclear power plants: (I) Methodology

    Science.gov (United States)

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.

    2011-01-01

    A new procedure for probabilistic seismic risk assessment of nuclear power plants (NPPs) is proposed. This procedure modifies the current procedures using tools developed recently for performance-based earthquake engineering of buildings. The proposed procedure uses (a) response-based fragility curves to represent the capacity of structural and nonstructural components of NPPs, (b) nonlinear response-history analysis to characterize the demands on those components, and (c) Monte Carlo simulations to determine the damage state of the components. The use of response-rather than ground-motion-based fragility curves enables the curves to be independent of seismic hazard and closely related to component capacity. The use of Monte Carlo procedure enables the correlation in the responses of components to be directly included in the risk assessment. An example of the methodology is presented in a companion paper to demonstrate its use and provide the technical basis for aspects of the methodology. ?? 2011 Published by Elsevier B.V.

  8. Developments in UK defect assessment procedures R6 revision 4 and BS7910

    International Nuclear Information System (INIS)

    Sharples, J.K.; Ainsworth, R.A.; Budden, P.J.

    2003-01-01

    The R6 defect assessment procedures have been developed over many years by the UK nuclear power generation industry. The procedures are updated on a regular basis, taking into account the information resulting from the R6 development programme and other available information worldwide. A major revision, Revision 4, of the R6 procedures was released in 2000. Just prior to that release, in 1999, the British Standards flaw assessment procedure BS7910 was issued and combined and updated the previous published documents PD6493 and PD6539, for components operating at temperatures where creep was negligible and important, respectively. BS79l0 is also under constant development. This paper provides a brief overview of the BS7910 and R6 Revision 4 procedures and describes updates to the respective documents since they were first issued. Some ongoing developments which will lead to future revisions to the documents are also described. (author)

  9. Geographical Detector-Based Risk Factors Assessment of the Hand-Foot-Mouth Disease in China

    Science.gov (United States)

    Huang, J.

    2017-12-01

    Background: Hand, foot and mouth disease(HFMD) is a common infectious disease, causing thousands of deaths among children in China. This study focused on analyzing the impacts of different populations and different industry structures on HFMD incidence in China. Methods: We collected HFMD cases from 2307 counties during May 2008 in China. The potential risk factors included: monthly mean temperature, monthly mean relative humidity, monthly precipitation, different population density, different industry structures. Geographical detector technique was used to analyze the main and interactive effect of potential risk factors on HFMD incidence. Result: Using risk detector, we found the most serious HFMD incidence mainly located in the Yangtze River delta and the Pearl River delta. When the temperature was high, the incidence of HFMD was also high. This finding indicates that there is a correlation between monthly mean temperature and the incidence of HFMD. Similar analysis was undertaken to analyze the correlation between other variables and the incidence of HFMD using the risk detector. Using factor detector, we found the effect of risk factors on the incidence of HFMD, and this was ranked by PD value as follows: density of children aged 0-9 years (0.25) > tertiary industry (0.23) > GDP (0.20) >middle school student density (0.13) > relative humidity (0.12) >average temperature (0.11) >first industry (0.05). Using ecological detector, we found that child density, tertiary industry, and GDP had a strong effect on the incidence of HFMD. Using interactive detector, we found that the interactive PD value of tertiary industry and child population density was 0.42, which of GDP and tertiary industry was 0.34, that of child population density and GDP was 0.35, and that of average temperature and relative humidity was 0.28. All of these interactive PD values appeared to be higher than any PD value of sole risk factors. The combinations of the above-mentioned risk factors

  10. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  11. Structural assessment procedure of corroding submarine gas pipelines using on-line inspection data

    International Nuclear Information System (INIS)

    Nordin Yahaya

    2000-01-01

    This paper presents 'the alternative approach of overall procedure in the assessment of corroded pipelines using data gathered by the on-line inspection device. The methodology adopts a generalised approach of analysing pipeline inspection data and a prediction of the structural reliability due to the deteriorating corrosion environment. The whole assessment methodology is divided into four separate stages; 1 to IV. Stages 1 and 11 are the initial procedure prior to the actual analysis of the inspection data. The scope of this paper is concerted into the procedure to be taken in Stage 111 where the stage is sub-divided into 3 major steps; Part A, B and C. These procedures are Part A (statistical and probabilistic analysis of the inspection data) and Part B (the application of extreme value statistics) and C (reliability assessment). Stage IV (risk assessment) is the final step in the procedure where the consequences of failure are evaluated. The proposed risk-based assessment procedure is more systematic and reliable to account for a huge amount of collected data usually obtained in an on-line inspection using the intelligent devices. The outcomes of this risk-based methodology can be very useful in the decision-making process by the operation management. This in turn will produce an efficient inspection, repair and maintenance program and enhanced the optimised return in investment. (author)

  12. A combined deterministic and probabilistic procedure for safety assessment of components with cracks - Handbook.

    Energy Technology Data Exchange (ETDEWEB)

    Dillstroem, Peter; Bergman, Mats; Brickstad, Bjoern; Weilin Zang; Sattari-Far, Iradj; Andersson, Peder; Sund, Goeran; Dahlberg, Lars; Nilsson, Fred (Inspecta Technology AB, Stockholm (Sweden))

    2008-07-01

    SSM has supported research work for the further development of a previously developed procedure/handbook (SKI Report 99:49) for assessment of detected cracks and tolerance for defect analysis. During the operative use of the handbook it was identified needs to update the deterministic part of the procedure and to introduce a new probabilistic flaw evaluation procedure. Another identified need was a better description of the theoretical basis to the computer program. The principal aim of the project has been to update the deterministic part of the recently developed procedure and to introduce a new probabilistic flaw evaluation procedure. Other objectives of the project have been to validate the conservatism of the procedure, make the procedure well defined and easy to use and make the handbook that documents the procedure as complete as possible. The procedure/handbook and computer program ProSACC, Probabilistic Safety Assessment of Components with Cracks, has been extensively revised within this project. The major differences compared to the last revision are within the following areas: It is now possible to deal with a combination of deterministic and probabilistic data. It is possible to include J-controlled stable crack growth. The appendices on material data to be used for nuclear applications and on residual stresses are revised. A new deterministic safety evaluation system is included. The conservatism in the method for evaluation of the secondary stresses for ductile materials is reduced. A new geometry, a circular bar with a circumferential surface crack has been introduced. The results of this project will be of use to SSM in safety assessments of components with cracks and in assessments of the interval between the inspections of components in nuclear power plants

  13. The Implicit Relational Assessment Procedure as a Measure of Self-Esteem

    Science.gov (United States)

    Timko, C. Alix; England, Erica L.; Herbert, James D.; Forman, Evan M.

    2010-01-01

    Two studies were conducted to pilot the Implicit Relational Assessment Procedure (IRAP) in measuring attitudes toward the self: one related to body image specifically and another assessing the broader construct of self-esteem. Study 1 utilized the IRAP with female college students to examine self-referential beliefs regarding body image. Results…

  14. Teachers' Use of a Self-Assessment Procedure: The Role of Criteria, Standards, Feedback and Reflection

    Science.gov (United States)

    van Diggelen, Migchiel; den Brok, Perry; Beijaard, Douwe

    2013-01-01

    This article reports on the way teachers assess their own coaching competencies regarding the development of vocational education students' reflection skills. The participating teachers used a self-assessment procedure in which they had to judge themselves with the help of criteria and standards, received feedback from a colleague based on the…

  15. Teachers' use of a self-assessment procedure : the role of criteria, standards, feedback and reflection

    NARCIS (Netherlands)

    Diggelen, van M.R.; Brok, den P.J.; Beijaard, D.

    2013-01-01

    This article reports on the way teachers assess their own coaching competencies regarding the development of vocational education students’ reflection skills. The participating teachers used a self-assessment procedure in which they had to judge themselves with the help of criteria and standards,

  16. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study

    Science.gov (United States)

    Perraton, Luke G.; Bower, Kelly J.; Adair, Brooke; Pua, Yong-Hao; Williams, Gavin P.; McGaw, Rebekah

    2015-01-01

    Introduction Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. Methods 30 healthy young adults (age: 23±5yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Results Comparison of RFD methods revealed that a peak 200ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31–0.79). Conclusions Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability

  17. Using a virtual reality game to assess goal-directed hand movements in children: A pilot feasibility study.

    Science.gov (United States)

    Gabyzon, M Elboim; Engel-Yeger, B; Tresser, S; Springer, S

    2016-01-01

    Virtual reality gaming environments may be used as a supplement to the motor performance assessment tool box by providing clinicians with quantitative information regarding motor performance in terms of movement accuracy and speed, as well as sensory motor integration under different levels of dual tasking. To examine the feasibility of using the virtual reality game `Timocco' as an assessment tool for evaluating goal-directed hand movements among typically developing children. In this pilot study, 47 typically-developing children were divided into two age groups, 4-6 years old and 6-8 years old. Performance was measured using two different virtual environment games (Bubble Bath and Falling Fruit), each with two levels of difficulty. Discriminative validity (age effect) was examined by comparing the performance of the two groups, and by comparing the performance between levels of the games for each group (level effect). Test-retest reliability was examined by reassessing the older children 3-7 days after the first session. The older children performed significantly better in terms of response time, action time, game duration, and efficiency in both games compared to the younger children. Both age groups demonstrated poorer performance at the higher game level in the Bubble Bath game compared to the lower level. A similar level effect was found in the Falling Fruit game for both age groups in response time and efficiency, but not in action time. The performance of the older children was not significantly different between the two sessions at both game levels. The discriminative validity and test-retest reliability indicate the feasibility of using the Timocco virtual reality game as a tool for assessing goal-directed hand movements in children. Further studies should examine its feasibility for use in children with disabilities.

  18. Hand Therapy

    Science.gov (United States)

    ... from conditions such as carpal tunnel syndrome and tennis elbow , as well as from chronic problems such as ... Tools Advice from a Certified Hand Therapist on Tennis Elbow Advice from a Certified Hand Therapist: Living with( ...

  19. An assessment of the BEST procedure to estimate the soil water retention curve

    Science.gov (United States)

    Castellini, Mirko; Di Prima, Simone; Iovino, Massimo

    2017-04-01

    The Beerkan Estimation of Soil Transfer parameters (BEST) procedure represents a very attractive method to accurately and quickly obtain a complete hydraulic characterization of the soil (Lassabatère et al., 2006). However, further investigations are needed to check the prediction reliability of soil water retention curve (Castellini et al., 2016). Four soils with different physical properties (texture, bulk density, porosity and stoniness) were considered in this investigation. Sites of measurement were located at Palermo University (PAL site) and Villabate (VIL site) in Sicily, Arborea (ARB site) in Sardinia and in Foggia (FOG site), Apulia. For a given site, BEST procedure was applied and the water retention curve was estimated using the available BEST-algorithms (i.e., slope, intercept and steady), and the reference values of the infiltration constants (β=0.6 and γ=0.75) were considered. The water retention curves estimated by BEST were then compared with those obtained in laboratory by the evaporation method (Wind, 1968). About ten experiments were carried out with both methods. A sensitivity analysis of the constants β and γ within their feasible range of variability (0.1analysis showed that S tended to increase for increasing β values and decreasing values of γ for all the BEST-algorithms and soils. On the other hand, Ks tended to decrease for increasing β and γ values. Our results also reveal that: i) BEST-intercept and BEST-steady algorithms yield lower S and higher Ks values than BEST-slope; ii) these algorithms yield also more variable values. For the latter, a higher sensitiveness of these two alternative algorithms to β than for γ was established. The decreasing sensitiveness to γ may lead to a possible lack in the correction of the simplified theoretical description of the parabolic two-dimensional and one-dimensional wetting front along the soil profile (Smettem et al., 1994). This likely resulted in lower S and higher Ks values

  20. Hand Anatomy

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy Bones Joints Muscles Nerves Vessels Tendons Anatomy The upper extremity is ...

  1. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Science.gov (United States)

    Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

    2012-01-01

    Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first

  2. Health and environmental impacts of electricity generation systems: procedures for comparative assessments

    International Nuclear Information System (INIS)

    Demin, V.F.

    2002-01-01

    The IAEA technical report involving description of the Manual for procedure of comparison risk assessment (CRA) and external cost (ECA) of environmental and public health effect from nuclear energetics and other power generation is treated. CRA and ECA results depend on national and regional social-economic, geographic, medical and demographic, and other features. When using CRA and ECA procedures developed in concrete countries their adaptation is necessary for conditions of other countries [ru

  3. Preparation of a continuative brochure as supplement to the evaluation hand-out for the assessment of study results

    International Nuclear Information System (INIS)

    Wilhelmy, S.; Gollnick, F.; Driessen, S.; Schmidt, M.; Gross, D.

    2015-01-01

    In 2013 the Federal Office for Radiation Protection gave the responsibility to the Department of History, Philosophy and Ethics of Medicine (Institut GTE Med) in Aachen for the project ''Creating a practical hand-out for the assessment of study results for employees of local governments'' (FM 8855). The manual serves as a practical way for the qualitative evaluation of texts for persons who deal with the topics Mobile Communication and Health (for example communities or government agencies) in their profession. The main objective of the manual is to aid users in performing a faster and more efficient evaluation of texts by answering the containing questions. This approach is purely functional and precludes the placement of deeper information. At this point the new project FM 8862 started by ''Creating a continuative brochure in addition to the hand-out for the assessment of study results''. It continued the previous project FM 8855 to further develop the information which was up to this point purely functional. The brochure presents the issues in an overall context and provides valuable background knowledge. As a result, possible users get in a more casual and clear manner a deeper understanding of the evaluating of texts. It should be possible for a user to better evaluate texts and by obtaining arguments, thus being better prepared to engage with interested Laymen in an objective discussion. The brochure was submitted together with the existing manual for a practical test, which was attended by 21 target group-specific subjects. The study tested in detail the intelligibility, clarity, applicability, and the support of the brochure. The feedback of the test participants were then used as basis for the final optimization of the brochure. Project participants belong to the Department of History, Philosophy and Ethics of Medicine and the Research Center for Bioelectromagnetic Interaction of the RWTH Aachen University (femu).

  4. [Hand osteoarthritis].

    Science.gov (United States)

    Šenolt, Ladislav

    Hand osteoarthritis (OA) is a common chronic disorder causing pain and limitation of mobility of affected joints. The prevalence of hand OA increases with age and more often affects females. Clinical signs obviously do not correlate with radiographic findings - symptomatic hand OA affects approximately 26 % of adult subjects, but radiographic changes can be found in up to two thirds of females and half of males older than 55 years.Disease course differ among individual patients. Hand OA is a heterogeneous disease. Nodal hand OA is the most common subtype affecting interphalangeal joints, thumb base OA affects first carpometacarpal joint. Erosive OA represents a specific subtype of hand OA, which is associated with joint inflammation, more pain, functional limitation and erosive findings on radiographs.Treatment of OA is limited. Analgesics and nonsteroidal anti-inflammatory drugs are the only agents reducing symptoms. New insights into the pathogenesis of disease should contribute to the development of novel effective treatment of hand OA.

  5. Validation of digit-length ratio (2D:4D) assessments on the basis of DXA-derived hand scans

    International Nuclear Information System (INIS)

    Romann, Michael; Fuchslocher, Jörg

    2015-01-01

    The second-to-fourth digit-length ratio (2D:4D) may be a correlate of prenatal sex steroids, and it has been linked to sporting prowess. The aim of the study was to validate dual-energy X-ray-absorptiometry (DXA) as a technique to assess 2D:4D in soccer players under 15 years of age (U-15). Paired X-ray and DXA scans of the left hands of 63 male U-15 elite soccer players (age: 14.0 ± 0.3 years) were performed, and 2D:4D was then compared between the two techniques. The 2D:4D measurements were performed twice by two blinded raters. Intrarater and interrater reliability, as well as agreement between the X-ray and the DXA assessments, were tested. Intrarater reliabilities of both raters using X-ray with intraclass correlation coefficients (ICCs) of 0.97 and 0.90 were excellent. Using DXA, the ICCs were 0.90 and 0.91 thus also showing excellent reliability. Interrater reliabilities were excellent using both the X-ray (ICC of 0.94) and the DXA (ICC of 0.90), assessments respectively. Bland-Altman plots demonstrated that the 2D:4D ratios of the two raters did not differ significantly between the X-ray and the DXA assessments. The standard errors of estimate were 0.01 for both techniques. The 95% limits of agreement of ±0.018 (±2.0%) and ±0.023 (±2.6%), respectively, were within the acceptable tolerance of 5%, and showed very good agreement. DXA offered a replicable technique for assessing 2D:4D in youth soccer players. Therefore, the DXA technique seems to be an alternative method for evaluating 2D:4D in youth sports

  6. 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

  7. Hands-on 2.0: improving transfer of training via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program.

    Science.gov (United States)

    Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Dunkin, Brian

    2017-08-01

    Practicing surgeons commonly learn new procedures and techniques by attending a "hands-on" course, though trainings are often ineffective at promoting subsequent procedure adoption in practice. We describe implementation of a new program with the SAGES All Things Hernia Hands-On Course, Acquisition of Data for Outcomes and Procedure Transfer (ADOPT), which employs standardized, proven teaching techniques, and 1-year mentorship. Attendee confidence and procedure adoption are compared between standard and ADOPT programs. For the pilot ADOPT course implementation, a hands-on course focusing on abdominal wall hernia repair was chosen. ADOPT participants were recruited among enrollees for the standard Hands-On Hernia Course. Enrollment in ADOPT was capped at 10 participants and limited to a 2:1 student-to-faculty ratio, compared to the standard course 22 participants with a 4:1 student-to-faculty ratio. ADOPT mentors interacted with participants through webinars, phone conferences, and continuous email availability throughout the year. All participants were asked to provide pre- and post-course surveys inquiring about the number of targeted hernia procedures performed and related confidence level. Four of 10 ADOPT participants (40%) and six of 22 standard training participants (27%) returned questionnaires. Over the 3 months following the course, ADOPT participants performed more ventral hernia mesh insertion procedures than standard training participants (median 13 vs. 0.5, p = 0.010) and considerably more total combined procedures (median 26 vs. 7, p = 0.054). Compared to standard training, learners who participated in ADOPT reported greater confidence improvements in employing a components separation via an open approach (p = 0.051), and performing an open transversus abdominis release, though the difference did not achieve statistical significance (p = 0.14). These results suggest that the ADOPT program, with standardized and structured teaching

  8. Procedure to select test organisms for environmental risk assessment of genetically modified crops in aquatic systems.

    Science.gov (United States)

    Hilbeck, Angelika; Bundschuh, Rebecca; Bundschuh, Mirco; Hofmann, Frieder; Oehen, Bernadette; Otto, Mathias; Schulz, Ralf; Trtikova, Miluse

    2017-11-01

    For a long time, the environmental risk assessment (ERA) of genetically modified (GM) crops focused mainly on terrestrial ecosystems. This changed when it was scientifically established that aquatic ecosystems are exposed to GM crop residues that may negatively affect aquatic species. To assist the risk assessment process, we present a tool to identify ecologically relevant species usable in tiered testing prior to authorization or for biological monitoring in the field. The tool is derived from a selection procedure for terrestrial ecosystems with substantial but necessary changes to adequately consider the differences in the type of ecosystems. By using available information from the Water Framework Directive (2000/60/EC), the procedure can draw upon existing biological data on aquatic systems. The proposed procedure for aquatic ecosystems was tested for the first time during an expert workshop in 2013, using the cultivation of Bacillus thuringiensis (Bt) maize as the GM crop and 1 stream type as the receiving environment in the model system. During this workshop, species executing important ecological functions in aquatic environments were identified in a stepwise procedure according to predefined ecological criteria. By doing so, we demonstrated that the procedure is practicable with regard to its goal: From the initial long list of 141 potentially exposed aquatic species, 7 species and 1 genus were identified as the most suitable candidates for nontarget testing programs. Integr Environ Assess Manag 2017;13:974-979. © 2017 SETAC. © 2017 SETAC.

  9. Eye lens exposure to medical staff performing electrophysiology procedures: dose assessment and correlation to patient dose

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Bozovic, Predrag; Arandjic, Danijela; Antic, Vojislav; Selakovic, Jovana; Pavlovic, Sinisa

    2016-01-01

    The purpose of this study was to assess the patient exposure and staff eye dose levels during implantation procedures for all types of pacemaker therapy devices performed under fluoroscopic guidance and to investigate potential correlation between patients and staff dose levels. The mean eye dose during pacemaker/defibrillator implementation was 12 μSv for the first operator, 8.7 μSv for the second operator/nurse and 0.50 μSv for radiographer. Corresponding values for cardiac re-synchronisation therapy procedures were 30, 26 and 2.0 μSv, respectively. Significant (p < 0.01) correlation between the eye dose and the kerma-area product was found for the first operator and radiographers, but not for other staff categories. The study revealed eye dose per procedure and eye dose normalised to patient dose indices for different staff categories and provided an input for radiation protection in electrophysiology procedures. (authors)

  10. Assessment of creep-fatigue damage using the UK strain based procedure

    International Nuclear Information System (INIS)

    Bate, S.K.

    1997-01-01

    The UK strain based procedures have been developed for the evaluation of damage in structures, arising from fatigue cycles and creep processes. The fatigue damage is assessed on the basis of modelling crack growth from about one grain depth to an allowable limit which represents an engineering definition of crack formation. Creep damage is based up on the exhaustion of available ductility by creep strain accumulation. The procedures are applicable only when level A and B service conditions apply, as defined in RCC-MR or ASME Code Case N47. The procedures require the components of strain to be evaluated separately, thus they may be used with either full inelastic analysis or simplified methods. To support the development of the UK strain based creep-fatigue procedures an experimental program was undertaken by NNC to study creep-fatigue interaction of structures operating at high temperature. These tests, collectively known as the SALTBATH tests considered solid cylinder and tube-plate specimens, manufactured from Type 316 stainless steel. These specimens were subjected to thermal cycles between 250 deg. C and 600 deg. C. In all the cases the thermal cycle produces tensile residual stresses during dwells at 600 deg. C. One of the tube-plate specimens was used as a benchmark for validating the strain based creep fatigue procedures and subsequently as part of a CEC co-operative study. This benchmark work is described in this paper. A thermal and inelastic stress analysis was carried out using the finite element code ABAQUS. The inelastic behaviour of the material was described using the ORNL constitutive equations. A creep fatigue assessment using the strain based procedures has been compared with an assessment using the RCC-MR inelastic rules. The analyses indicated that both the UK strain based procedures and the RCC-MR rules were conservative, but the conservatism was greater for the RCC-MR rules. (author). 8 refs, 8 figs, 4 tabs

  11. Definition, development, and demonstration of analytical procedures for the structured assessment approach. Final report

    International Nuclear Information System (INIS)

    1979-01-01

    Analytical procedures were refined for the Structural Assessment Approach for assessing the Material Control and Accounting systems at facilities that contain special nuclear material. Requirements were established for an efficient, feasible algorithm to be used in evaluating system performance measures that involve the probability of detection. Algorithm requirements to calculate the probability of detection for a given type of adversary and the target set are described

  12. Developing best practices teaching procedures for skinfold assessment: observational examination using the Think Aloud method.

    Science.gov (United States)

    Holmstrup, Michael E; Verba, Steven D; Lynn, Jeffrey S

    2015-12-01

    Skinfold assessment is valid and economical; however, it has a steep learning curve, and many programs only include one exposure to the technique. Increasing the number of exposures to skinfold assessment within an undergraduate curriculum would likely increase skill proficiency. The present study combined observational and Think Aloud methodologies to quantify procedural and cognitive characteristics of skinfold assessment. It was hypothesized that 1) increased curricular exposure to skinfold assessment would improve proficiency and 2) the combination of an observational and Think Aloud analysis would provide quantifiable areas of emphasis for instructing skinfold assessment. Seventy-five undergraduates with varied curricular exposure performed a seven-site skinfold assessment on a test subject while expressing their thoughts aloud. A trained practitioner recorded procedural observations, with transcripts generated from audio recordings to capture cognitive information. Skinfold measurements were compared with a criterion value, and bias scores were generated. Participants whose total bias fell within ±3.5% of the criterion value were proficient, with the remainder nonproficient. An independent-samples t-test was used to compare procedural and cognitive observations across experience and proficiency groups. Additional curricular exposure improved performance of skinfold assessment in areas such as the measurement of specific sites (e.g., chest, abdomen, and thigh) and procedural (e.g., landmark identification) and cognitive skills (e.g., complete site explanation). Furthermore, the Think Aloud method is a valuable tool for determining curricular strengths and weaknesses with skinfold assessment and as a pedagogical tool for individual instruction and feedback in the classroom. Copyright © 2015 The American Physiological Society.

  13. Development of Procedures to Assess Problem-Solving Competence in Computing Engineering

    Science.gov (United States)

    Pérez, Jorge; Vizcarro, Carmen; García, Javier; Bermúdez, Aurelio; Cobos, Ruth

    2017-01-01

    In the context of higher education, a competence may be understood as the combination of skills, knowledge, attitudes, values, and abilities that underpin effective and/or superior performance in a professional area. The aim of the work reported here was to design a set of procedures to assess a transferable competence, i.e., problem solving, that…

  14. Standardised Observation Analogue Procedure (SOAP) for Assessing Parent and Child Behaviours in Clinical Trials

    Science.gov (United States)

    Johnson, Cynthia R.; Butter, Eric M.; Handen, Benjamin L.; Sukhodolsky, Denis G.; Mulick, James; Lecavalier, Luc; Aman, Michael G.; Arnold, Eugene L.; Scahill, Lawrence; Swiezy, Naomi; Sacco, Kelley; Stigler, Kimberly A.; McDougle, Christopher J.

    2009-01-01

    Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before…

  15. Assessing Women's Responses to Sexual Threat: Validity of a Virtual Role-Play Procedure

    Science.gov (United States)

    Jouriles, Ernest N.; Rowe, Lorelei Simpson; McDonald, Renee; Platt, Cora G.; Gomez, Gabriella S.

    2011-01-01

    This study evaluated the validity of a role-play procedure that uses virtual reality technology to assess women's responses to sexual threat. Forty-eight female undergraduate students were randomly assigned to either a standard, face-to-face role-play (RP) or a virtual role-play (VRP) of a sexually coercive situation. A multimethod assessment…

  16. Meeting on Common Ground: Assessing Parent-Child Relationships through the Joint Painting Procedure

    Science.gov (United States)

    Gavron, Tami

    2013-01-01

    A basic assumption in psychotherapy with children is that the parent-child relationship is central to the child's development. This article describes the Joint Painting Procedure, an art-based assessment for evaluating relationships with respect to the two main developmental tasks of middle childhood: (a) the parent's ability to monitor and…

  17. IRS/TUEV activities during the licensing procedure. Safety assessment and preexamination

    International Nuclear Information System (INIS)

    Fendler, H.

    1976-01-01

    Short summary about the IRS/TUEV activities in the licensing procedure for a nuclear power plant: work for assessments, for pre-examination and approval specifications and drawings and for the quality control, time and the manpower necessary for this work. (orig./HP) [de

  18. Phantoms for quality control procedures in digital breast tomosynthesis: dose assessment

    NARCIS (Netherlands)

    Bouwman, R. W.; Diaz, O.; van Engen, R. E.; Young, K. C.; den Heeten, G. J.; Broeders, M. J. M.; Veldkamp, W. J. H.; Dance, D. R.

    2013-01-01

    The recent introduction of digital breast tomosynthesis into clinical practice requires quality control procedures. In this study we have investigated whether the assessment of the average glandular dose for modelled standard breasts can be performed using a combination of polymethyl methacrylate

  19. Procedural advice on self-assessment and task selection in learner-controlled education

    NARCIS (Netherlands)

    Taminiau, Bettine; Corbalan, Gemma; Kester, Liesbeth; Van Merriënboer, Jeroen; Kirschner, Paul A.

    2011-01-01

    Taminiau, E. M. C., Corbalan, G., Kester, L., Van Merriënboer, J. J. G., & Kirschner, P. A. (2010, March). Procedural advice on self-assessment and task selection in learner-controlled education. Presentation at the ICO Springschool, Niederalteich, Germany.

  20. Procedural advice on self-assessment and task selection in learner-controlled education

    NARCIS (Netherlands)

    Taminiau, Bettine; Kester, Liesbeth; Corbalan, Gemma; Van Merriënboer, Jeroen; Kirschner, Paul A.

    2010-01-01

    Taminiau, E. M. C., Kester, L., Corbalan, G., Van Merriënboer, J. J. G., & Kirschner, P. A. (2010, July). Procedural advice on self-assessment and task selection in learner-controlled education. Paper presented at the Junior Researchers of EARLI Conference 2010, Frankfurt, Germany.

  1. The quality of procedures to assess and credit prior learning: Implications for design.

    NARCIS (Netherlands)

    Joosten-ten Brinke, Desirée; Sluijsmans, Dominique; Brand-Gruwel, Saskia; Jochems, Wim

    2008-01-01

    Joosten-ten Brinke, D., Sluijsmans, D. M. A., Brand-Gruwel, S., & Jochems, W. M. G. (2008). The quality of procedures to assess and credit prior learning: Implications for design. Educational Research Review, 3, 51-65. doi:10.1016/j.edurev.2007.08.001.

  2. Assessment procedure and probability determination methods of aircraft crash events in siting for nuclear power plants

    International Nuclear Information System (INIS)

    Zheng Qiyan; Zhang Lijun; Huang Weiqi; Yin Qingliao

    2010-01-01

    Assessment procedure of aircraft crash events in siting for nuclear power plants, and the methods of probability determination in two different stages of prelimi- nary screening and detailed evaluation are introduced in this paper. Except for general air traffic, airport operations and aircraft in the corridor, the probability of aircraft crash by military operation in the military airspaces is considered here. (authors)

  3. Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

    Science.gov (United States)

    Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

    2018-01-01

    There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

  4. Procedures and Tools Used by Teachers When Completing Functional Vision Assessments with Children with Visual Impairments

    Science.gov (United States)

    Kaiser, Justin T.; Herzberg, Tina S.

    2017-01-01

    Introduction: This study analyzed survey responses from 314 teachers of students with visual impairments regarding the tools and procedures used in completing functional vision assessments (FVAs). Methods: Teachers of students with visual impairments in the United States and Canada completed an online survey during spring 2016. Results: The…

  5. The Implicit Relational Assessment Procedure (IRAP) as a Measure of Spider Fear

    Science.gov (United States)

    Nicholson, Emma; Barnes-Holmes, Dermot

    2012-01-01

    A greater understanding of implicit cognition can provide important information regarding the etiology and maintenance of psychological disorders. The current study sought to determine the utility of the Implicit Relational Assessment Procedure (IRAP) as a measure of implicit aversive bias toward spiders in two groups of known variation, high fear…

  6. Optimized in vitro procedure for assessing the cytocompatibility of magnesium-based biomaterials.

    Science.gov (United States)

    Jung, Ole; Smeets, Ralf; Porchetta, Dario; Kopp, Alexander; Ptock, Christoph; Müller, Ute; Heiland, Max; Schwade, Max; Behr, Björn; Kröger, Nadja; Kluwe, Lan; Hanken, Henning; Hartjen, Philip

    2015-09-01

    Magnesium (Mg) is a promising biomaterial for degradable implant applications that has been extensively studied in vitro and in vivo in recent years. In this study, we developed a procedure that allows an optimized and uniform in vitro assessment of the cytocompatibility of Mg-based materials while respecting the standard protocol DIN EN ISO 10993-5:2009. The mouse fibroblast line L-929 was chosen as the preferred assay cell line and MEM supplemented with 10% FCS, penicillin/streptomycin and 4mM l-glutamine as the favored assay medium. The procedure consists of (1) an indirect assessment of effects of soluble Mg corrosion products in material extracts and (2) a direct assessment of the surface compatibility in terms of cell attachment and cytotoxicity originating from active corrosion processes. The indirect assessment allows the quantification of cell-proliferation (BrdU-assay), viability (XTT-assay) as well as cytotoxicity (LDH-assay) of the mouse fibroblasts incubated with material extracts. Direct assessment visualizes cells attached to the test materials by means of live-dead staining. The colorimetric assays and the visual evaluation complement each other and the combination of both provides an optimized and simple procedure for assessing the cytocompatibility of Mg-based biomaterials in vitro. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  7. A procedure for NEPA assessment of selenium hazards associated with mining.

    Science.gov (United States)

    Lemly, A Dennis

    2007-02-01

    This paper gives step-by-step instructions for assessing aquatic selenium hazards associated with mining. The procedure was developed to provide the U.S. Forest Service with a proactive capability for determining the risk of selenium pollution when it reviews mine permit applications in accordance with the National Environmental Policy Act (NEPA). The procedural framework is constructed in a decision-tree format in order to guide users through the various steps, provide a logical sequence for completing individual tasks, and identify key decision points. There are five major components designed to gather information on operational parameters of the proposed mine as well as key aspects of the physical, chemical, and biological environment surrounding it--geological assessment, mine operation assessment, hydrological assessment, biological assessment, and hazard assessment. Validation tests conducted at three mines where selenium pollution has occurred confirmed that the procedure will accurately predict ecological risks. In each case, it correctly identified and quantified selenium hazard, and indicated the steps needed to reduce this hazard to an acceptable level. By utilizing the procedure, NEPA workers can be confident in their ability to understand the risk of aquatic selenium pollution and take appropriate action. Although the procedure was developed for the Forest Service it should also be useful to other federal land management agencies that conduct NEPA assessments, as well as regulatory agencies responsible for issuing coal mining permits under the authority of the Surface Mining Control and Reclamation Act (SMCRA) and associated Section 401 water quality certification under the Clean Water Act. Mining companies will also benefit from the application of this procedure because priority selenium sources can be identified in relation to specific mine operating parameters. The procedure will reveal the point(s) at which there is a need to modify operating

  8. A procedure for safety assessment of components with cracks - Handbook. 3rd revised edition

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, P.; Bergman, M.; Brickstad, B.; Dahlberg, L.; Nilsson, F.; Sattari-Far, I. [SAQ Kontroll AB, Stockholm (Sweden)

    1999-12-01

    In this handbook a procedure is described which can be used both for assessment of detected cracks or crack-like defects and for defect tolerance analysis. The procedure can be used to calculate possible crack growth due to fatigue or stress corrosion and to calculate the reserve margin for failure due to fracture and plastic collapse. For ductile materials, the procedure gives the reserve margin for initiation of stable crack growth. Thus, an extra reserve margin, unknown to size, exists for failure in components made of ductile materials. The procedure was developed for operative use with the following objectives in mind: a) The procedure should be able to handle both linear and non-linear problems without any a priori division. b) The procedure shall ensure uniqueness of the safety assessment. c) The procedure should be well defined and easy to use. d) The conservatism of the procedure should be well validated. e) The handbook, that documents the procedure, should be so complete that for most assessments, access to any other fracture mechanics literature should not be necessary. The method utilized in the procedure is based on the R6-method developed at Nuclear Electric plc. The basic assumption is that fracture initiated by a crack can be described by the variables K{sub r} and L{sub r}. K{sub r} is the ratio between the stress intensity factor and the fracture toughness of the material. L{sub r} is the ratio between applied load and the plastic limit load of the structure. The pair of calculated values of these variables is plotted in a diagram. If the point is situated within the noncritical region, fracture is assumed not to occur. If the point is situated outside the region, crack growth and fracture may occur. The method can in principal be used for all metallic materials. It is, however, more extensively verified for steel alloys only. The method is not intended for use in temperature regions where creep deformation is of importance. To fulfil the above

  9. A procedure for safety assessment of components with cracks - Handbook. 3rd revised edition

    International Nuclear Information System (INIS)

    Andersson, P.; Bergman, M.; Brickstad, B.; Dahlberg, L.; Nilsson, F.; Sattari-Far, I.

    1999-12-01

    In this handbook a procedure is described which can be used both for assessment of detected cracks or crack-like defects and for defect tolerance analysis. The procedure can be used to calculate possible crack growth due to fatigue or stress corrosion and to calculate the reserve margin for failure due to fracture and plastic collapse. For ductile materials, the procedure gives the reserve margin for initiation of stable crack growth. Thus, an extra reserve margin, unknown to size, exists for failure in components made of ductile materials. The procedure was developed for operative use with the following objectives in mind: a) The procedure should be able to handle both linear and non-linear problems without any a priori division. b) The procedure shall ensure uniqueness of the safety assessment. c) The procedure should be well defined and easy to use. d) The conservatism of the procedure should be well validated. e) The handbook, that documents the procedure, should be so complete that for most assessments, access to any other fracture mechanics literature should not be necessary. The method utilized in the procedure is based on the R6-method developed at Nuclear Electric plc. The basic assumption is that fracture initiated by a crack can be described by the variables K r and L r . K r is the ratio between the stress intensity factor and the fracture toughness of the material. L r is the ratio between applied load and the plastic limit load of the structure. The pair of calculated values of these variables is plotted in a diagram. If the point is situated within the noncritical region, fracture is assumed not to occur. If the point is situated outside the region, crack growth and fracture may occur. The method can in principal be used for all metallic materials. It is, however, more extensively verified for steel alloys only. The method is not intended for use in temperature regions where creep deformation is of importance. To fulfil the above given objectives

  10. Development of a Three-Dimensional Hand Model Using Three-Dimensional Stereophotogrammetry: Assessment of Image Reproducibility.

    Directory of Open Access Journals (Sweden)

    Inge A Hoevenaren

    Full Text Available Using three-dimensional (3D stereophotogrammetry precise images and reconstructions of the human body can be produced. Over the last few years, this technique is mainly being developed in the field of maxillofacial reconstructive surgery, creating fusion images with computed tomography (CT data for precise planning and prediction of treatment outcome. Though, in hand surgery 3D stereophotogrammetry is not yet being used in clinical settings.A total of 34 three-dimensional hand photographs were analyzed to investigate the reproducibility. For every individual, 3D photographs were captured at two different time points (baseline T0 and one week later T1. Using two different registration methods, the reproducibility of the methods was analyzed. Furthermore, the differences between 3D photos of men and women were compared in a distance map as a first clinical pilot testing our registration method.The absolute mean registration error for the complete hand was 1.46 mm. This reduced to an error of 0.56 mm isolating the region to the palm of the hand. When comparing hands of both sexes, it was seen that the male hand was larger (broader base and longer fingers than the female hand.This study shows that 3D stereophotogrammetry can produce reproducible images of the hand without harmful side effects for the patient, so proving to be a reliable method for soft tissue analysis. Its potential use in everyday practice of hand surgery needs to be further explored.

  11. Diagnostic flexible pharyngo-laryngoscopy: development of a procedure specific assessment tool using a Delphi methodology.

    Science.gov (United States)

    Melchiors, Jacob; Henriksen, Mikael Johannes Vuokko; Dikkers, Frederik G; Gavilán, Javier; Noordzij, J Pieter; Fried, Marvin P; Novakovic, Daniel; Fagan, Johannes; Charabi, Birgitte W; Konge, Lars; von Buchwald, Christian

    2018-05-01

    Proper training and assessment of skill in flexible pharyngo-laryngoscopy are central in the education of otorhinolaryngologists. To facilitate an evidence-based approach to curriculum development in this field, a structured analysis of what constitutes flexible pharyngo-laryngoscopy is necessary. Our aim was to develop an assessment tool based on this analysis. We conducted an international Delphi study involving experts from twelve countries in five continents. Utilizing reiterative assessment, the panel defined the procedure and reached consensus (defined as 80% agreement) on the phrasing of an assessment tool. FIFTY PANELISTS COMPLETED THE DELPHI PROCESS. THE MEDIAN AGE OF THE PANELISTS WAS 44 YEARS (RANGE 33-64 YEARS). MEDIAN EXPERIENCE IN OTORHINOLARYNGOLOGY WAS 15 YEARS (RANGE 6-35 YEARS). TWENTY-FIVE WERE SPECIALIZED IN LARYNGOLOGY, 16 WERE HEAD AND NECK SURGEONS, AND NINE WERE GENERAL OTORHINOLARYNGOLOGISTS. AN ASSESSMENT TOOL WAS CREATED CONSISTING OF TWELVE DISTINCT ITEMS.: Conclusion The gathering of validity evidence for assessment of core procedural skills within Otorhinolaryngology is central to the development of a competence-based education. The use of an international Delphi panel allows for the creation of an assessment tool which is widely applicable and valid. This work allows for an informed approach to technical skills training for flexible pharyngo-laryngoscopy and as further validity evidence is gathered allows for a valid assessment of clinical performance within this important skillset.

  12. Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach.

    Science.gov (United States)

    Sousa, Liliana B; Simões, Mário R; Firmino, Horácio; Peisah, Carmelle

    2014-02-01

    Mental health professionals are frequently involved in mental capacity determinations. However, there is a lack of specific measures and well-defined procedures for these evaluations. The main purpose of this paper is to provide a review of financial and testamentary capacity evaluation procedures, including not only the traditional neuropsychological and functional assessment but also the more recently developed forensic assessment instruments (FAIs), which have been developed to provide a specialized answer to legal systems regarding civil competencies. Here the main guidelines, papers, and other references are reviewed in order to achieve a complete and comprehensive selection of instruments used in the assessment of financial and testamentary capacity. Although some specific measures for financial abilities have been developed recently, the same is not true for testamentary capacity. Here are presented several instruments or methodologies for assessing financial and testamentary capacity, including neuropsychological assessment, functional assessment scales, performance based functional assessment instruments, and specific FAIs. FAIs are the only specific instruments intended to provide a specific and direct answer to the assessment of financial capacity based on legal systems. Considering the need to move from a diagnostic to a functional approach in financial and testamentary capacity evaluations, it is essential to consider both general functional examination as well as cognitive functioning.

  13. 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

  14. Assessment of eye lens doses for workers during interventional radiology procedures

    International Nuclear Information System (INIS)

    Urboniene, A.; Sadzeviciene, E.; Ziliukas, J.

    2015-01-01

    The assessment of eye lens doses for workers during interventional radiology (IR) procedures was performed using a new eye lens dosemeter. In parallel, the results of routine individual monitoring were analysed and compared with the results obtained from measurements with a new eye lens dosemeter. The eye lens doses were assessed using H p (3) measured at the level of the eyes and were compared with H p (10) measured with the whole-body dosemeter above the lead collar. The information about use of protective measures, the number of performed interventional procedures per month and their fluoroscopy time was also collected. The assessment of doses to the lens of the eye was done for 50 IR workers at 9 Lithuanian hospitals for the period of 2012-2013. If the use of lead glasses is not taken into account, the estimated maximum annual dose equivalent to the lens of the eye was 82 mSv. (authors)

  15. A probabilistic seismic risk assessment procedure for nuclear power plants: (II) Application

    Science.gov (United States)

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.

    2011-01-01

    This paper presents the procedures and results of intensity- and time-based seismic risk assessments of a sample nuclear power plant (NPP) to demonstrate the risk-assessment methodology proposed in its companion paper. The intensity-based assessments include three sets of sensitivity studies to identify the impact of the following factors on the seismic vulnerability of the sample NPP, namely: (1) the description of fragility curves for primary and secondary components of NPPs, (2) the number of simulations of NPP response required for risk assessment, and (3) the correlation in responses between NPP components. The time-based assessment is performed as a series of intensity-based assessments. The studies illustrate the utility of the response-based fragility curves and the inclusion of the correlation in the responses of NPP components directly in the risk computation. ?? 2011 Published by Elsevier B.V.

  16. A cadaveric procedural anatomy simulation course improves video-based assessment of operative performance.

    Science.gov (United States)

    Sharma, Gaurav; Aycart, Mario A; O'Mara, Lynne; Havens, Joaquim; Nehs, Matthew; Shimizu, Naomi; Smink, Douglas S; Gravereaux, Edwin; Gates, Jonathan D; Askari, Reza

    2018-03-01

    Inadequate anatomic knowledge has been cited as a major contributor to declining surgical resident operative competence. We analyzed the impact of a comprehensive, procedurally oriented cadaveric procedural anatomy dissection laboratory on the operative performance of surgery residents, hypothesizing that trainees' performance of surgical procedures would improve after such a dissection course. Midlevel general surgery residents (n = 9) participated in an 8 wk, 16-h surgery faculty-led procedurally oriented cadaver simulation course. Both before and after completion of the course, residents participated in a practical examination, in which they were randomized to perform one of nine Surgical Council on Resident Education-designated "essential" procedures. The procedures were recorded using wearable video technology. Videos were deidentified before evaluation by six faculty raters blinded to examinee and whether performances occurred before or after an examinee had taken the course. Raters used the validated Operative Performance Rating System and Objective Structured Assessment of Technical Skill scales. After the course residents had higher procedure-specific scores (median, 4.0 versus 2.4, P 4.0 versus 3.0, P = 0.006), respect for tissue (4.0 versus 3.0, P = 0.0004), time and motion (3.0 versus 2.0, P = 0.0007), operation flow (3.0 versus 2.0, P = 0.0005), procedural knowledge (4.0 versus 2.0, P = 0.0001), and overall performance scores (4.0 versus 2.0, P < 0.0001). Operative Performance Rating System and Objective Structured Assessment of Technical Skill scales averaged by number of items in each were also higher (3.2 versus 2.0, P = 0.0002 and 3.1 versus 2.2, P = 0.002, respectively). A cadaveric procedural anatomy simulation course covering a broad range of open general surgery procedures was associated with significant improvements in trainees' operative performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A Proposed Model for Selecting Measurement Procedures for the Assessment and Treatment of Problem Behavior.

    Science.gov (United States)

    LeBlanc, Linda A; Raetz, Paige B; Sellers, Tyra P; Carr, James E

    2016-03-01

    Practicing behavior analysts frequently assess and treat problem behavior as part of their ongoing job responsibilities. Effective measurement of problem behavior is critical to success in these activities because some measures of problem behavior provide more accurate and complete information about the behavior than others. However, not every measurement procedure is appropriate for every problem behavior and therapeutic circumstance. We summarize the most commonly used measurement procedures, describe the contexts for which they are most appropriate, and propose a clinical decision-making model for selecting measurement produces given certain features of the behavior and constraints of the therapeutic environment.

  18. 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.

  19. Robotic Hand

    Science.gov (United States)

    1993-01-01

    The Omni-Hand was developed by Ross-Hime Designs, Inc. for Marshall Space Flight Center (MSFC) under a Small Business Innovation Research (SBIR) contract. The multiple digit hand has an opposable thumb and a flexible wrist. Electric muscles called Minnacs power wrist joints and the interchangeable digits. Two hands have been delivered to NASA for evaluation for potential use on space missions and the unit is commercially available for applications like hazardous materials handling and manufacturing automation. Previous SBIR contracts resulted in the Omni-Wrist and Omni-Wrist II robotic systems, which are commercially available for spray painting, sealing, ultrasonic testing, as well as other uses.

  20. Variability in Resident Operative Hand Experience by Specialty.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, L Scott; Chang, Benjamin

    2018-01-01

    Recent attention has sought to standardize hand surgery training in the United States. This study analyzes the variability in operative hand experience for orthopedic and general surgery residents. Case logs for orthopedic and general surgery residency graduates were obtained from the American Council of Graduate Medical Education (2006-2007 to 2014-2015). Plastic surgery case logs were not available for comparison. Hand surgery case volumes were compared between specialties with parametric tests. Intraspecialty variation in orthopedic surgery was assessed between the bottom and top 10th percentiles in procedure categories. Case logs for 9605 general surgery residents and 5911 orthopedic surgery residents were analyzed. Orthopedic surgery residents performed a greater number of hand surgery cases than general surgery residents ( P < .001). Mean total hand experience ranged from 2.5 ± 4 to 2.8 ± 5 procedures for general surgery residents with no reported cases of soft tissue repairs, vascular repairs, and replants. Significant intraspecialty variation existed in orthopedic surgery for all hand procedure categories (range, 3.3-15.0). As the model for hand surgery training evolves, general surgeons may represent an underutilized talent pool to meet the critical demand for hand surgeon specialists. Future research is needed to determine acceptable levels of training variability in hand surgery.

  1. Psycho-physiological assessment of a prosthetic hand sensory feedback system based on an auditory display: a preliminary study.

    Science.gov (United States)

    Gonzalez, Jose; Soma, Hirokazu; Sekine, Masashi; Yu, Wenwei

    2012-06-09

    Prosthetic hand users have to rely extensively on visual feedback, which seems to lead to a high conscious burden for the users, in order to manipulate their prosthetic devices. Indirect methods (electro-cutaneous, vibrotactile, auditory cues) have been used to convey information from the artificial limb to the amputee, but the usability and advantages of these feedback methods were explored mainly by looking at the performance results, not taking into account measurements of the user's mental effort, attention, and emotions. The main objective of this study was to explore the feasibility of using psycho-physiological measurements to assess cognitive effort when manipulating a robot hand with and without the usage of a sensory substitution system based on auditory feedback, and how these psycho-physiological recordings relate to temporal and grasping performance in a static setting. 10 male subjects (26+/-years old), participated in this study and were asked to come for 2 consecutive days. On the first day the experiment objective, tasks, and experiment setting was explained. Then, they completed a 30 minutes guided training. On the second day each subject was tested in 3 different modalities: Auditory Feedback only control (AF), Visual Feedback only control (VF), and Audiovisual Feedback control (AVF). For each modality they were asked to perform 10 trials. At the end of each test, the subject had to answer the NASA TLX questionnaire. Also, during the test the subject's EEG, ECG, electro-dermal activity (EDA), and respiration rate were measured. The results show that a higher mental effort is needed when the subjects rely only on their vision, and that this effort seems to be reduced when auditory feedback is added to the human-machine interaction (multimodal feedback). Furthermore, better temporal performance and better grasping performance was obtained in the audiovisual modality. The performance improvements when using auditory cues, along with vision

  2. Psycho-physiological assessment of a prosthetic hand sensory feedback system based on an auditory display: a preliminary study

    Directory of Open Access Journals (Sweden)

    Gonzalez Jose

    2012-06-01

    Full Text Available Abstract Background Prosthetic hand users have to rely extensively on visual feedback, which seems to lead to a high conscious burden for the users, in order to manipulate their prosthetic devices. Indirect methods (electro-cutaneous, vibrotactile, auditory cues have been used to convey information from the artificial limb to the amputee, but the usability and advantages of these feedback methods were explored mainly by looking at the performance results, not taking into account measurements of the user’s mental effort, attention, and emotions. The main objective of this study was to explore the feasibility of using psycho-physiological measurements to assess cognitive effort when manipulating a robot hand with and without the usage of a sensory substitution system based on auditory feedback, and how these psycho-physiological recordings relate to temporal and grasping performance in a static setting. Methods 10 male subjects (26+/-years old, participated in this study and were asked to come for 2 consecutive days. On the first day the experiment objective, tasks, and experiment setting was explained. Then, they completed a 30 minutes guided training. On the second day each subject was tested in 3 different modalities: Auditory Feedback only control (AF, Visual Feedback only control (VF, and Audiovisual Feedback control (AVF. For each modality they were asked to perform 10 trials. At the end of each test, the subject had to answer the NASA TLX questionnaire. Also, during the test the subject’s EEG, ECG, electro-dermal activity (EDA, and respiration rate were measured. Results The results show that a higher mental effort is needed when the subjects rely only on their vision, and that this effort seems to be reduced when auditory feedback is added to the human-machine interaction (multimodal feedback. Furthermore, better temporal performance and better grasping performance was obtained in the audiovisual modality. Conclusions The performance

  3. Procedures for conducting common cause failure analysis in probabilistic safety assessment

    International Nuclear Information System (INIS)

    1992-05-01

    The principal objective of this report is to supplement the procedure developed in Mosleh et al. (1988, 1989) by providing more explicit guidance for a practical approach to common cause failures (CCF) analysis. The detailed CCF analysis following that procedure would be very labour intensive and time consuming. This document identifies a number of options for performing the more labour intensive parts of the analysis in an attempt to achieve a balance between the need for detail, the purpose of the analysis and the resources available. The document is intended to be compatible with the Agency's Procedures for Conducting Probabilistic Safety Assessments for Nuclear Power Plants (IAEA, 1992), but can be regarded as a stand-alone report to be used in conjunction with NUREG/CR-4780 (Mosleh et al., 1988, 1989) to provide additional detail, and discussion of key technical issues

  4. Assessment of skeletal age using MP3 and hand-wrist radiographs and its correlation with dental and chronological ages in children.

    Science.gov (United States)

    Bala, M; Pathak, A; Jain, R L

    2010-01-01

    The purpose of the study was to assess skeletal age using MP3 and hand-wrist radiographs and to find the correlation amongst the skeletal, dental and chronological ages. One hundred and sixty North-Indian healthy children in the age group 8-14 years, comprising equal number of males and females were included in the study. The children were radiographed for middle phalanx of third finger (MP3) and hand-wrist of the right hand and intra oral periapical X-ray for right permanent maxillary canine. Skeletal age was assessed from MP3 and hand-wrist radiographs according to the standards of Greulich and Pyle. The dental age was assessed from IOPA radiographs of right permanent maxillary canine based on Nolla's calcification stages. Skeletal age from MP3 and hand-wrist radiographs shows high correlation in all the age groups for both sexes. Females were advanced in skeletal maturation than males. Skeletal age showed high correlation with dental age in 12-14 years age group. Chronological age showed inconsistent correlation with dental and skeletal ages.

  5. Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry-based study assessing risk of disability pension.

    Science.gov (United States)

    Heede, Nina G; Thuesen, Betina H; Thyssen, Jacob P; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Menné, Torkil; Johansen, Jeanne D

    2017-08-01

    Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Disability pension was associated with hand eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15-14.11; and OR 6.01 and 95%CI: 2.37-15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed hand eczema had experienced symptoms before adulthood. In the general population, self-reported hand eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Assessment of radiation protection of patients and staff in interventional procedures in four Algerian hospitals

    International Nuclear Information System (INIS)

    Khelassi-Toutaoui, N.; Toutaoui, A.; Merad, A.; Sakhri-Brahimi, Z.; Baggoura, B.; Mansouri, B.

    2016-01-01

    This study was aimed to assess patient dosimetry in interventional cardiology (IC) and radiology (IR) and radiation safety of the medical operating staff. For this purpose, four major Algerian hospitals were investigated. The data collected cover radiation protection tools assigned to the operating staff and measured radiation doses to some selected patient populations. The analysis revealed that lead aprons are systematically worn by the staff but not lead eye glasses, and only a single personal monitoring badge is assigned to the operating staff. Measured doses to patients exhibited large variations in the maximum skin dose (MSD) and in the dose area product (DAP). The mean MSD registered values are as follows: 0.20, 0.14 and 1.28 Gy in endoscopic retrograde cholangio-pancreatography (ERCP), coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) procedures, respectively. In PTCA, doses to 3 out of 22 patients (13.6 %) had even reached the threshold value of 2 Gy. The mean DAP recorded values are as follows: 21.6, 60.1 and 126 Gy cm 2 in ERCP, CA and PTCA procedures, respectively. Mean fluoroscopic times are 2.5, 5 and 15 min in ERCP, CA and PTCA procedures, respectively. The correlation between DAP and MSD is fair in CA (r = 0.62) and poor in PTCA (r = 0.28). Fluoroscopic time was moderately correlated with DAP in CA (r = 0.55) and PTCA (r = 0.61) procedures. Local diagnostic reference levels (DRLs) in CA and PTCA procedures have been proposed. In conclusion, this study stresses the need for a continuous patient dose monitoring in interventional procedures with a special emphasis in IC procedures. Common strategies must be undertaken to substantially reduce radiation doses to both patients and medical staff. (authors)

  7. Prospective randomized assessment of single versus double-gloving for general surgical procedures.

    Science.gov (United States)

    Na'aya, H U; Madziga, A G; Eni, U E

    2009-01-01

    There is increased tendency towards double-gloving by general surgeons in our practice, due probably to awareness of the risk of contamination with blood or other body fluids during surgery. The aim of the study was to compare the relative frequency of glove puncture in single-glove versus double glove sets in general surgical procedures, and to determine if duration of surgery affects perforation rate. Surgeons at random do single or double gloves at their discretion, for general surgical procedures. All the gloves used by the surgeons were assessed immediately after surgery for perforation. A total of 1120 gloves were tested, of which 880 were double-glove sets and 240 single-glove sets. There was no significant difference in the overall perforation rate between single and double glove sets (18.3% versus 20%). However, only 2.3% had perforations in both the outer and inner gloves in the double glove group. Therefore, there was significantly greater risk for blood-skin exposure in the single glove sets (p < 0.01). The perforation rate was also significantly greater during procedures lasting an hour or more compared to those lasting less than an hour (p < 0.01). Double-gloving reduces the risk of blood-skin contamination in all general surgical procedures, and especially so in procedures lasting an hour or more.

  8. Readability and Content Assessment of Informed Consent Forms for Medical Procedures in Croatia.

    Science.gov (United States)

    Vučemilo, Luka; Borovečki, Ana

    2015-01-01

    High quality of informed consent form is essential for adequate information transfer between physicians and patients. Current status of medical procedure consent forms in clinical practice in Croatia specifically in terms of the readability and the content is unknown. The aim of this study was to assess the readability and the content of informed consent forms for diagnostic and therapeutic procedures used with patients in Croatia. 52 informed consent forms from six Croatian hospitals on the secondary and tertiary health-care level were tested for reading difficulty using Simple Measure of Gobbledygook (SMOG) formula adjusted for Croatian language and for qualitative analysis of the content. The averaged SMOG grade of analyzed informed consent forms was 13.25 (SD 1.59, range 10-19). Content analysis revealed that informed consent forms included description of risks in 96% of the cases, benefits in 81%, description of procedures in 78%, alternatives in 52%, risks and benefits of alternatives in 17% and risks and benefits of not receiving treatment or undergoing procedures in 13%. Readability of evaluated informed consent forms is not appropriate for the general population in Croatia. The content of the forms failed to include in high proportion of the cases description of alternatives, risks and benefits of alternatives, as well as risks and benefits of not receiving treatments or undergoing procedures. Data obtained from this research could help in development and improvement of informed consent forms in Croatia especially now when Croatian hospitals are undergoing the process of accreditation.

  9. Considering the normative, systemic and procedural dimensions in indicator-based sustainability assessments in agriculture

    International Nuclear Information System (INIS)

    Binder, Claudia R.; Feola, Giuseppe; Steinberger, Julia K.

    2010-01-01

    This paper develops a framework for evaluating sustainability assessment methods by separately analyzing their normative, systemic and procedural dimensions as suggested by Wiek and Binder [Wiek, A, Binder, C. Solution spaces for decision-making - a sustainability assessment tool for city-regions. Environ Impact Asses Rev 2005, 25: 589-608.]. The framework is then used to characterize indicator-based sustainability assessment methods in agriculture. For a long time, sustainability assessment in agriculture has focused mostly on environmental and technical issues, thus neglecting the economic and, above all, the social aspects of sustainability, the multi-functionality of agriculture and the applicability of the results. In response to these shortcomings, several integrative sustainability assessment methods have been developed for the agricultural sector. This paper reviews seven of these that represent the diversity of tools developed in this area. The reviewed assessment methods can be categorized into three types: (i) top-down farm assessment methods; (ii) top-down regional assessment methods with some stakeholder participation; (iii) bottom-up, integrated participatory or transdisciplinary methods with stakeholder participation throughout the process. The results readily show the trade-offs encountered when selecting an assessment method. A clear, standardized, top-down procedure allows for potentially benchmarking and comparing results across regions and sites. However, this comes at the cost of system specificity. As the top-down methods often have low stakeholder involvement, the application and implementation of the results might be difficult. Our analysis suggests that to include the aspects mentioned above in agricultural sustainability assessment, the bottom-up, integrated participatory or transdisciplinary methods are the most suitable ones.

  10. Development of residual stress analysis procedure for fitness-for-service assessment of welded structure

    International Nuclear Information System (INIS)

    Kim, Jong Sung; Jin, Tae Eun; Dong, P.; Prager, M.

    2003-01-01

    In this study, a state of art review of existing residual stress analysis techniques and representative solutions is presented in order to develop the residual stress analysis procedure for Fitness-For-Service(FFS) assessment of welded structure. Critical issues associated with existing residual stress solutions and their treatments in performing FFS are discussed. It should be recognized that detailed residual stress evolution is an extremely complicated phenomenon that typically involves material-specific thermomechanical/metallurgical response, welding process physics, and structural interactions within a component being welded. As a result, computational procedures can vary significantly from highly complicated numerical techniques intended only to elucidate a small part of the process physics to cost-effective procedures that are deemed adequate for capturing some of the important features in a final residual stress distribution. Residual stress analysis procedure for FFS purposes belongs to the latter category. With this in mind, both residual stress analysis techniques and their adequacy for FFS are assessed based on both literature data and analyses performed in this investigation

  11. Assessment of bleeding during minor oral surgical procedures and extraction in patients on anticoagulant therapy

    Directory of Open Access Journals (Sweden)

    S Jimson

    2015-01-01

    Full Text Available Introduction: The risk of postoperative hemorrhage from oral surgical procedures has been a concern in the treatment of patients who are receiving long-term anticoagulation therapy. A study undertaken in our institution to address questions about the amount and severity of bleeding associated with minor outpatient oral surgery procedures by assessing bleeding in patients who did not alter their anticoagulant regimen. Subjects and Methods: Eighty-three patients receiving long-term anticoagulant therapy visited Department of Oral and Maxillofacial Surgery from May 2010 to October 2011 for extractions and minor oral surgical procedures. Each patient was required to undergo preoperative assessment of prothrombin time (PT and measurement of the international normalized ratio. Fifty-six patients with preoperative PT values within the therapeutic range 3-4 were included in the study. The patients′ age ranged between 30 and 75 years. Application of surgispon was done following the procedure. Extraction of teeth performed with minimal trauma to the surrounding tissues, the socket margins sutured, and sutures removed after 5 days. Results: There was no significant incidence of prolonged or excessive hemorrhage and wound infection and the healing process was normal.

  12. A limited assessment of the ASEP human reliability analysis procedure using simulator examination results

    International Nuclear Information System (INIS)

    Gore, B.R.; Dukelow, J.S. Jr.; Mitts, T.M.; Nicholson, W.L.

    1995-10-01

    This report presents a limited assessment of the conservatism of the Accident Sequence Evaluation Program (ASEP) human reliability analysis (HRA) procedure described in NUREG/CR-4772. In particular, the, ASEP post-accident, post-diagnosis, nominal HRA procedure is assessed within the context of an individual's performance of critical tasks on the simulator portion of requalification examinations administered to nuclear power plant operators. An assessment of the degree to which operator perforn:Lance during simulator examinations is an accurate reflection of operator performance during actual accident conditions was outside the scope of work for this project; therefore, no direct inference can be made from this report about such performance. The data for this study are derived from simulator examination reports from the NRC requalification examination cycle. A total of 4071 critical tasks were identified, of which 45 had been failed. The ASEP procedure was used to estimate human error probability (HEP) values for critical tasks, and the HEP results were compared with the failure rates observed in the examinations. The ASEP procedure was applied by PNL operator license examiners who supplemented the limited information in the examination reports with expert judgment based upon their extensive simulator examination experience. ASEP analyses were performed for a sample of 162 critical tasks selected randomly from the 4071, and the results were used to characterize the entire population. ASEP analyses were also performed for all of the 45 failed critical tasks. Two tests were performed to assess the bias of the ASEP HEPs compared with the data from the requalification examinations. The first compared the average of the ASEP HEP values with the fraction of the population actually failed and it found a statistically significant factor of two bias on the average

  13. Assessment of Apical Extrusion of Debris during Endodontic Retreatment with 3 Rotary Nickel-Titanium Retreatment Systems and Hand Files

    Directory of Open Access Journals (Sweden)

    Gkampesi S.

    2016-03-01

    Full Text Available Aim: to evaluate the amount of debris extruded apically as well as the time needed for removal of root canal filling material using ProTaper, MTwo, REndo NiTi rotary retreatment systems and hand files.

  14. Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection

    Directory of Open Access Journals (Sweden)

    Omnia A Abu-Bakr

    2017-01-01

    Conclusion BTX injection in spastic muscles of the wrist and hand, followed by a rehabilitation program led to greater clinical and functional improvement compared with implementing the rehabilitation program alone.

  15. Breast-density assessment with hand-held ultrasound: A novel biomarker to assess breast cancer risk and to tailor screening?

    Science.gov (United States)

    Sanabria, Sergio J; Goksel, Orcun; Martini, Katharina; Forte, Serafino; Frauenfelder, Thomas; Kubik-Huch, Rahel A; Rominger, Marga B

    2018-03-19

    To assess feasibility and diagnostic accuracy of a novel hand-held ultrasound (US) method for breast density assessment that measures the speed of sound (SoS), in comparison to the ACR mammographic (MG) categories. ACR-MG density (a=fatty to d=extremely dense) and SoS-US were assessed in the retromamillary, inner and outer segments of 106 women by two radiographers. A conventional US system was used for SoS-US. A reflector served as timing reference for US signals transmitted through the breasts. Four blinded readers assessed average SoS (m/s), ΔSoS (segment-variation SoS; m/s) and the ACR-MG density. The highest SoS and ΔSoS values of the three segments were used for MG-ACR whole breast comparison. SoS-US breasts were examined in densities a-d were 1,421 m/s (SD 14), 1,432 m/s (SD 17), 1,448 m/s (SD 20) and 1,500 m/s (SD 31), with significant differences between all groups (pdensity was evident (r s =0.622, p=density without discomfort, readers evaluated measurements with high inter-reader agreement, and SoS-US correlated significantly with ACR-MG breast-density categories. • The novel speed-of-sound ultrasound correlated significantly with mammographic ACR breast density categories. • Radiographers measured breast density without women discomfort or radiation. • SoS-US can be implemented on a standard US machine. • SoS-US shows potential for a quantifiable, cost-effective assessment of breast density.

  16. Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods.

    Science.gov (United States)

    Rajkumar, Sarah; Huynh, Cong Khanh; Bauer, Georg F; Hoffmann, Susanne; Röösli, Martin

    2013-06-04

    In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law. Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated. Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum). Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.

  17. A Study to Assess Knowledge and Attitude Regarding Hand Hygiene amongst Residents and Nursing Staff in a Tertiary Health Care Setting of Bhopal City.

    Science.gov (United States)

    Maheshwari, Veena; Kaore, Navin Chandra M; Ramnani, Vijay Kumar; Gupta, Sanjay Kumar; Borle, Amod; Kaushal, Rituja

    2014-08-01

    Infection due to hospital-acquired microbes is an evolving problem worldwide, and horizontal transmission of bacterial organism continues to cause a high nosocomial infection rate in health care settings. Most nosocomial infections are thought to be transmitted by the hands of health care workers.The application of hand hygiene is effective in reducing infection rates. To assess the level of knowledge and attitude regarding hand hygiene practices amongst the health care professionals and to identify areas of gaps in their knowledge and attitude. A cross-sectional study. A total 160 respondents were studied about their knowledge and attitude towards hand hygiene practices and significant difference with a p-value of 0.0025 was observed regarding most frequent source of germs responsible for health care associated infections among resident and nurses. A significant difference with p-value of 0.0001 & 0.04 was observed in colonization due to jewellery and artificial nail among the study groups. The attitude regarding correct hand hygiene practices to be followed at all times was found to be better among nurses (62.5%) as compared to residents (21.3%) which was found to be highly significant with p-value hand hygiene practices among the health care workers to provide the current knowledge in the area with a behavioral change in attitudes and practices leading to reduction of nosocomial infections.

  18. A comparison of Google Glass and traditional video vantage points for bedside procedural skill assessment.

    Science.gov (United States)

    Evans, Heather L; O'Shea, Dylan J; Morris, Amy E; Keys, Kari A; Wright, Andrew S; Schaad, Douglas C; Ilgen, Jonathan S

    2016-02-01

    This pilot study assessed the feasibility of using first person (1P) video recording with Google Glass (GG) to assess procedural skills, as compared with traditional third person (3P) video. We hypothesized that raters reviewing 1P videos would visualize more procedural steps with greater inter-rater reliability than 3P rating vantages. Seven subjects performed simulated internal jugular catheter insertions. Procedures were recorded by both Google Glass and an observer's head-mounted camera. Videos were assessed by 3 expert raters using a task-specific checklist (CL) and both an additive- and summative-global rating scale (GRS). Mean scores were compared by t-tests. Inter-rater reliabilities were calculated using intraclass correlation coefficients. The 1P vantage was associated with a significantly higher mean CL score than the 3P vantage (7.9 vs 6.9, P = .02). Mean GRS scores were not significantly different. Mean inter-rater reliabilities for the CL, additive-GRS, and summative-GRS were similar between vantages. 1P vantage recordings may improve visualization of tasks for behaviorally anchored instruments (eg, CLs), whereas maintaining similar global ratings and inter-rater reliability when compared with conventional 3P vantage recordings. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. An independent safety assessment of Department of Energy nuclear reactor facilities: Procedures, operations and maintenance

    International Nuclear Information System (INIS)

    Toto, G.; Lindgren, A.J.

    1981-02-01

    The 1979 accident at the Three Mile Island commercial nuclear power plant has led to a number of studies of nuclear reactors, in both the public and private sectors. One of these is that of the Department of Energy's (DOE) Nuclear Facilities Personnel Qualification and Training (NFPQT) Committee, which has outlined tasks for assessment of 13 reactors owned by DOE and operated by contractors. This report covers one of the tasks, the assessment of procedures, operations, and maintenance at the DOE reactor facilities, based on a review of actual documents used at the reactor sites

  20. Relationship between the Short-Term Visual Memory and IQ in the Right-and Left-Handed Subjects Trained in Different Educational Programs: I-General Assessment

    Science.gov (United States)

    Yilmaz, Yavuz; Yetkin, Yalçin

    2014-01-01

    The relationship between mean intelligence quotient (IQ), hand preferences and visual memory (VM) were investigated on (N = 612) males and females students trained in different educational programs in viewpoint of laterality. IQ was assessed by cattle's culture Fair intelligence test-A (CCFIT-A). The laterality of the one side of the body was…

  1. Portfolio assessment during medical internships: How to obtain a reliable and feasible assessment procedure?

    Science.gov (United States)

    Michels, Nele R M; Driessen, Erik W; Muijtjens, Arno M M; Van Gaal, Luc F; Bossaert, Leo L; De Winter, Benedicte Y

    2009-12-01

    A portfolio is used to mentor and assess students' clinical performance at the workplace. However, students and raters often perceive the portfolio as a time-consuming instrument. In this study, we investigated whether assessment during medical internship by a portfolio can combine reliability and feasibility. The domain-oriented reliability of 61 double-rated portfolios was measured, using a generalisability analysis with portfolio tasks and raters as sources of variation in measuring the performance of a student. We obtained reliability (Phi coefficient) of 0.87 with this internship portfolio containing 15 double-rated tasks. The generalisability analysis showed that an acceptable level of reliability (Phi = 0.80) was maintained when the amount of portfolio tasks was decreased to 13 or 9 using one and two raters, respectively. Our study shows that a portfolio can be a reliable method for the assessment of workplace learning. The possibility of reducing the amount of tasks or raters while maintaining a sufficient level of reliability suggests an increase in feasibility of portfolio use for both students and raters.

  2. Default values for assessment of potential dermal exposure of the hands to industrial chemicals in the scope of regulatory risk assessments.

    Science.gov (United States)

    Marquart, Hans; Warren, Nicholas D; Laitinen, Juha; van Hemmen, Joop J

    2006-07-01

    Dermal exposure needs to be addressed in regulatory risk assessment of chemicals. The models used so far are based on very limited data. The EU project RISKOFDERM has gathered a large number of new measurements on dermal exposure to industrial chemicals in various work situations, together with information on possible determinants of exposure. These data and information, together with some non-RISKOFDERM data were used to derive default values for potential dermal exposure of the hands for so-called 'TGD exposure scenarios'. TGD exposure scenarios have similar values for some very important determinant(s) of dermal exposure, such as amount of substance used. They form narrower bands within the so-called 'RISKOFDERM scenarios', which cluster exposure situations according to the same purpose of use of the products. The RISKOFDERM scenarios in turn are narrower bands within the so-called Dermal Exposure Operation units (DEO units) that were defined in the RISKOFDERM project to cluster situations with similar exposure processes and exposure routes. Default values for both reasonable worst case situations and typical situations were derived, both for single datasets and, where possible, for combined datasets that fit the same TGD exposure scenario. The following reasonable worst case potential hand exposures were derived from combined datasets: (i) loading and filling of large containers (or mixers) with large amounts (many litres) of liquids: 11,500 mg per scenario (14 mg cm(-2) per scenario with surface of the hands assumed to be 820 cm(2)); (ii) careful mixing of small quantities (tens of grams in default values are considered useful for estimating exposure for similar substances in similar situations with low uncertainty. Several other default values based on single datasets can also be used, but lead to estimates with a higher uncertainty, due to their more limited basis. Sufficient analogy in all described parameters of the scenario, including duration, is needed

  3. A Double-Coil TMS Method to Assess Corticospinal Excitability Changes at a Near-Simultaneous Time in the Two Hands during Movement Preparation

    Science.gov (United States)

    Wilhelm, Emmanuelle; Quoilin, Caroline; Petitjean, Charlotte; Duque, Julie

    2016-01-01

    Background: Many previous transcranial magnetic stimulation (TMS) studies have investigated corticospinal excitability changes occurring when choosing which hand to use for an action, one of the most frequent decision people make in daily life. So far, these studies have applied single-pulse TMS eliciting motor-evoked potential (MEP) in one hand when this hand is either selected or non-selected. Using such method, hand choices were shown to entail the operation of two inhibitory mechanisms, suppressing MEPs in the targeted hand either when it is non-selected (competition resolution, CR) or selected (impulse control, IC). However, an important limitation of this “Single-Coil” method is that MEPs are elicited in selected and non-selected conditions during separate trials and thus those two settings may not be completely comparable. Moreover, a more important problem is that MEPs are computed in relation to the movement of different hands. The goal of the present study was to test a “Double-Coil” method to evaluate IC and CR preceding the same hand responses by applying Double-Coil TMS over the two primary motor cortices (M1) at a near-simultaneous time (1 ms inter-pulse interval). Methods: MEPs were obtained in the left (MEPLEFT) and right (MEPRIGHT) hands while subjects chose between left and right hand key-presses in blocks using a Single-Coil or a Double-Coil method; in the latter blocks, TMS was either applied over left M1 first (TMSLRM1 group, n = 12) or right M1 first (TMSRLM1 group, n = 12). Results: MEPLEFT were suppressed preceding both left (IC) and right (CR) hand responses whereas MEPRIGHT were only suppressed preceding left (CR) but not right (IC) hand responses. This result was observed regardless of whether Single-Coil or Double-Coil TMS was applied in the two subject groups. However, in the TMSLRM1 group, the MEP suppression was attenuated in Double-Coil compared to Single-Coil blocks for both IC and CR, when probed with MEPLEFT (elicited by

  4. Assessment of Myoelectric Controller Performance and Kinematic Behavior of a Novel Soft Synergy-Inspired Robotic Hand for Prosthetic Applications.

    Science.gov (United States)

    Fani, Simone; Bianchi, Matteo; Jain, Sonal; Pimenta Neto, José Simões; Boege, Scott; Grioli, Giorgio; Bicchi, Antonio; Santello, Marco

    2016-01-01

    Myoelectric artificial limbs can significantly advance the state of the art in prosthetics, since they can be used to control mechatronic devices through muscular activity in a way that mimics how the subjects used to activate their muscles before limb loss. However, surveys indicate that dissatisfaction with the functionality of terminal devices underlies the widespread abandonment of prostheses. We believe that one key factor to improve acceptability of prosthetic devices is to attain human likeness of prosthesis movements, a goal which is being pursued by research on social and human-robot interactions. Therefore, to reduce early abandonment of terminal devices, we propose that controllers should be designed so as to ensure effective task accomplishment in a natural fashion. In this work, we have analyzed and compared the performance of three types of myoelectric controller algorithms based on surface electromyography to control an underactuated and multi-degrees of freedom prosthetic hand, the SoftHand Pro. The goal of the present study was to identify the myoelectric algorithm that best mimics the native hand movements. As a preliminary step, we first quantified the repeatability of the SoftHand Pro finger movements and identified the electromyographic recording sites for able-bodied individuals with the highest signal-to-noise ratio from two pairs of muscles, i.e., flexor digitorum superficialis/extensor digitorum communis, and flexor carpi radialis/extensor carpi ulnaris. Able-bodied volunteers were then asked to execute reach-to-grasp movements, while electromyography signals were recorded from flexor digitorum superficialis/extensor digitorum communis as this was identified as the muscle pair characterized by high signal-to-noise ratio and intuitive control. Subsequently, we tested three myoelectric controllers that mapped electromyography signals to position of the SoftHand Pro. We found that a differential electromyography-to-position mapping ensured the

  5. How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives.

    Directory of Open Access Journals (Sweden)

    Haw-Yen Chiu

    Full Text Available To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM, static and moving two-point discrimination (S2PD and M2PD, maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05 in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001 revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001 between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.

  6. A methodological approach to assessing alveolar ridge preservation procedures in humans: soft tissue profile.

    Science.gov (United States)

    Vanhoutte, Vanessa; Rompen, Eric; Lecloux, Geoffrey; Rues, Stefan; Schmitter, Marc; Lambert, France

    2014-03-01

    The aesthetic results of implant restoration in the anterior maxilla are particularly related to the soft tissue profile. Although socket preservation techniques appear to reduce bone remodelling after tooth extraction, there is still few investigations assessing the external soft tissue profile after such procedures. The goal of this study was to describe an accurate technique to evaluate soft tissue contour changes after performing socket preservation procedures. The secondary objective was to apply the newly developed measuring method to a specific socket preservation using a "saddled" connective tissue graft combined with the insertion of slowly resorbable biomaterials into the socket. A total of 14 patients needing tooth replacement in the aesthetic region were included to receive a socket preservation procedure using a connective tissue graft. Impressions were taken before the tooth extraction (baseline) and at 2, 4, and 12 weeks after the procedure. The corresponding plaster casts were scanned, and the evolution of the soft tissue profile in relation to the baseline situation was assessed using imaging software. The measuring technique allowed assessing the soft tissue profiles accurately at different levels of the alveolar process. The insertion of a saddled connective tissue appeared to compensate for the horizontal and vertical bone remodelling after a socket preservation procedure in most regions of the alveolar crest. After 12 weeks, the only significant change was located in the more cervical and central region of the alveolar process and reached a median drop of 0.62 mm from baseline. Within the limitations of this study, we found that a saddled connective tissue graft combined with a socket preservation procedure could almost completely counteract the bone remodelling in terms of the external soft tissue profile. The minor changes found in the cervical region might disappear with the emergence profile of the prosthodontic components. The described

  7. 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.

  8. Generic assessment procedures for determining protective actions during a reactor accident

    International Nuclear Information System (INIS)

    1997-08-01

    This manual provides the tools, procedures and data needed to evaluate the consequences of a nuclear accident occurring at a nuclear power plant throughout all phases of the emergency before, during and after a release of radioactive material. It is intended for use by on-site and off-site groups responsible for evaluating the accident consequences and making recommendations for the protection of the plant personnel, the emergency workers and the public. The scope of this manual is restricted to the technical assessment of radiological consequences. It does not address the emergency response infrastructure requirements, nor does it cover the emergency management aspects of accident assessment (e.g. reporting, staff qualification, shift replacement, and procedure implementation). The procedures and methods in this manual were developed based on a number of assumptions concerning the design and operation of the nuclear power plant and national practices. Therefore, this manual must be reviewed as part of the planning process to match the potential accidents, local conditions, national criteria and other unique characteristics of an area or nuclear reactor where it may be used. Refs, figs, tabs

  9. Hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Flyvholm, M.-A.

    2012-01-01

    Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients/materials......Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients...... dermatitis, younger age, male sex (male doctors), and working hours. Eighty nine per cent of subjects reported mild/moderate lesions. Atopic dermatitis was the only factor significantly related to severity. Sick leave was reported by 8% of subjects, and notification to the authorities by 12%. Conclusions...... or severity, but cultural differences between professions with respect to coping with the eczema were significant. Atopic dermatitis was related to increased prevalence and severity, and preventive efforts should be made for healthcare workers with atopic dermatitis....

  10. Hand Osteoblastoma

    Directory of Open Access Journals (Sweden)

    M. Farzan

    2006-06-01

    Full Text Available Background and Aim: Osteoblastoma is one of the rarest primary bone tumors. Although, small bones of the hands and feet are the third most common location for this tumor, the hand involvement is very rare and few case observations were published in the English-language literature. Materials and Methods: In this study, we report five cases of benign osteoblastoma of the hand, 3 in metacarpals and two in phalanxes. The clinical feature is not specific. The severe nocturnal, salicylate-responsive pain is not present in patients with osteoblastoma. The pain is dull, persistent and less localized. The clinical course is usually long and there is often symptoms for months before medical attention are sought. Swelling is a more persistent finding in osteoblastoma of the hand that we found in all of our patients. The radiologic findings are indistinctive, so preoperative diagnosis based on X-ray appearance is difficult. In all of our 5 cases, we fail to consider osteoblastoma as primary diagnosis. Pathologically, osteoblastoma consisting of a well-vascularized connective tissue stroma in which there is active production of osteoid and primitive woven bone. Treatment depends on the stage and localization of the tumor. Curettage and bone grafting is sufficient in stage 1 or stage 2, but in stage 3 wide resection is necessary for prevention of recurrence. Osteosarcoma is the most important differential diagnosis that may lead to inappropriate operation.

  11. Psychometrics of the wrist stability and hand mobility subscales of the Fugl-Meyer assessment in moderately impaired stroke.

    Science.gov (United States)

    Page, Stephen J; Hade, Erinn; Persch, Andrew

    2015-01-01

    There remains a need for a quickly administered, stroke-specific, bedside measure of active wrist and finger movement for the expanding stroke population. The wrist stability and hand mobility scales of the upper extremity Fugl-Meyer Assessment (w/h UE FM) constitute a valid, reliable measure of paretic UE impairment in patients with active wrist and finger movement. The aim of this study was to determine performance on the w/h UE FM in a stable cohort of survivors of stroke with only palpable movement in their paretic wrist flexors. A single-center cohort study was conducted. Thirty-two individuals exhibiting stable, moderate upper extremity hemiparesis (15 male, 17 female; mean age=56.6 years, SD=10.1; mean time since stroke=4.6 years, SD=5.8) participated in the study, which was conducted at an outpatient rehabilitation clinic in the midwestern United States. The w/h UE FM and Action Research Arm Test (ARAT) were administered twice. Intraclass correlation coefficients (ICCs), Cronbach alpha, and ordinal alpha were computed to determine reliability, and Spearman rank correlation coefficients and Bland-Altman plots were computed to establish validity. Intraclass correlation coefficients for the w/h UE FM and ARAT were .95 and .99, respectively. The w/h UE FM intrarater reliability and internal consistency were greater than .80, and concurrent validity was greater than .70. This also was the first stroke rehabilitative study to apply ordinal alpha to examine internal consistency values, revealing w/h UE FM levels greater than .85. Concurrent validity findings were corroborated by Bland-Altman plots. It appears that the w/h UE FM is a promising tool to measure distal upper extremity movement in patients with little active paretic wrist and finger movement. This finding widens the segment of patients on whom the w/h UE FM can be effectively used and addresses a gap, as commonly used measures necessitate active distal upper extremity movement. © 2015 American

  12. An assessment of methods for monitoring entrance surface dose in fluoroscopically guided interventional procedures

    International Nuclear Information System (INIS)

    Waite, J.C.; Fitzgerald, M.

    2001-01-01

    In the light of a growing awareness of the risks of inducing skin injuries as a consequence of fluoroscopically guided interventional procedures (FGIPs), this paper compares three methods of monitoring entrance surface dose (ESD). It also reports measurements of ESDs made during the period August 1998 to June 1999 on 137 patients undergoing cardiac, neurological and general FGIPs. Although the sample is small, the results reinforce the need for routine assessments to be made of ESDs in FGIPs. At present, the most reliable and accurate form of ESD measurement would seem to be arrays of TLDs. However, transducer based methods, although likely to be less accurate, have considerable advantages in relation to a continuous monitoring programme. It is also suggested that there may be the potential locally for threshold dose area product (DAP) values to be set for specific procedures. These could be used to provide early warning of the potential for skin injuries. (author)

  13. Assessment of organ doses by standard X-ray procedures in the GDR

    International Nuclear Information System (INIS)

    Tautz, M.; Brandt, G.A.

    1986-01-01

    A modern method has been described to assess the radiation burden by X-ray procedures with consideration of the standards of our Society for Medical Radiology in the GDR. The underlying methodology is a Monte Carlo computer technique, which simulates stochastically the energy deposition of X-ray photons in a mathematically described heterogeneous anthropomorphic phantom by Rosenstein (US Department of Health, Education and Welfare). To apply the procedure specific values for the following parameters must be determined for each dose estimation: projection and view, X-ray field size and location entrance exposure at skin surface, beam quality, source-to-image receptor distance. The base data are obtained in terms of tissue-air ratio. Organ doses were calculated for chest, urography, skull, cervical spine, thoracic spine, lumbar spine, pelvis and lymphography. Concluding possibilities have been discussed for reduction of radiation burden. 9 refs., 6 figs., 9 tabs. (author)

  14. Environmental risk assessment for plant pests: a procedure to evaluate their impacts on ecosystem services

    DEFF Research Database (Denmark)

    Gilioli, G.; Schrader, G.; Baker, R.H.A.

    2014-01-01

    and temporal resolution is then used to explore how an IAS, as an exogenous driving force, may trigger modifications in the target environment. The method presented here provides a standardized approach to generate comparable and reproducible results for environmental risk assessment as a component of Pest...... Risk Analysis. The method enables the assessment of overall environmental risk which integrates the impacts on different components of the environment and their probabilities of occurrence. The application of the proposed scheme is illustrated by evaluating the environmental impacts of the invasive......The current methods to assess the environmental impacts of plant pests differ in their approaches and there is a lack of the standardized procedures necessary to provide accurate and consistent results, demonstrating the complexity of developing a commonly accepted scheme for this purpose...

  15. Framework and operational procedure for implementing Strategic Environmental Assessment in China

    International Nuclear Information System (INIS)

    Bao Cunkuan; Lu Yongsen; Shang Jincheng

    2004-01-01

    Over the last 20 years, Environmental Impact Assessment (EIA) has been implemented and become an important instrument for decision-making in development projects in China. The Environmental Impact Assessment Law of the P.R. China was promulgated on 28 October 2002 and will be put into effect on 1 September of 2003. The law provides that Strategic Environmental Assessment (SEA) is required in regional and sector plans and programs. This paper introduces the research achievements and practice of SEA in China, discusses the relationship of SEA and 'integrating of environment and development in decision-making (IEDD)', and relevant political and legal basis of SEA. The framework and operational procedures of SEA administration and enforcement are presented. Nine cases are analyzed and some proposals are given

  16. Readability and Content Assessment of Informed Consent Forms for Medical Procedures in Croatia

    Science.gov (United States)

    Vučemilo, Luka; Borovečki, Ana

    2015-01-01

    Background High quality of informed consent form is essential for adequate information transfer between physicians and patients. Current status of medical procedure consent forms in clinical practice in Croatia specifically in terms of the readability and the content is unknown. The aim of this study was to assess the readability and the content of informed consent forms for diagnostic and therapeutic procedures used with patients in Croatia. Methods 52 informed consent forms from six Croatian hospitals on the secondary and tertiary health-care level were tested for reading difficulty using Simple Measure of Gobbledygook (SMOG) formula adjusted for Croatian language and for qualitative analysis of the content. Results The averaged SMOG grade of analyzed informed consent forms was 13.25 (SD 1.59, range 10–19). Content analysis revealed that informed consent forms included description of risks in 96% of the cases, benefits in 81%, description of procedures in 78%, alternatives in 52%, risks and benefits of alternatives in 17% and risks and benefits of not receiving treatment or undergoing procedures in 13%. Conclusions Readability of evaluated informed consent forms is not appropriate for the general population in Croatia. The content of the forms failed to include in high proportion of the cases description of alternatives, risks and benefits of alternatives, as well as risks and benefits of not receiving treatments or undergoing procedures. Data obtained from this research could help in development and improvement of informed consent forms in Croatia especially now when Croatian hospitals are undergoing the process of accreditation. PMID:26376183

  17. Using pliers in assembly work: short and long task duration effects of gloves on hand performance capabilities and subjective assessments of discomfort and ease of tool manipulation.

    Science.gov (United States)

    Dianat, Iman; Haslegrave, Christine M; Stedmon, Alex W

    2012-03-01

    The present study investigated the effects of wearing typical industrial gloves on hand performance capabilities (muscle activity, wrist posture, touch sensitivity, hand grip and forearm torque strength) and subjective assessments for an extended duration of performing a common assembly task, wire tying with pliers, which requires a combination of manipulation and force exertion. Three commercially available gloves (cotton, nylon and nitrile gloves) were tested and compared with a bare hand condition while participants performed the simulated assembly task for 2 h. The results showed that wearing gloves significantly increased the muscle activity, wrist deviation, and discomfort whilst reducing hand grip strength, forearm torque strength and touch sensitivity. The combined results showed that the length of time for which gloves are worn does affect hand performance capability and that gloves need to be evaluated in a realistic working context. The results are discussed in terms of selection of gloves for industrial assembly tasks involving pliers. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  18. Comparison between automated breast volume scanner (ABVS) versus hand-held ultrasound as a second look procedure after magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Girometti, Rossano; Zanotel, Martina; Londero, Viviana; Bazzocchi, Massimo; Zuiani, Chiara [University of Udine, Azienda Ospedaliero-Universitaria, ' S. Maria della Misericordia' , Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy)

    2017-09-15

    To evaluate the agreement between automated breast volume scanner (ABVS) and conventional ultrasound (US) as a second-look (SL) tool for assessing additional findings found on MRI. Over a 7-month period, we prospectively assigned to SL-US and SL-ABVS all patients undergoing 1.5 T breast MRI in whom additional findings were found. Five experienced breast radiologists independently interpreted SL-US and SL-ABVS in blinded sessions to evaluate the detection rate of MRI findings and assign them to BI-RADS categories. We calculated the agreement between the two methods in assessing MRI findings as significant (BI-RADS 3-5) versus not significant (BI-RADS 1-2), as well as their cancer detection rate. In a population of 131 patients, SL-ABVS and SL-US showed a comparable detection rate of MRI findings (69.3 vs. 71.5%) (p > 0.05; McNemar test), with an almost perfect agreement in assessing them as significant or not (k = 0.94). This translated into a comparably high cancer detection rate (83.8% for SL-ABVS vs. 87.0% for SL-US). Only 1/31 cancers was missed by SL-ABVS. SL-ABVS and SL-US are nearly equivalent in assessing the significance of MRI findings, leading to a comparable cancer detection rate. SL-ABVS has the potential to replace SL-US in the SL scenario. (orig.)

  19. Comparison between automated breast volume scanner (ABVS) versus hand-held ultrasound as a second look procedure after magnetic resonance imaging

    International Nuclear Information System (INIS)

    Girometti, Rossano; Zanotel, Martina; Londero, Viviana; Bazzocchi, Massimo; Zuiani, Chiara

    2017-01-01

    To evaluate the agreement between automated breast volume scanner (ABVS) and conventional ultrasound (US) as a second-look (SL) tool for assessing additional findings found on MRI. Over a 7-month period, we prospectively assigned to SL-US and SL-ABVS all patients undergoing 1.5 T breast MRI in whom additional findings were found. Five experienced breast radiologists independently interpreted SL-US and SL-ABVS in blinded sessions to evaluate the detection rate of MRI findings and assign them to BI-RADS categories. We calculated the agreement between the two methods in assessing MRI findings as significant (BI-RADS 3-5) versus not significant (BI-RADS 1-2), as well as their cancer detection rate. In a population of 131 patients, SL-ABVS and SL-US showed a comparable detection rate of MRI findings (69.3 vs. 71.5%) (p > 0.05; McNemar test), with an almost perfect agreement in assessing them as significant or not (k = 0.94). This translated into a comparably high cancer detection rate (83.8% for SL-ABVS vs. 87.0% for SL-US). Only 1/31 cancers was missed by SL-ABVS. SL-ABVS and SL-US are nearly equivalent in assessing the significance of MRI findings, leading to a comparable cancer detection rate. SL-ABVS has the potential to replace SL-US in the SL scenario. (orig.)

  20. Prevention of hand eczema

    DEFF Research Database (Denmark)

    Fisker, Maja H; Ebbehøj, Niels E; Vejlstrup, Søren Grove

    2018-01-01

    Objective Occupational hand eczema has adverse health and socioeconomic impacts for the afflicted individuals and society. Prevention and treatment strategies are needed. This study aimed to assess the effectiveness of an educational intervention on sickness absence, quality of life and severity...... of hand eczema. Methods PREVEX (PreVention of EXema) is an individually randomized, parallel-group superiority trial investigating the pros and cons of one-time, 2-hour, group-based education in skin-protective behavior versus treatment as usual among patients with newly notified occupational hand eczema...

  1. Assessing the impact of representational and contextual problem features on student use of right-hand rules

    Science.gov (United States)

    Kustusch, Mary Bridget

    2016-06-01

    Students in introductory physics struggle with vector algebra and these challenges are often associated with contextual and representational features of the problems. Performance on problems about cross product direction is particularly poor and some research suggests that this may be primarily due to misapplied right-hand rules. However, few studies have had the resolution to explore student use of right-hand rules in detail. This study reviews literature in several disciplines, including spatial cognition, to identify ten contextual and representational problem features that are most likely to influence performance on problems requiring a right-hand rule. Two quantitative measures of performance (correctness and response time) and two qualitative measures (methods used and type of errors made) were used to explore the impact of these problem features on student performance. Quantitative results are consistent with expectations from the literature, but reveal that some features (such as the type of reasoning required and the physical awkwardness of using a right-hand rule) have a greater impact than others (such as whether the vectors are placed together or separate). Additional insight is gained by the qualitative analysis, including identifying sources of difficulty not previously discussed in the literature and revealing that the use of supplemental methods, such as physically rotating the paper, can mitigate errors associated with certain features.

  2. The Safety Assessment of OPR-1000 for Station Blackout Applying Combined Deterministic and Probabilistic Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dong Gu; Ahn, Seung-Hoon; Cho, Dae-Hyung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    This is termed station blackout (SBO). However, it does not generally include the loss of available AC power to safety buses fed by station batteries through inverters or by alternate AC sources. Historically, risk analysis results have indicated that SBO was a significant contributor to overall core damage frequency. In this study, the safety assessment of OPR-1000 nuclear power plant for SBO accident, which is a typical beyond design basis accident and important contributor to overall plant risk, is performed by applying the combined deterministic and probabilistic procedure (CDPP). In addition, discussions are made for reevaluation of SBO risk at OPR-1000 by eliminating excessive conservatism in existing PSA. The safety assessment of OPR-1000 for SBO accident, which is a typical BDBA and significant contributor to overall plant risk, was performed by applying the combined deterministic and probabilistic procedure. However, the reference analysis showed that the CDF and CCDP did not meet the acceptable risk, and it was confirmed that the SBO risk should be reevaluated. By estimating the offsite power restoration time appropriately, the SBO risk was reevaluated, and it was finally confirmed that current OPR-1000 system lies in the acceptable risk against the SBO. In addition, it was demonstrated that the proposed CDPP is applicable to safety assessment of BDBAs in nuclear power plants without significant erosion of the safety margin.

  3. Measurement procedure to assess exposure to extremely low-frequency fields: A primary school case study

    International Nuclear Information System (INIS)

    Alonso, A.; Bahillo, A.; De la Rosa, R.; Carrera, A.; Duran, R. J.; Fernandez, P.

    2012-01-01

    How to correctly measure the exposure of general public to extremely low-frequency (ELF) radiation is a key issue for ELF epidemiological studies. This paper proposes a measurement procedure to accurately assess the exposure of people to electric and magnetic field in the frequency band from 5 Hz to 100 kHz in buildings and their premises. As ELF radiation could be particularly harmful to children, the measurement procedure is focused on exposure to ELF in schools. Thus, the students' exposure to ELF fields can be assessed by correlating the ELF measurements to the hours of school activity. In this paper, the measurement protocol was applied to study the ELF exposure on students from Garcia Quintana primary school in Valladolid, Spain. The campaign of measurements for ELF exposure assessment in this primary school was of great interest for the Regional Council of Public Health because of the social alarm generated by the presence of a significant number cancer cases in children. (authors)

  4. Assessment of Myoelectric Controller Performance and Kinematic Behavior of a Novel Soft Synergy-inspired Robotic Hand for Prosthetic Applications

    Directory of Open Access Journals (Sweden)

    Simone Fani

    2016-10-01

    Full Text Available Myoelectric-artificial limbs can significantly advance the state of the art in prosthetics, since they can be used to control mechatronic devices through muscular activity in a way that mimics how the subjects used to activate their muscles before limb loss. However, surveys indicate that dissatisfaction with the functionality of terminal devices underlies the widespread abandonment of prostheses. We believe that one key factor to improve acceptability of prosthetic devices is to attain human-likeness of prosthesis movements, a goal which is being pursued by research on social and human-robot interactions. Therefore, to reduce early abandonment of terminal devices, we propose that controllers should be designed such as to ensure effective task accomplishment in a natural fashion. In this work, we have analyzed and compared the performance of three types of myoelectric controller algorithms based on surface electromyography to control an under-actuated and multi-degrees of freedom prosthetic hand, the SoftHand Pro. The goal of the present study was to identify the myoelectric algorithm that best mimics the native hand movements. As a preliminary step, we first quantified the repeatability of the SoftHand Pro finger movements and identified the electromyographic recording sites for able-bodied individuals with the highest signal-to-noise ratio from two pairs of muscles, i.e. flexor digitorum superficialis/extensor digitorum communis, and flexor carpi radialis/extensor carpi ulnaris. Able-bodied volunteers were then asked to execute reach-to-grasp movements, while electromyography signals were recorded from flexor digitorum superficialis/extensor digitorum communis as this was identified as the muscle pair characterized by high signal-to-noise ratio and intuitive control. Subsequently, we tested three myoelectric controllers that mapped electromyography signals to position of the SoftHand Pro. We found that a differential electromyography

  5. Hand-assisted laparoscopic splenectomy

    NARCIS (Netherlands)

    Bemelman, W. A.; de Wit, L. T.; Busch, O. R.; Gouma, D. J.

    2000-01-01

    Laparoscopic splenectomy is performed routinely in patients with small and moderately enlarged spleens at specialized centers. Large spleens are difficult to handle laparoscopically and hand-assisted laparoscopic splenectomy might facilitate the procedure through enhanced vascular control, easier

  6. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  7. Assessment of Laparoscopic Skills Performance: 2D Versus 3D Vision and Classic Instrument Versus New Hand-Held Robotic Device for Laparoscopy.

    Science.gov (United States)

    Leite, Mariana; Carvalho, Ana F; Costa, Patrício; Pereira, Ricardo; Moreira, Antonio; Rodrigues, Nuno; Laureano, Sara; Correia-Pinto, Jorge; Vilaça, João L; Leão, Pedro

    2016-02-01

    Laparoscopic surgery has undeniable advantages, such as reduced postoperative pain, smaller incisions, and faster recovery. However, to improve surgeons' performance, ergonomic adaptations of the laparoscopic instruments and introduction of robotic technology are needed. The aim of this study was to ascertain the influence of a new hand-held robotic device for laparoscopy (HHRDL) and 3D vision on laparoscopic skills performance of 2 different groups, naïve and expert. Each participant performed 3 laparoscopic tasks-Peg transfer, Wire chaser, Knot-in 4 different ways. With random sequencing we assigned the execution order of the tasks based on the first type of visualization and laparoscopic instrument. Time to complete each laparoscopic task was recorded and analyzed with one-way analysis of variance. Eleven experts and 15 naïve participants were included. Three-dimensional video helps the naïve group to get better performance in Peg transfer, Wire chaser 2 hands, and Knot; the new device improved the execution of all laparoscopic tasks (P < .05). For expert group, the 3D video system benefited them in Peg transfer and Wire chaser 1 hand, and the robotic device in Peg transfer, Wire chaser 1 hand, and Wire chaser 2 hands (P < .05). The HHRDL helps the execution of difficult laparoscopic tasks, such as Knot, in the naïve group. Three-dimensional vision makes the laparoscopic performance of the participants without laparoscopic experience easier, unlike those with experience in laparoscopic procedures. © The Author(s) 2015.

  8. A review on the conservatism embodied in the integrity assessment procedure of CANDU pressure tubes

    International Nuclear Information System (INIS)

    Chung, Han Sub; Kim, Hong Duk

    2009-01-01

    Excessive conservatism may be embodied in the integrity assessment procedure for PTs of CANDUs, as guided in the CSA N285.8-05 code. Four sources of conservatism are suggested as (1) the effect of thermal history on DHC, (2) the effect of manufacturing variables on properties of PTs, (3) poor definition or limited availability of databases regarding the aging degradation trends and probability density functions of important material properties, and (4) the simplified equations defining threshold condition for the initiation of DHC at the volumetric flaws. It is suggested that both extensive review of databases available and extensive calculation case studies are required to remove the potential excessive conservatism.

  9. Video observation of procedural skills for assessment of trabeculectomy performed by residents.

    Science.gov (United States)

    Hassanpour, Narges; Chen, Rebecca; Baikpour, Masoud; Moghimi, Sasan

    2016-06-01

    The efficacy and sufficiency of a healthcare system is directly related to the knowledge and skills of graduates working in the system. In this regard, many different assessment methods have been proposed to evaluate various skills of the learners. Video Observation of Procedural Skills (VOPS) is one newly-proposed method. In this study we aimed to compare the results of the VOPS method with the more commonly used Direct Observation of Procedural Skills (DOPS). In this prospective study conducted in 2012, all 10 ophthalmology residents of post graduate year 4 were selected for participation. Three months into training in the glaucoma ward, these residents performed trabeculectomy surgery on patients, and their procedural skills were assessed in real time by an expert via the DOPS method. All surgeries were also recorded and later evaluated via the VOPS method by an expert. Bland-Altman plot also was used to compare the two methods and calculating the mean and 95% limit of agreement. Residents have been done a mean of 14.9 ± 3.5 (range 10-20) independent trabeculectomy before the assessments. DOPS grade was positively associated with number of independent trabeculectomy during glaucoma rotation (β=0.227, p = 0.004). The intra-observer reproducibility of VOPS measurements was 0.847 (95% CI: 0.634, 0.961). The mean VOPS grade was significantly lower than the mean DOPS grade (8.4 vs. 8.9, p = 0.02). However, a good correlation was observed between the grades of VOPS and DOPS (r = 0.89, p = 0.001). Bland-Altman analysis demonstrated that all data points fell within the 95% limits of agreement (-1.46, 0.46). The present study showed that VOPS might be considered a feasible, valid, and reliable assessment method for procedural skills of medical students and residents that can be used as an alternative to the DOPS method. However, VOPS might underestimate DOPS in evaluating surgical skills of residents.

  10. Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

    Science.gov (United States)

    Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2012-10-01

    To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; PTechnical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; PTechnical Skills scores. Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.

  11. Preoperative testing and risk assessment: perspectives on patient selection in ambulatory anesthetic procedures

    Directory of Open Access Journals (Sweden)

    Stierer TL

    2015-08-01

    Full Text Available Tracey L Stierer,1,2 Nancy A Collop3,41Department of Anesthesiology, 2Department of Critical Care Medicine, Otolaryngology Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, USA; 3Department of Medicine, 4Department of Neurology, Emory University, Emory Sleep Center, Wesley Woods Center, Atlanta, GA, USAAbstract: With recent advances in surgical and anesthetic technique, there has been a growing emphasis on the delivery of care to patients undergoing ambulatory procedures of increasing complexity. Appropriate patient selection and meticulous preparation are vital to the provision of a safe, quality perioperative experience. It is not unusual for patients with complex medical histories and substantial systemic disease to be scheduled for discharge on the same day as their surgical procedure. The trend to “push the envelope” by triaging progressively sicker patients to ambulatory surgical facilities has resulted in a number of challenges for the anesthesia provider who will assume their care. It is well known that certain patient diseases are associated with increased perioperative risk. It is therefore important to define clinical factors that warrant more extensive testing of the patient and medical conditions that present a prohibitive risk for an adverse outcome. The preoperative assessment is an opportunity for the anesthesia provider to determine the status and stability of the patient’s health, provide preoperative education and instructions, and offer support and reassurance to the patient and the patient’s family members. Communication between the surgeon/proceduralist and the anesthesia provider is critical in achieving optimal outcome. A multifaceted approach is required when considering whether a specific patient will be best served having their procedure on an outpatient basis. Not only should the patient's comorbidities be stable and optimized, but details regarding the planned procedure and the resources available

  12. Programs and procedures for assessing quality of spectral gamma-ray borehole data for the UGTA

    International Nuclear Information System (INIS)

    Conaway, J.G.

    1998-01-01

    This report describes the procedures and computer programs used to process spectral gamma-ray borehole logging data in the UGTA (UnderGround Test Area) program at the NTS (Nevada Test Site) to assess data quality. These programs and procedures were used to analyze data from five boreholes in the UGTA program. Development of these computer programs and procedures required considerable effort and the primary purpose of this report is to provide continuity with future activities related to spectral gamma-ray borehole logging in the UGTA program. This is especially important because of the long time interval between cessation of logging in April, 1996 and the next round of activity, which has not yet occurred. This report should also be useful if any quality control issues arise regarding past or forthcoming spectral gamma-ray log analyses. In the characterization work underway at the Nevada Test Site Underground Test Area, the logging contractor, Western Atlas, agreed to identify five artificial nuclides based on their gamma-ray signatures. Those nuclides are 60 Co, 106 Ru, 125 Sb, 134 Cs, and 137 Cs. In the case of 106 Ru, which is not a gamma emitter, any detected gamma rays come from the daughter nuclide 106 Rh which has a half-life of 30 s. With such a short half-life, 106 Rh can be considered to be in equilibrium with 106 Ru under most conditions so the result is the same as if the gamma rays were emitted by the 106 Ru. The Western Atlas spectral gamma-ray curve plots from a given borehole present detailed qualitative information on the apparent distribution of natural and artificial nuclides with depth in the borehole. The computer programs and procedures described in this report were used to provide a quality analysis of the contractor's processed data and to work with the contractor to validate and/or refine their existing automatic processing. This was done using a procedure that was developed and tested successfully in earlier work at the NTS; the revised

  13. Incorporating mesh-insensitive structural stress into the fatigue assessment procedure of common structural rules for bulk carriers

    Directory of Open Access Journals (Sweden)

    Seong-Min Kim

    2015-01-01

    Full Text Available This study introduces a fatigue assessment procedure using mesh-insensitive structural stress method based on the Common Structural Rules for Bulk Carriers by considering important factors, such as mean stress and thickness effects. The fatigue assessment result of mesh-insensitive structural stress method have been compared with CSR procedure based on equivalent notch stress at major hot spot points in the area near the ballast hold for a 180 K bulk carrier. The possibility of implementing mesh-insensitive structural stress method in the fatigue assessment procedure for ship structures is discussed.

  14. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1994-09-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature

  15. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    Energy Technology Data Exchange (ETDEWEB)

    Trauth, K.M. [Sandia National Labs., Albuquerque, NM (United States); Guzowski, R.V. [Science Applications International Corp., Albuquerque, NM (United States); Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States). Business Administration & Economics Div.

    1994-09-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature.

  16. Positive predictive value of abnormal mammographic findings and role of assessment procedures

    International Nuclear Information System (INIS)

    Menna, S.; Marra, V.; Di Virgilio, M.R.; Macchia, G.; Frigerio, A.

    1999-01-01

    To investigate the positive predictive value for cancer of abnormal mammographic findings and the role of assessment, the authors reviewed a series of 962 patients recalled and examined in the first breast screening center of Turin (Italy), out of 18996 women aged 50-59 from 1991 to 1995, within a population-based mammography program. The results of this study confirm the accuracy of mammography in the early detection of breast cancer and the different role of assessment procedures in the various abnormal mammographic findings. The improvement in positive predictive value for screening demonstrates the importance of the learning curve within the screening team. Most of this improvement could be referred to refined diagnostic criteria for calcifications [it

  17. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1993-01-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature

  18. High-temperature flaw assessment procedure: A state-of-the-art survey

    International Nuclear Information System (INIS)

    Ruggles, M.B.; Takahashi, Y.

    1989-05-01

    High-temperature crack growth under cyclic, static, and combined loading is received with an emphasis on fracture mechanics aspects. Experimental studies of the effects of loading history, microstructure, temperature, and environment on crack growth behavior are described and interpreted. The experimental evidence is used to examine crack growth parameters and theoretical models for fatigue, creep, and creep-fatigue crack propagation at elevated temperatures. The limitations of both elastic and elastic-plastic fracture mechanics for high-temperature subcritical crack growth are assessed. Existing techniques for modeling critical crack growth/ligament instability failure are also presented. Related topics of defect modeling and engineering flaw assessment procedures, nondestructive evaluation methods, and probabilistic failure analysis are briefly discussed. 142 refs., 33 figs

  19. RISK-ASSESSMENT PROCEDURES AND ESTABLISHING THE SIZE OF SAMPLES FOR AUDITING FINANCIAL STATEMENTS

    Directory of Open Access Journals (Sweden)

    Daniel Botez

    2014-12-01

    Full Text Available In auditing financial statements, the procedures for the assessment of the risks and the calculation of the materiality differ from an auditor to another, by audit cabinet policy or advice professional bodies. All, however, have the reference International Audit Standards ISA 315 “Identifying and assessing the risks of material misstatement through understanding the entity and its environment” and ISA 320 “Materiality in planning and performing an audit”. On the basis of specific practices auditors in Romania, the article shows some laborious and examples of these aspects. Such considerations are presented evaluation of the general inherent risk, a specific inherent risk, the risk of control and the calculation of the materiality.

  20. Development of a new assessment tool for cervical myelopathy using hand-tracking sensor: Part 2: normative values.

    Science.gov (United States)

    Alagha, M Abdulhadi; Alagha, Mahmoud A; Dunstan, Eleanor; Sperwer, Olaf; Timmins, Kate A; Boszczyk, Bronek M

    2017-04-01

    To set a baseline measurement of the number of hand flexion-extension cycles and analyse the degree of motion in young healthy individuals, measured by leap motion controller (LMC), besides describing gender and dominant hand differences. Fifty healthy participants were asked to fully grip-and-release their dominant hand as rapidly as possible for a maximum of 3 min or until subjects fatigued, while wearing a non-metal wrist splint. Participants also performed a 15-s grip-and-release test. An assessor blindly counted the frequency of grip-and-release cycles and magnitude of motion from the LMC data. The mean number of the 15-s G-R cycles recorded by LMC was: 47.7 ± 6.5 (test 1, LMC); and 50.2 ± 6.5 (test 2, LMC). In the 3-min test, the total number of hand flexion-extension cycles and the degree of motion decreased as the person fatigued. However, the decline in frequency preceded that of motion's magnitude. The mean frequency of cycles per 10-s interval decreased from 35.4 to 26.6 over the 3 min. Participants reached fatigue from 59.38 s; 43 participants were able to complete the 3-min test. Normative values of the frequency of cycles and extent of motion for young healthy individuals, aged 18-35 years, are provided. Future work is needed to establish values in a wider age range and in a clinical setting.

  1. Improving the effectiveness of impact assessment pertaining to Indigenous peoples in the Brazilian environmental licensing procedure

    International Nuclear Information System (INIS)

    Hanna, Philippe; Vanclay, Frank; Langdon, Esther Jean; Arts, Jos

    2014-01-01

    The number of environmental licence applications for projects affecting Indigenous peoples in Brazil has increased since the implementation of a major infrastructure program (Programa de Aceleração do Crescimento) in 2007. This increase has caused problems for Brazilian agencies involved in environmental licensing procedures (IBAMA, FUNAI and others). We analyze the Brazilian environmental licensing procedure for situations involving Indigenous peoples, Maroons (Quilombolas) or other traditional communities in order to identify potential improvements for Brazil and potentially other countries. Although Brazilian procedures are consistent with international best practice in environmental licensing, in practice social impacts are inadequately addressed, mitigation measures are poorly implemented, and there is a lack of enforcement and compliance. The paper is based on document analysis and interviews with key actors in governmental and non-governmental organizations and Indigenous leaders. We suggest that Free, Prior and Informed Consent (FPIC) processes need to be conducted at the earliest stages of project planning, and that Indigenous peoples should actively participate in impact assessment, monitoring and evaluation processes. In order to achieve a social licence to operate, there needs to be full recognition of traditional knowledge and acceptance of Indigenous values and concepts. We also recommend increased involvement of social experts and mediators as well as improved accountability, enforcement and grievance mechanisms in the licensing process. - Highlights: • The Brazilian environmental licensing system needs to address social impacts better. • Communities need to be consulted at the earliest stage possible. • Indigenous peoples need to be invited to participate in impact assessment teams. • Independent Indigenous committees to monitor implementation of mitigation measures. • Accountability, enforcement and grievance mechanisms need to be

  2. Improving the effectiveness of impact assessment pertaining to Indigenous peoples in the Brazilian environmental licensing procedure

    Energy Technology Data Exchange (ETDEWEB)

    Hanna, Philippe [Department of Cultural Geography, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV Groningen (Netherlands); Vanclay, Frank, E-mail: frank.vanclay@rug.nl [Department of Cultural Geography, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV Groningen (Netherlands); Langdon, Esther Jean [Department of Anthropology, Center for Philosophy and Human Sciences, Federal University of Santa Catarina PO Box 5104, 88040-970, Florianópolis, SC (Brazil); Arts, Jos [Department of Planning, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV Groningen (Netherlands)

    2014-04-01

    The number of environmental licence applications for projects affecting Indigenous peoples in Brazil has increased since the implementation of a major infrastructure program (Programa de Aceleração do Crescimento) in 2007. This increase has caused problems for Brazilian agencies involved in environmental licensing procedures (IBAMA, FUNAI and others). We analyze the Brazilian environmental licensing procedure for situations involving Indigenous peoples, Maroons (Quilombolas) or other traditional communities in order to identify potential improvements for Brazil and potentially other countries. Although Brazilian procedures are consistent with international best practice in environmental licensing, in practice social impacts are inadequately addressed, mitigation measures are poorly implemented, and there is a lack of enforcement and compliance. The paper is based on document analysis and interviews with key actors in governmental and non-governmental organizations and Indigenous leaders. We suggest that Free, Prior and Informed Consent (FPIC) processes need to be conducted at the earliest stages of project planning, and that Indigenous peoples should actively participate in impact assessment, monitoring and evaluation processes. In order to achieve a social licence to operate, there needs to be full recognition of traditional knowledge and acceptance of Indigenous values and concepts. We also recommend increased involvement of social experts and mediators as well as improved accountability, enforcement and grievance mechanisms in the licensing process. - Highlights: • The Brazilian environmental licensing system needs to address social impacts better. • Communities need to be consulted at the earliest stage possible. • Indigenous peoples need to be invited to participate in impact assessment teams. • Independent Indigenous committees to monitor implementation of mitigation measures. • Accountability, enforcement and grievance mechanisms need to be

  3. A Multimode Adaptive Pushover Procedure for Seismic Assessment of Integral Bridges

    Directory of Open Access Journals (Sweden)

    Ehsan Mohtashami

    2013-01-01

    Full Text Available This paper presents a new adaptive pushover procedure to account for the effect of higher modes in order to accurately estimate the seismic response of bridges. The effect of higher modes is considered by introducing a minimum value for the total effective modal mass. The proposed method employs enough number of modes to ensure that the defined total effective modal mass participates in all increments of the pushover loading. An adaptive demand curve is also developed for assessment of the seismic demand. The efficiency and robustness of the proposed method are demonstrated by conducting a parametric study. The analysis includes 18 four-span integral bridges with various heights of piers. The inelastic response history analysis is employed as reference solution in this study. Numerical results indicate excellent accuracy of the proposed method in assessment of the seismic response. For most bridges investigated in this study, the difference between the estimated response of the proposed method and the inelastic response history analysis is less than 25% for displacements and 10% for internal forces. This indicates a very good accuracy compared to available pushover procedures in the literature. The proposed method is therefore recommended to be applied to the seismic performance evaluation of integral bridges for engineering applications.

  4. Environmental risk assessment for plant pests: a procedure to evaluate their impacts on ecosystem services.

    Science.gov (United States)

    Gilioli, G; Schrader, G; Baker, R H A; Ceglarska, E; Kertész, V K; Lövei, G; Navajas, M; Rossi, V; Tramontini, S; van Lenteren, J C

    2014-01-15

    The current methods to assess the environmental impacts of plant pests differ in their approaches and there is a lack of the standardized procedures necessary to provide accurate and consistent results, demonstrating the complexity of developing a commonly accepted scheme for this purpose. By including both the structural and functional components of the environment threatened by invasive alien species (IAS), in particular plant pests, we propose an environmental risk assessment scheme that addresses this complexity. Structural components are investigated by evaluating the impacts of the plant pest on genetic, species and landscape diversity. Functional components are evaluated by estimating how plant pests modify ecosystem services in order to determine the extent to which an IAS changes the functional traits that influence ecosystem services. A scenario study at a defined spatial and temporal resolution is then used to explore how an IAS, as an exogenous driving force, may trigger modifications in the target environment. The method presented here provides a standardized approach to generate comparable and reproducible results for environmental risk assessment as a component of Pest Risk Analysis. The method enables the assessment of overall environmental risk which integrates the impacts on different components of the environment and their probabilities of occurrence. The application of the proposed scheme is illustrated by evaluating the environmental impacts of the invasive citrus long-horn beetle, Anoplophora chinensis. © 2013.

  5. Injury Risk Assessment of Extravehicular Mobility Unit (EMU) Phase VI and Series 4000 Gloves During Extravehicular Activity (EVA) Hand Manipulation Tasks

    Science.gov (United States)

    Kilby, Melissa

    2015-01-01

    Functional Extravehicular Mobility Units (EMUs) with high precision gloves are essential for the success of Extravehicular Activity (EVA). Previous research done at NASA has shown that total strength capabilities and performance are reduced when wearing a pressurized EMU. The goal of this project was to characterize the human-space suit glove interaction and assess the risk of injury during common EVA hand manipulation tasks, including pushing, pinching and gripping objects. A custom third generation sensor garment was designed to incorporate a combination of sensors, including force sensitive resistors, strain gauge sensors, and shear force sensors. The combination of sensors was used to measure the forces acting on the finger nails, finger pads, finger tips, as well as the knuckle joints. In addition to measuring the forces, data was collected on the temperature, humidity, skin conductance, and blood perfusion of the hands. Testing compared both the Phase VI and Series 4000 glove against an ungloved condition. The ungloved test was performed wearing the sensor garment only. The project outcomes identified critical landmarks that experienced higher workloads and are more likely to suffer injuries. These critical landmarks varied as a function of space suit glove and task performed. The results showed that less forces were acting on the hands while wearing the Phase VI glove as compared to wearing the Series 4000 glove. Based on our findings, the engineering division can utilize these methods for optimizing the current space suit glove and designing next generation gloves to prevent injuries and optimize hand mobility and comfort.

  6. Hand protection from ultraviolet exposure

    International Nuclear Information System (INIS)

    Khazova, M.; O'Hagan, J.B.

    2006-01-01

    Full text of publication follows: A number of industrial applications and public services involve exposure to ultraviolet radiation (U.V.R.) from a variety of lamps and lasers, for example, in forensic examination, biological trans-illuminators, dentistry, laser material processing, microelectronics, etc. The proposed European Union Directive on Optical Radiation would place specific requirements on employers to provide adequate safety measures to reduce exposure to U.V.R., including gloves for hand protection. The selection of gloves should be based on a risk assessment and on the performance characteristics of the gloves for the task. However, current International and national standards do not describe evaluation procedures of disposable gloves for hand protection against non-ionising radiation. A methodology for assessment of the UV protection level for disposable gloves and a simple measurement protocol are proposed, based on a common approach with UV protection by clothing and sunscreens. Glove Ultraviolet Protection Factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. However, the wide variety of U.V.R. sources and the real-life conditions of glove use (stretching and wetting the surface by liquids) bring substantial challenges to the assessment method. Our study of ∼ 50 samples of widely used disposable gloves made of different materials (nitrile, vinyl, latex and chloroprene) showed that for all tested gloves a change in U.V.R. attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of U.V.R. protection. Glove material has a bigger effect on U.V.R. protection level than variations in the glove thickness or its colour. The following approaches are suggested to overcome the problem of variable U.V.R. sources: - Worst case scenario minimal protection level, most restrictive case - Application

  7. Hand protection from ultraviolet exposure

    Energy Technology Data Exchange (ETDEWEB)

    Khazova, M.; O' Hagan, J.B. [Health Protection Agency, Radiation Protection Division, Chilton, Did cot (United Kingdom)

    2006-07-01

    Full text of publication follows: A number of industrial applications and public services involve exposure to ultraviolet radiation (U.V.R.) from a variety of lamps and lasers, for example, in forensic examination, biological trans-illuminators, dentistry, laser material processing, microelectronics, etc. The proposed European Union Directive on Optical Radiation would place specific requirements on employers to provide adequate safety measures to reduce exposure to U.V.R., including gloves for hand protection. The selection of gloves should be based on a risk assessment and on the performance characteristics of the gloves for the task. However, current International and national standards do not describe evaluation procedures of disposable gloves for hand protection against non-ionising radiation. A methodology for assessment of the UV protection level for disposable gloves and a simple measurement protocol are proposed, based on a common approach with UV protection by clothing and sunscreens. Glove Ultraviolet Protection Factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. However, the wide variety of U.V.R. sources and the real-life conditions of glove use (stretching and wetting the surface by liquids) bring substantial challenges to the assessment method. Our study of {approx} 50 samples of widely used disposable gloves made of different materials (nitrile, vinyl, latex and chloroprene) showed that for all tested gloves a change in U.V.R. attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of U.V.R. protection. Glove material has a bigger effect on U.V.R. protection level than variations in the glove thickness or its colour. The following approaches are suggested to overcome the problem of variable U.V.R. sources: - Worst case scenario minimal protection level, most restrictive case - Application

  8. Evaluation and assessment methodology, standards, and procedures manual of the United States Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Kerns, K.C.; Burson, Z.G.; Smith, J.M.; Blanchard, R.L.

    2000-01-01

    In the event of a major radiological emergency, the U.S. Federal Radiological Emergency Response Plan authorises the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC). The FRMAC is established to co-ordinate the Federal off-site monitoring and assessment activities, and is comprised of representatives from several Federal agencies and Department of Energy contractors who provide assistance to the state(s) and Lead Federal Agency. The Evaluation and Assessment (E and A) Division of the FRMAC is responsible for receiving, storing, and interpreting environmental surveillance data to estimate the potential health consequences to the population in the vicinity of the accident site. The E and A Division has commissioned the preparation of a methodology and procedures manual which will result in a consistent approach by Division members in carrying out their duties. The first edition of this manual is nearing completion. In this paper, a brief review of the structure of the FRMAC is presented, with emphasis on the E and A Division. The contents of the E and A manual are briefly described, as are future plans for its expansion. (author)

  9. An assessment of firework particle persistence on the hands and related police force practices in relation to GSR evidence.

    Science.gov (United States)

    Grima, Matthew; Hanson, Robert; Tidy, Helen

    2014-06-01

    In a previous study by Grima et al. Sci. Justice 52 (1) (2012) 49, it was shown that background particles can aid in the exclusion of firework particles which are indistinguishable from GSR. Issues relating to the persistence of such particle populations were presented. The scope of this project was to examine persistence on the hands in the context of possible post-display scene contamination and how this can affect GSR evidence, especially in light of possible GSR/firework mixtures. Persistence was investigated by recovering firework residues eight hours post-display following contact of the hands with bedding. In addition, particle profiling was carried out using SEM-EDX. Firework particle populations exhibited strong persistence in all displays, with not less than 667 particles persisting in each scenario. This factor challenges GSR evidence, especially if personnel stationed at display sites enter scenes of crime or come into contact with suspects after a display. A survey of UK police force practices following firework displays showed that authorities are not aware of the impact particle transfer may have on GSR evidence. Recommendations for the implementation of basic hygiene practices for particle transfer control have also been made. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Development of Computational Procedure for Assessment of Patient Dose in Multi-Detector Computed Tomography

    International Nuclear Information System (INIS)

    Park, Dong Wook

    2007-02-01

    Technological development to improve the quality and speed with which images are obtained have fostered the growth of frequency and collective effective dose of CT examination. Especially, High-dose x-ray technique of CT has increased in the concern of patient dose. However CTDI and DLP in CT dosimetry leaves something to be desired to evaluate patient dose. And even though the evaluation of effective dose in CT practice is required for comparison with other radiography, it's not sufficient to show any estimation because it's not for medical purpose. Therefore the calculation of effective dose in CT procedure is needed for that purpose. However modelling uncertainties will be due to insufficient information from manufacturing tolerances. Therefore the purpose of this work is development of computational procedure for assessment of patient dose through the experiment for getting essential information in MDCT. In order to obtain exact absorbed dose, normalization factors must be created to relate simulated dose values with CTDI air measurement. The normalization factors applied to the calculation of CTDI 100 using axial scanning and organ effective dose using helical scanning. The calculation of helical scanning was compared with the experiment of Groves et al.(2004). The result has a about factor 2 of the experiment. It seems because AEC is not simulated. In several studies, when AEC applied to a CT examination, approximately 20-30% dose reduction was appeared. Therefore the study of AEC simulation should be added and modified

  11. Measuring implicit attitudes: A positive framing bias flaw in the Implicit Relational Assessment Procedure (IRAP).

    Science.gov (United States)

    O'Shea, Brian; Watson, Derrick G; Brown, Gordon D A

    2016-02-01

    How can implicit attitudes best be measured? The Implicit Relational Assessment Procedure (IRAP), unlike the Implicit Association Test (IAT), claims to measure absolute, not just relative, implicit attitudes. In the IRAP, participants make congruent (Fat Person-Active: false; Fat Person-Unhealthy: true) or incongruent (Fat Person-Active: true; Fat Person-Unhealthy: false) responses in different blocks of trials. IRAP experiments have reported positive or neutral implicit attitudes (e.g., neutral attitudes toward fat people) in cases in which negative attitudes are normally found on explicit or other implicit measures. It was hypothesized that these results might reflect a positive framing bias (PFB) that occurs when participants complete the IRAP. Implicit attitudes toward categories with varying prior associations (nonwords, social systems, flowers and insects, thin and fat people) were measured. Three conditions (standard, positive framing, and negative framing) were used to measure whether framing influenced estimates of implicit attitudes. It was found that IRAP scores were influenced by how the task was framed to the participants, that the framing effect was modulated by the strength of prior stimulus associations, and that a default PFB led to an overestimation of positive implicit attitudes when measured by the IRAP. Overall, the findings question the validity of the IRAP as a tool for the measurement of absolute implicit attitudes. A new tool (Simple Implicit Procedure:SIP) for measuring absolute, not just relative, implicit attitudes is proposed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Assessment procedure for the soft skills requested by Industry 4.0

    Directory of Open Access Journals (Sweden)

    Cotet Gabriela Beatrice

    2017-01-01

    Full Text Available In the context of an increasingly more performant global and informational environment, as the one found in the virtual organization, the process of selecting and evaluating the human resources holds a particular important role. The premise behind this article is that of the need to adapt the human resource performance to the requests of the industry 4.0 being supported by the organizational culture. Following the analysis of the state of the art literature we concluded that there is no clear procedure for the assessment of the constellation of skills and personal qualities – soft skills requested by industry 4.0. These capabilities should complete professional technical hard-skills; the procedure should provide a map for the constellation of capabilities necessary to adapt and perform, in specific industry 4.0 activities. Current psychological evaluation systems consider only some of such requested capabilities not always the most relevant. To solve this problem, we tried to identify and evaluate what we considered as the core of the complex various skills required. Our research was centred on the use of a psychological instrument for evaluating transversal capabilities. The capabilities map needed for the evaluation and selection of the human resource fit to work in the industry 4.0 environment was designed after the application of this complex system of evaluation on successive series of students from the University POLITEHNICA of Bucharest.

  13. DEA radial measurement for environmental assessment and planning: Desirable procedures to evaluate fossil fuel power plants

    International Nuclear Information System (INIS)

    Sueyoshi, Toshiyuki; Goto, Mika

    2012-01-01

    Energy policy depends on a proper use of methodology in guiding a large energy issue such as the global warming and climate change. DEA is one of such methodologies that are often used for preparing environmental policy, which is closely linked to various energy issues. Unfortunately, the use of DEA applied to environmental policy is insufficient, often misguiding policy makers and other individuals who are involved in energy issues. This study provides three guidelines for a use of DEA in preparing environmental assessment. First, it is important to prepare both primal and dual formulations to confirm whether information regarding all production factors (i.e., inputs, desirable and undesirable outputs) is fully utilized in DEA assessment. Second, DEA has model variations in radial and non-radial measurements. It is necessary for us to examine environmental issues by different models in order to avoid a methodological bias existing in those empirical studies. Finally, DEA environmental assessment needs to incorporate the concept of natural and managerial disposability. The natural disposability indicates that a firm negatively adapts a regulation change on undesirable outputs. In contrast, the managerial disposability indicates that a firm positively adapts the regulation change because the firm considers the regulation change as a new business opportunity. - Highlights: ► This study proposes three disable procedures. ► The disposability is separated into natural and managerial disposability. ► All extensions have large applicability in energy policy.

  14. Diagnostic performance of three-dimensional MR maximum intensity projection for the assessment of synovitis of the hand and wrist in rheumatoid arthritis: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xubin, E-mail: lixb@bjmu.edu.cn [Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060 (China); Liu, Xia; Du, Xiangke [Department of Radiology, Peking University People' s Hospital, Beijing 100044 (China); Ye, Zhaoxiang [Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060 (China)

    2014-05-15

    Purpose: To evaluate the diagnostic performance of three-dimensional (3D) MR maximum intensity projection (MIP) in the assessment of synovitis of the hand and wrist in rheumatoid arthritis (RA) compared to 3D contrast-enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Twenty-five patients with RA underwent MR examinations. 3D MR MIP images were derived from the enhanced images. MR images were reviewed by two radiologists for the presence and location of synovitis of the hand and wrist. The diagnostic sensitivity, specificity and accuracy of 3D MIP were, respectively, calculated with the reference standard 3D CE-MRI. Results: In all subjects, 3D MIP images yielded directly and clearly the presence and location of synovitis with just one image. Synovitis demonstrated high signal intensity on MIP images. The k-values for the detection of articular synovitis indicated excellent interobserver agreements using 3D MIP images (k = 0.87) and CE-MR images (k = 0.91), respectively. 3D MIP demonstrated a sensitivity, specificity and accuracy of 91.07%, 98.57% and 96.0%, respectively, for the detection of synonitis. Conclusion: 3D MIP can provide a whole overview of lesion locations and a reliable diagnostic performance in the assessment of articular synovitis of the hand and wrist in patients with RA, which has potential value of clinical practice.

  15. Assessment of soil/structure interaction analysis procedures for nuclear power plant structures

    International Nuclear Information System (INIS)

    Young, G.A.; Wei, B.C.

    1977-01-01

    The paper presents an assessment of two state-of-the-art soil/structure interaction analysis procedures that are frequently used to provide seismic analyses of nuclear power plant structures. The advantages of large three-dimensional, elastic, discrete mass models and two-dimensional finite element models are compared. The discrete mass models can provide three-dimensional response capability with economical computer costs but only fair soil/structure interaction representation. The two-dimensional finite element models provide good soil/structure interaction representation, but cannot provide out-of-plane response. Three-dimensional finite element models would provide the most informative and complete analyses. For this model, computer costs would be much greater, but modeling costs would be approximately the same as those required for three-dimensional discrete mass models

  16. Assessment of Calculation Procedures for Piles in Clay Based on Static Loading Tests

    DEFF Research Database (Denmark)

    Augustesen, Anders; Andersen, Lars

    2008-01-01

    College in London. The calculation procedures are assessed based on an established database of static loading tests. To make a consistent evaluation of the design methods, corrections related to undrained shear strength and time between pile driving and testing have been employed. The study indicates...... that the interpretation of the field tests is of paramount importance, both with regard to the soil profile and the loading conditions. Based on analyses of 253 static pile loading tests distributed on 111 sites, API-RP2A provides the better description of the data. However, it should be emphasised that some input......Numerous methods are available for the prediction of the axial capacity of piles in clay. In this paper, two well-known models are considered, namely the current API-RP2A (1987 to present) and the recently developed ICP method. The latter is developed by Jardine and his co-workers at Imperial...

  17. Procedures for conducting probabilistic safety assessment for non-reactor nuclear facilities

    International Nuclear Information System (INIS)

    2002-01-01

    A well performed and adequately documented safety assessment of a nuclear facility will serve as a basis to determine whether the facility complies with the safety objectives, principles and criteria as stipulated by the national regulatory body of the country where the facility is in operation. International experience shows that the practices and methodologies used to perform safety assessments and periodic safety re-assessment for non-reactor nuclear facilities differ significantly from county to country. Most developing countries do not have methods and guidance for safety assessment that are prescribed by the regulatory body. Typically the safety evaluation for the facility is based on a case by case assessment. Whilst conservative deterministic analyses are predominantly used as a licensing basis in many countries, recently probabilistic safety assessment (PSA) techniques have been applied as a useful complementary tool to support safety decision making. The main benefit of PSA is to provide insights into the safety aspects of facility design and operation. PSA points up the potential environmental impacts of postulated accidents, including the dominant risk contributors, and enables safety analysts to compare options for reducing risk. In order to advise on how to apply PSA methodology for the safety assessment of non-reactor nuclear facilities, the IAEA organized several consultants meetings, which led to the preparation of this TECDOC. This document is intended as guidance for the conduct of PSA in non-nuclear facilities. The main emphasis here is on the general procedural steps of a PSA that is specific for a non-reactor nuclear facility, rather than the details of the specific methods. The report is directed at technical staff managing or performing such probabilistic assessments and to promote a standardized framework, terminology and form of documentation for these PSAs. It is understood that the level of detail implied in the tasks presented in this

  18. Environmental impact assessment procedure: A new approach based on fuzzy logic

    International Nuclear Information System (INIS)

    Peche, Roberto; Rodriguez, Esther

    2009-01-01

    The information related to the different environmental impacts produced by the execution of activities and projects is often limited, described by semantic variables and, affected by a high degree of inaccuracy and uncertainty, thereby making fuzzy logic a suitable tool with which to express and treat this information. The present study proposes a new approach based on fuzzy logic to carry out the environmental impact assessment (EIA) of these activities and projects. Firstly, a set of impact properties is stated and two nondimensional parameters - ranging from 0 to 100 -are assigned, (p i ) to assess the value of the property and (v i ) to assess its contribution to each environmental impact. Next, the impact properties are described by means of fuzzy numbers p i - using generalised confidence intervals. Then, a procedure based on fuzzy arithmetic is developed to define the assessment functions v-bar = f(p-bar) - conventional mathematical functions, which incorporate the knowledge of these impact properties and give the fuzzy values v i - corresponding to each p i - . Subsequently, the fuzzy value of each environmental impact V-bar is estimated by aggregation of the values v i - , in order to obtain the total positive and negative environmental impacts V +- and V -- and, later - from them - the total environmental impact of the activity or project TV - . Finally, the defuzzyfication of TV - leads to a punctual impact estimator TV (1) - a conventional EI estimation - and its corresponding uncertainty interval estimator {(δ l (TV - ),δ r (TV - )}, which represent the total value of the environmental impact caused by the execution of the considered activity or project.

  19. Procedures to relate the NII safety assessment principles for nuclear reactors to risk

    CERN Document Server

    Kelly, G N; Hemming, C R

    1985-01-01

    Within the framework of the Public Inquiry into the proposed pressurised water reactor (PWR) at Sizewell, estimates were made of the levels of individual and societal risk from a PWR designed in a manner which would conform to the safety assessment principles formulated by the Nuclear Installations Inspectorate (NII). The procedures used to derive these levels of risk are described in this report. The opportunity has also been taken to revise the risk estimates made at the time of the Inquiry by taking account of additional data which were not then available, and to provide further quantification of the likely range of uncertainty in the predictions. This re-analysis has led to small changes in the levels of risk previously evaluated, but these are not sufficient to affect the broad conclusions reached before. For a reactor just conforming to the NII safety assessment principles a maximum individual risk of fatal cancer of about 10 sup - sup 6 per year of reactor operation has been estimated; the societal ris...

  20. Refining a complex diagnostic construct: subtyping Dysthymia with the Shedler-Westen Assessment Procedure-II.

    Science.gov (United States)

    Huprich, Steven K; Defife, Jared; Westen, Drew

    2014-01-01

    We sought to determine whether meaningful subtypes of Dysthymic patients could be identified when grouping them by similar personality profiles. A random, national sample of psychiatrists and clinical psychologists (n=1201) described a randomly selected current patient with personality pathology using the descriptors in the Shedler-Westen Assessment Procedure-II (SWAP-II), completed assessments of patients' adaptive functioning, and provided DSM-IV Axis I and II diagnoses. We applied Q-factor cluster analyses to those patients diagnosed with Dysthymic Disorder. Four clusters were identified-High Functioning, Anxious/Dysphoric, Emotionally Dysregulated, and Narcissistic. These factor scores corresponded with a priori hypotheses regarding diagnostic comorbidity and level of adaptive functioning. We compared these groups to diagnostic constructs described and empirically identified in the past literature. The results converge with past and current ideas about the ways in which chronic depression and personality are related and offer an enhanced means by which to understand a heterogeneous diagnostic category that is empirically grounded and clinically useful. © 2013 Published by Elsevier B.V.

  1. Toward a procedure for integrating moral issues in health technology assessment.

    Science.gov (United States)

    Hofmann, Bjørn

    2005-01-01

    Although ethics has been on the agenda in health technology assessment (HTA) since its inception, the integration of moral issues is still not standard and is performed in a vast variety of ways. Therefore, there is a need for a procedure for integrating moral issues in HTA. Literature review of existing approaches together with application of various theories in moral philosophy and axiology. The article develops a set of questions that addresses a wide range of moral issues related to the assessment and implementation of health technology. The issues include general moral issues and moral issues related to stakeholders, methodology, characteristics of technology, and to the HTA process itself. The questions form a kind of checklist for use in HTAs. The presented approach for integrating moral issues in HTA has a broad theoretical foundation and has shown to be useful in practice. Integrating ethical issues in HTAs can be of great importance with respect to the dissemination of HTA results and in efficient health policy making.

  2. Assessing mental workload and situation awareness in the evaluation of computerized procedures in the main control room

    International Nuclear Information System (INIS)

    Yang, Chih-Wei; Yang, Li-Chen; Cheng, Tsung-Chieh; Jou, Yung-Tsan; Chiou, Shian-Wei

    2012-01-01

    reactors, this study applied the NASA-TLX instrument for assessing mental workload. For the assessment of situation awareness (SA), the present research used the situational awareness rating technique (SART). In support of summarizing the results of user interface evaluation along multiple dimensions (e.g., workload, SA), we propose advantages for the CPs compared to the paper-based procedures.

  3. Assessing mental workload and situation awareness in the evaluation of computerized procedures in the main control room

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Chih-Wei, E-mail: yangcw@iner.gov.tw [Institute of Nuclear Energy Research, 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan (China); Yang, Li-Chen; Cheng, Tsung-Chieh [Institute of Nuclear Energy Research, 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan (China); Jou, Yung-Tsan; Chiou, Shian-Wei [Department of Industrial Engineering, Chung-Yuan Christian University, 200, Chung Pei Rd., Chung-Li 32023, Taiwan (China)

    2012-09-15

    status and progress through the procedure. Based on a human factors experiment in which each participant monitored and controlled multiple simulated reactors, this study applied the NASA-TLX instrument for assessing mental workload. For the assessment of situation awareness (SA), the present research used the situational awareness rating technique (SART). In support of summarizing the results of user interface evaluation along multiple dimensions (e.g., workload, SA), we propose advantages for the CPs compared to the paper-based procedures.

  4. A Curriculum-Based Vocational Assessment Procedure: Addressing the School-to-Work Transition Needs of Secondary Schools.

    Science.gov (United States)

    Porter, Mahlone E.; Stodden, Robert A.

    1986-01-01

    Curriculum-based vocational assessment procedures as implemented in the United States Department of Defense Dependents Schools in Germany are assessing a match of handicapped students' interests and strengths in terms of career and vocational instructional options. The model is described, with emphasis on project planning and design and…

  5. Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE), Version 5.0. Volume 5, Systems Analysis and Risk Assessment (SARA) tutorial manual

    International Nuclear Information System (INIS)

    Sattison, M.B.; Russell, K.D.; Skinner, N.L.

    1994-07-01

    The Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE) refers to a set of several microcomputer programs that were developed to create and analyze probabilistic risk assessments (PRAs) primarily for nuclear power plants. This volume is the tutorial manual for the Systems Analysis and Risk Assessment (SARA) System Version 5.0, a microcomputer-based system used to analyze the safety issues of a open-quotes familyclose quotes [i.e., a power plant, a manufacturing facility, any facility on which a probabilistic risk assessment (PRA) might be performed]. A series of lessons is provided that guides the user through some basic steps common to most analyses performed with SARA. The example problems presented in the lessons build on one another, and in combination, lead the user through all aspects of SARA sensitivity analysis capabilities

  6. Human health risk assessment of chloroxylenol in liquid hand soap and dishwashing soap used by consumers and health-care professionals.

    Science.gov (United States)

    Yost, Lisa J; Rodricks, Joseph D; Turnbull, Duncan; DeLeo, Paul C; Nash, J Frank; Quiñones-Rivera, Antonio; Carlson, Pete A

    2016-10-01

    A quantitative human risk assessment of chloroxylenol was conducted for liquid hand and dishwashing soap products used by consumers and health-care workers. The toxicological data for chloroxylenol indicate lack of genotoxicity, no evidence of carcinogenicity, and minimal systemic toxicity. No observed adverse effect levels (NOAEL) were established from chronic toxicity studies, specifically a carcinogenicity study that found no cancer excess (18 mg/kg-day) and studies of developmental and reproductive toxicity (100 mg/kg-day). Exposure to chloroxylenol for adults and children was estimated for two types of rinse-off cleaning products, one liquid hand soap, and two dishwashing products. The identified NOAELs were used together with exposure estimates to derive margin of exposure (MOE) estimates for chloroxylenol (i.e., estimates of exposure over NOAELs). These estimates were designed with conservative assumptions and likely overestimate exposure and risk (i.e., highest frequency, 100% dermal penetration). The resulting MOEs ranged from 178 to over 100, 000, 000 indicating negligibly small potential for harm related to consumer or health-care worker exposure to chloroxylenol in liquid soaps used in dish washing and hand washing. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Short and longer duration effects of protective gloves on hand performance capabilities and subjective assessments in a screw-driving task.

    Science.gov (United States)

    Dianat, Iman; Haslegrave, Christine M; Stedmon, Alex W

    2010-12-01

    The study investigated short and longer duration effects of gloves on hand performance capabilities (muscle activity, dexterity, touch sensitivity, finger pinch and forearm torque strength) and subjective assessments of discomfort and ease of manipulation when performing a light assembly task. The independent variables were hand condition with four levels (wearing cotton, nylon or nitrile gloves as well as barehanded) and point of time within the 2 h duration of the task (with measurements taken at 0, 30, 60, 90 and 120 min). Participants worked with a screwdriver to fit two components together using screws. Wearing gloves significantly increased the muscle activity, pinch strength and discomfort but reduced the dexterity and touch sensitivity. There was also a significant effect of task time on the muscle activity, dexterity, forearm torque strength and touch sensitivity, which indicates that the duration of the task should be an important consideration in glove evaluation studies and in the selection of work gloves. STATEMENT OF RELEVANCE: It is important to evaluate the effects of gloves on hand performance capabilities in a working context so that job demands can be taken into account and the most appropriate type of glove be chosen for each task. This study gives recommendations regarding the evaluation and use of gloves for screw-driving tasks.

  8. Assessment of isometric muscle strength and rate of torque development with hand-held dynamometry: Test-retest reliability and relationship with gait velocity after stroke.

    Science.gov (United States)

    Mentiplay, Benjamin F; Tan, Dawn; Williams, Gavin; Adair, Brooke; Pua, Yong-Hao; Bower, Kelly J; Clark, Ross A

    2018-04-27

    Isometric rate of torque development examines how quickly force can be exerted and may resemble everyday task demands more closely than isometric strength. Rate of torque development may provide further insight into the relationship between muscle function and gait following stroke. Aims of this study were to examine the test-retest reliability of hand-held dynamometry to measure isometric rate of torque development following stroke, to examine associations between strength and rate of torque development, and to compare the relationships of strength and rate of torque development to gait velocity. Sixty-three post-stroke adults participated (60 years, 34 male). Gait velocity was assessed using the fast-paced 10 m walk test. Isometric strength and rate of torque development of seven lower-limb muscle groups were assessed with hand-held dynamometry. Intraclass correlation coefficients were calculated for reliability and Spearman's rho correlations were calculated for associations. Regression analyses using partial F-tests were used to compare strength and rate of torque development in their relationship with gait velocity. Good to excellent reliability was shown for strength and rate of torque development (0.82-0.97). Strong associations were found between strength and rate of torque development (0.71-0.94). Despite high correlations between strength and rate of torque development, rate of torque development failed to provide significant value to regression models that already contained strength. Assessment of isometric rate of torque development with hand-held dynamometry is reliable following stroke, however isometric strength demonstrated greater relationships with gait velocity. Further research should examine the relationship between dynamic measures of muscle strength/torque and gait after stroke. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

    Science.gov (United States)

    Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

    2017-05-25

    To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

  10. Procedural Documentation and Accuracy Assessment of Bathymetric Maps and Area/Capacity Tables for Small Reservoirs

    Science.gov (United States)

    Wilson, Gary L.; Richards, Joseph M.

    2006-01-01

    Because of the increasing use and importance of lakes for water supply to communities, a repeatable and reliable procedure to determine lake bathymetry and capacity is needed. A method to determine the accuracy of the procedure will help ensure proper collection and use of the data and resulting products. It is important to clearly define the intended products and desired accuracy before conducting the bathymetric survey to ensure proper data collection. A survey-grade echo sounder and differential global positioning system receivers were used to collect water-depth and position data in December 2003 at Sugar Creek Lake near Moberly, Missouri. Data were collected along planned transects, with an additional set of quality-assurance data collected for use in accuracy computations. All collected data were imported into a geographic information system database. A bathymetric surface model, contour map, and area/capacity tables were created from the geographic information system database. An accuracy assessment was completed on the collected data, bathymetric surface model, area/capacity table, and contour map products. Using established vertical accuracy standards, the accuracy of the collected data, bathymetric surface model, and contour map product was 0.67 foot, 0.91 foot, and 1.51 feet at the 95 percent confidence level. By comparing results from different transect intervals with the quality-assurance transect data, it was determined that a transect interval of 1 percent of the longitudinal length of Sugar Creek Lake produced nearly as good results as 0.5 percent transect interval for the bathymetric surface model, area/capacity table, and contour map products.

  11. A Spatial Allocation Procedure to Downscale Regional Crop Production Estimates from an Integrated Assessment Model

    Science.gov (United States)

    Moulds, S.; Djordjevic, S.; Savic, D.

    2017-12-01

    The Global Change Assessment Model (GCAM), an integrated assessment model, provides insight into the interactions and feedbacks between physical and human systems. The land system component of GCAM, which simulates land use activities and the production of major crops, produces output at the subregional level which must be spatially downscaled in order to use with gridded impact assessment models. However, existing downscaling routines typically consider cropland as a homogeneous class and do not provide information about land use intensity or specific management practices such as irrigation and multiple cropping. This paper presents a spatial allocation procedure to downscale crop production data from GCAM to a spatial grid, producing a time series of maps which show the spatial distribution of specific crops (e.g. rice, wheat, maize) at four input levels (subsistence, low input rainfed, high input rainfed and high input irrigated). The model algorithm is constrained by available cropland at each time point and therefore implicitly balances extensification and intensification processes in order to meet global food demand. It utilises a stochastic approach such that an increase in production of a particular crop is more likely to occur in grid cells with a high biophysical suitability and neighbourhood influence, while a fall in production will occur more often in cells with lower suitability. User-supplied rules define the order in which specific crops are downscaled as well as allowable transitions. A regional case study demonstrates the ability of the model to reproduce historical trends in India by comparing the model output with district-level agricultural inventory data. Lastly, the model is used to predict the spatial distribution of crops globally under various GCAM scenarios.

  12. Strategic environmental assessment and national development plans in Turkey: Towards legal framework and operational procedure

    International Nuclear Information System (INIS)

    Say, Nuriye Peker; Yuecel, Muzaffer

    2006-01-01

    National development plans were started to be prepared in Turkey in 1963. These plans are mandatory for public investments and guiding principles for private investments. They have a quality which guides and sets objectives for other plans in the country. Therefore, they can be evaluated as the main reason of successes and failures of sectoral investments or the problems that they cause directly or indirectly. Turkey is undergoing rapid industrialization, urbanization and population growth, thus environmental problems are on the increase. Although Environmental Impact Assessment (EIA) has been applied to individual investments in Turkey since 1993, natural environment has continued to be affected because of human activities. Today, parallel to the developments in the world, it has been discussed that it is necessary to strengthen project-level Environmental Assessment (EA) and to practice Strategic Environmental Assessment (SEA). The interest in SEA, that is, EA at the level of proposed policies, plans and programs has grown significantly since 2000 in the country. Discussions and preparations have started about regulation which provides the legal and institutional framework for SEA in The Ministry of Environment and Forestry. However, since the scientific approach into the subject is very new in Turkey, it will take time to answer the questions about how and in what fields to practice. This research project aims at analyzing the possible practice opportunities of SEA in Turkey and the practicability of SEA into the National Five-Year Development Plan (FYDP) which is assumed at the highest level of planning hierarchy in the country. The research is conducted on two sections. In the first section, procedural approaches to SEA on national development plans are investigated and a framework for these approaches is adapted at the institutional level. In the second section, SEA form for energy sector in the development plans is developed. In this article, the findings

  13. Reliability and validity of procedure-based assessments in otolaryngology training.

    Science.gov (United States)

    Awad, Zaid; Hayden, Lindsay; Robson, Andrew K; Muthuswamy, Keerthini; Tolley, Neil S

    2015-06-01

    To investigate the reliability and construct validity of procedure-based assessment (PBA) in assessing performance and progress in otolaryngology training. Retrospective database analysis using a national electronic database. We analyzed PBAs of otolaryngology trainees in North London from core trainees (CTs) to specialty trainees (STs). The tool contains six multi-item domains: consent, planning, preparation, exposure/closure, technique, and postoperative care, rated as "satisfactory" or "development required," in addition to an overall performance rating (pS) of 1 to 4. Individual domain score, overall calculated score (cS), and number of "development-required" items were calculated for each PBA. Receiver operating characteristic analysis helped determine sensitivity and specificity. There were 3,152 otolaryngology PBAs from 46 otolaryngology trainees analyzed. PBA reliability was high (Cronbach's α 0.899), and sensitivity approached 99%. cS correlated positively with pS and level in training (rs : +0.681 and +0.324, respectively). ST had higher cS and pS than CT (93% ± 0.6 and 3.2 ± 0.03 vs. 71% ± 3.1 and 2.3 ± 0.08, respectively; P reliable and valid for assessing otolaryngology trainees' performance and progress at all levels. It is highly sensitive in identifying competent trainees. The tool is used in a formative and feedback capacity. The technical domain is the best predictor and should be given close attention. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

    International Nuclear Information System (INIS)

    Bertovic, Marija; Mueller, Christina; Fahlbruch, Babette; Ronneteg, Ulf; Pitkaenen, Jorma

    2013-01-01

    The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

  15. Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

    Energy Technology Data Exchange (ETDEWEB)

    Bertovic, Marija; Mueller, Christina [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany); Fahlbruch, Babette [TUEV NORD Systems GmbH und Co. KG, Berlin (Germany); Ronneteg, Ulf [SKB Swedish Nuclear Fuel and Waste Management Co., Oskarshamn (Sweden); Pitkaenen, Jorma [Posiva Oy, Eurajoki (Finland)

    2013-07-01

    The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

  16. A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS).

    Science.gov (United States)

    Hilal, Ziad; Kumpernatz, Anne K; Rezniczek, Günther A; Cetin, Cem; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2017-03-01

    To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P training is superior to video demonstration for teaching VE on a pelvic model.

  17. How soft is that pillow? The perceptual localization of the hand and the haptic assessment of contact rigidity.

    Science.gov (United States)

    Pressman, Assaf; Karniel, Amir; Mussa-Ivaldi, Ferdinando A

    2011-04-27

    A new haptic illusion is described, in which the location of the mobile object affects the perception of its rigidity. There is theoretical and experimental support for the notion that limb position sense results from the brain combining ongoing sensory information with expectations arising from prior experience. How does this probabilistic state information affect one's tactile perception of the environment mechanics? In a simple estimation process, human subjects were asked to report the relative rigidity of two simulated virtual objects. One of the objects remained fixed in space and had various coefficients of stiffness. The other virtual object had constant stiffness but moved with respect to the subjects. Earlier work suggested that the perception of an object's rigidity is consistent with a process of regression between the contact force and the perceived amount of penetration inside the object's boundary. The amount of penetration perceived by the subject was affected by varying the position of the object. This, in turn, had a predictable effect on the perceived rigidity of the contact. Subjects' reports on the relative rigidity of the object are best accounted for by a probabilistic model in which the perceived boundary of the object is estimated based on its current location and on past observations. Therefore, the perception of contact rigidity is accounted for by a stochastic process of state estimation underlying proprioceptive localization of the hand.

  18. Reliability and validity of a smartphone-based assessment of gait parameters across walking speed and smartphone locations: Body, bag, belt, hand, and pocket.

    Science.gov (United States)

    Silsupadol, Patima; Teja, Kunlanan; Lugade, Vipul

    2017-10-01

    The assessment of spatiotemporal gait parameters is a useful clinical indicator of health status. Unfortunately, most assessment tools require controlled laboratory environments which can be expensive and time consuming. As smartphones with embedded sensors are becoming ubiquitous, this technology can provide a cost-effective, easily deployable method for assessing gait. Therefore, the purpose of this study was to assess the reliability and validity of a smartphone-based accelerometer in quantifying spatiotemporal gait parameters when attached to the body or in a bag, belt, hand, and pocket. Thirty-four healthy adults were asked to walk at self-selected comfortable, slow, and fast speeds over a 10-m walkway while carrying a smartphone. Step length, step time, gait velocity, and cadence were computed from smartphone-based accelerometers and validated with GAITRite. Across all walking speeds, smartphone data had excellent reliability (ICC 2,1 ≥0.90) for the body and belt locations, with bag, hand, and pocket locations having good to excellent reliability (ICC 2,1 ≥0.69). Correlations between the smartphone-based and GAITRite-based systems were very high for the body (r=0.89, 0.98, 0.96, and 0.87 for step length, step time, gait velocity, and cadence, respectively). Similarly, Bland-Altman analysis demonstrated that the bias approached zero, particularly in the body, bag, and belt conditions under comfortable and fast speeds. Thus, smartphone-based assessments of gait are most valid when placed on the body, in a bag, or on a belt. The use of a smartphone to assess gait can provide relevant data to clinicians without encumbering the user and allow for data collection in the free-living environment. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Quantitative assessment of apical debris extrusion and intracanal debris in the apical third, using hand instrumentation and three rotary instrumentation systems.

    Science.gov (United States)

    H K, Sowmya; T S, Subhash; Goel, Beena Rani; T N, Nandini; Bhandi, Shilpa H

    2014-02-01

    Decreased apical extrusion of debris and apical one third debris have strong implications for decreased incidence of postoperative inflammation and pain. Thus, the aim of this study was to assess quantitatively the apical extrusion of debris and intracanal debris in the apical third during root canal instrumentation using hand and three different types of rotary instruments. Sixty freshly extracted single rooted human teeth were randomly divided into four groups. Canal preparation was done using step-back with hand instrumentation, crown-down technique with respect to ProTaper and K3, and hybrid technique with LightSpeed LSX. Irrigation was done with NaOCl, EDTA, and normal saline and for final irrigation, EndoVac system was used. The apically extruded debris was collected on the pre-weighed Millipore plastic filter disk and weighed using microbalance. The teeth were submitted to the histological processing. Sections from the apical third were analyzed by a trinocular research microscope that was coupled to a computer where the images were captured and analyzed using image proplus V4.1.0.0 software. The mean weight of extruded debris for each group and intracanal debris in the root canal was statistically analyzed by a Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. The result showed that, hand instrumentation using K files showed the highest amount of debris extrusion apically when compared to ProTaper, K3 and LightSpeed LSX. The result also showed that there was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third. Based on the results, all instrumentation techniques produced debris extrusion. The engine driven Ni-Ti systems extruded significantly less apical debris than hand instrumentation. There was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third.

  20. Risk assessment by the executive power versus efficiency of control by the courts - effects on administrative procedures and judicial proceedings

    International Nuclear Information System (INIS)

    Wahl, R.

    1991-01-01

    In conclusion it is stated that any cutbacks in the current system of judicial control have to be earned by appropriate improvements in the administrative procedure. One has to keep in mind the overall situation, which means to examine and assess any reduction of judicial control, the relevance of procedural defects, and the requirements to be met by administrative procedures, in their complete context. Since the acknowledgement of administrative regulations as instruments for putting into practice the legislative intent, and of the executive's scope for examination and assessment, has effects not only in regard to a reduction of judicial control, but also assigns to the administrative procedure an irreplaceable function that cannot be corrected by legal proceedings, there is reason enough to exercise restraint in this matter. (orig./HSCH) [de

  1. Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.

    Science.gov (United States)

    Branzetti, Jeremy B; Adedipe, Adeyinka A; Gittinger, Matthew J; Rosenman, Elizabeth D; Brolliar, Sarah; Chipman, Anne K; Grand, James A; Fernandez, Rosemarie

    2017-11-01

    A subset of high-risk procedures present significant safety threats due to their (1) infrequent occurrence, (2) execution under time constraints and (3) immediate necessity for patient survival. A Just-in-Time (JIT) intervention could provide real-time bedside guidance to improve high-risk procedural performance and address procedural deficits associated with skill decay. To evaluate the impact of a novel JIT intervention on transvenous pacemaker (TVP) placement during a simulated patient event. This was a prospective, randomised controlled study to determine the effect of a JIT intervention on performance of TVP placement. Subjects included board-certified emergency medicine physicians from two hospitals. The JIT intervention consisted of a portable, bedside computer-based procedural adjunct. The primary outcome was performance during a simulated patient encounter requiring TVP placement, as assessed by trained raters using a technical skills checklist. Secondary outcomes included global performance ratings, time to TVP placement, number of critical omissions and System Usability Scale scores (intervention only). Groups were similar at baseline across all outcomes. Compared with the control group, the intervention group demonstrated statistically significant improvement in the technical checklist score (11.45 vs 23.44, p<0.001, Cohen's d effect size 4.64), the global rating scale (2.27 vs 4.54, p<0.001, Cohen's d effect size 3.76), and a statistically significant reduction in critical omissions (2.23 vs 0.68, p<0.001, Cohen's d effect size -1.86). The difference in time to procedural completion was not statistically significant between conditions (11.15 min vs 12.80 min, p=0.12, Cohen's d effect size 0.65). System Usability Scale scores demonstrated excellent usability. A JIT intervention improved procedure perfromance, suggesting a role for JIT interventions in rarely performed procedures. © Article author(s) (or their employer(s) unless otherwise stated in

  2. Clinimetric properties of instruments to assess activities in patients with hand injury: a systematic review of the literature.

    NARCIS (Netherlands)

    Ven-Stevens, L.A.W. van de; Munneke, M.; Terwee, C.B.; Spauwen, P.H.M.; Linde, H. van der

    2009-01-01

    OBJECTIVE: To perform a systematic review of the literature to assess the clinimetric properties of instruments measuring limitations of activity. DATA SOURCES: The Medline, Cochrane Library, Picarta, Occupational Therapy-seeker, and CINAHL databases were searched for English or Dutch language

  3. A Specified Procedure for Distress Identification and Assessment for Urban Road Surfaces Based on PCI

    Directory of Open Access Journals (Sweden)

    Giuseppe Loprencipe

    2017-04-01

    Full Text Available In this paper, a simplified procedure for the assessment of pavement structural integrity and the level of service for urban road surfaces is presented. A sample of 109 Asphalt Concrete (AC urban pavements of an Italian road network was considered to validate the methodology. As part of this research, the most recurrent defects, those never encountered and those not defined with respect to the list collected in the ASTM D6433 have been determined by statistical analysis. The goal of this research is the improvement of the ASTM D6433 Distress Identification Catalogue to be adapted to urban road surfaces. The presented methodology includes the implementation of a Visual Basic for Application (VBA language-based program for the computerization of Pavement Condition Index (PCI calculation with interpolation by the parametric cubic spline of all of the density/deduct value curves of ASTM D6433 distress types. Also, two new distress definitions (for manholes and for tree roots and new density/deduct curve values were proposed to achieve a new distress identification manual for urban road pavements. To validate the presented methodology, for the 109 urban pavements considered, the PCI was calculated using the new distress catalogue and using the ASTM D6433 implemented on PAVERTM. The results of the linear regression between them and their statistical parameters are presented in this paper. The comparison of the results shows that the proposed method is suitable for the identification and assessment of observed distress in urban pavement surfaces at the PCI-based scale.

  4. Examination of the Triarchic Assessment Procedure for Inconsistent Responding in six non-English language samples.

    Science.gov (United States)

    Kelley, Shannon E; van Dongen, Josanne D M; Donnellan, M Brent; Edens, John F; Eisenbarth, Hedwig; Fossati, Andrea; Howner, Katarina; Somma, Antonella; Sörman, Karolina

    2018-05-01

    The Triarchic Assessment Procedure for Inconsistent Responding (TAPIR; Mowle et al., 2016) was recently developed to identify inattentiveness or comprehension difficulties that may compromise the validity of responses on the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). The TAPIR initially was constructed and cross-validated using exclusively English-speaking participants from the United States; however, research using the TriPM has been increasingly conducted internationally, with numerous foreign language translations of the measure emerging. The present study examined the cross-language utility of the TAPIR in German, Dutch, Swedish, and Italian translations of the TriPM using 6 archival samples of community members, university students, forensic psychiatric inpatients, forensic detainees, and adolescents residing outside the United States (combined N = 5,404). Findings suggest that the TAPIR effectively detects careless responding across these 4 translated versions of the TriPM without the need for language-specific modifications. The TAPIR total score meaningfully discriminated genuine participant responses from both fully and partially randomly generated data in every sample, and demonstrated further utility in detecting fixed "all true" or "all false" response patterns. In addition, TAPIR scores were reliably associated with inconsistent responding scores from another psychopathy inventory. Specificity for a range of tentative cut scores for assessing profile validity was modestly reduced among our samples relative to rates previously obtained with the English version of the TriPM; however, overall the TAPIR appears to demonstrate satisfactory cross-language generalizability. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Comparative assessment of immunization procedures for development of anti proinsulin antisera for radioimmunoassay

    International Nuclear Information System (INIS)

    Nascimento, M. do; Borghi, V.C.; Bellini, M.H.; Mesquita, C.H.; Wajchenberg, B.L.

    1992-08-01

    Two schedules of immunization were employed for developing anti proinsulin antisera for radioimmunoassay. Biosynthetic human proinsulin-h P I (Elli Lilly. US), was injected subcutaneously in guinea pigs in multiple sites. In the first schedule were used 50 u g of h P I and the booster injections were administered 4 weeks after the primary immunization and then at 3-week intervals. In the second schedule was used 250 u g of h P I and boosters were done 7, 9 and 18 weeks later. As the antisera were not sufficiently specific for h P I they were purified and assessed for kinetic of precipitation and avidity. Both immunization schedules gave comparable responses. The antisera generated by the use of 50 u g of h P I presented higher cross-reactivity with insulin while the reactivity with c p eptide was of the same order in both antiserum groups. The avidity was very variable in the two groups and the three most sensitive antisera required 24 h at 4 o C for achieving maximum binding with the 125 I-h P I. However, only one antiserum (from the first group) was suitable for the radioimmunoassay. This study emphasizes the difficulties of making valid comparisons between different immunization procedures, especially in the cases when highest avidity is required. (author)

  6. Creep-fatigue assessment of a thermina test specimen using the R5 procedure

    International Nuclear Information System (INIS)

    Booth, P.; Budden, P.J.; Bate, S.K.

    1997-01-01

    A creep-fatigue life assessment of an axisymmetric 316 stainless steel test specimen under constant mechanical and cyclic thermal shock loading using the R5 Procedure is described in this paper. This test was carried out at CEA, France, and formed part of the 'Thermina' series. Stress analysis has been carried out using both full inelastic finite element analysis and also the simplified shakedown methods, based on elastic calculation, within R5. The estimates of strain range and the stress at the start of the creep dwell have then been used with R5 to estimate creep and fatigue damage per cycle and hence to make predictions of component life. The predicted lives are compared with the lives observed in the tests. The simplified R5 estimate of life, based on development of a crack of depth 200 microns, is 260 cycles using best-estimate material properties. Experimentally, cracks of depth at least 150 microns were observed in between 526 and 650 cycles, for two similar tests. The simplified R5 route therefore leads to an estimate of life which is conservative but not unduly so on this component. Detailed cyclic inelastic analysis using the ORNL constitutive model and the ABAQUS finite element code to estimate the strain range and dwell stress led to a best estimate of 618 cycles to crack initiation using R5. (author). 16 refs, 11 figs, 4 tabs

  7. FRP-RC Beam in Shear: Mechanical Model and Assessment Procedure for Pseudo-Ductile Behavior

    Directory of Open Access Journals (Sweden)

    Floriana Petrone

    2014-07-01

    Full Text Available This work deals with the development of a mechanics-based shear model for reinforced concrete (RC elements strengthened in shear with fiber-reinforced polymer (FRP and a design/assessment procedure capable of predicting the failure sequence of resisting elements: the yielding of existing transverse steel ties and the debonding of FRP sheets/strips, while checking the corresponding compressive stress in concrete. The research aims at the definition of an accurate capacity equation, consistent with the requirement of the pseudo-ductile shear behavior of structural elements, that is, transverse steel ties yield before FRP debonding and concrete crushing. For the purpose of validating the proposed model, an extended parametric study and a comparison against experimental results have been conducted: it is proven that the common accepted rule of assuming the shear capacity of RC members strengthened in shear with FRP as the sum of the maximum contribution of both FRP and stirrups can lead to an unsafe overestimation of the shear capacity. This issue has been pointed out by some authors, when comparing experimental shear capacity values with the theoretical ones, but without giving a convincing explanation of that. In this sense, the proposed model represents also a valid instrument to better understand the mechanical behavior of FRP-RC beams in shear and to calculate their actual shear capacity.

  8. Objective Structured Assessment of Technical Skills (OSATS) evaluation of theoretical versus hands-on training of vaginal breech delivery management: a randomized trial.

    Science.gov (United States)

    Buerkle, Bernd; Rueter, Katharina; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2013-12-01

    To compare the skills of performing a vaginal breech (VB) delivery after hands-on training versus demonstration. We randomized medical students to a 30-min demonstration (group 1) or a 30-min hands-on (group 2) training session using a standardized VB management algorithm on a pelvic training model. Subjects were tested with a 25 item Objective Structured Assessment of Technical Skills (OSATS) scoring system immediately after training and 72 h thereafter. OSATS scores were the primary outcome. Performance time (PT), self assessment (SA), confidence (CON), and global rating scale (GRS) were the secondary outcomes. Statistics were performed using the Mann-Whitney U-test, chi-square test, and multiple linear regression analysis. 172 subjects were randomized. OSATS scores (primary outcome) were significantly higher in group 2 (n=88) compared to group 1 (n=84) (21.18±2.29 vs. 20.19±2.37, respectively; p=0.006). The secondary outcomes GRS (10.31±2.28 vs. 9.17±2.21; p=0.001), PT (214.60±57.97 s vs. 246.98±59.34 s; ptraining leads to a significant improvement of VB management in a pelvic training model, but this effect was only seen in the short term. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Development of a procedure for qualitative and quantitative evaluation of human factors as a part of probabilistic safety assessments of nuclear power plants. Part B. Technical documentation

    International Nuclear Information System (INIS)

    Richei, A.

    1998-01-01

    As international studies have shown, accidents in plants are increasingly caused by combinations of technical failures and human errors. Therefore careful investigations of man-machine-interactions to determine human reliability are gaining importance worldwide. Regarding nuclear power plants such investigations are usually carried out within the scope of probabilistic safety assessments. A great number of procedures to evaluate human factors has been developed up to now. However, none of them is able to take into account the whole spectrum of requirements - as for instance transferability of date to other plants, analysis of weak points, and evaluation of cognitive tasks - for a complete and reliable probabilistic safety assessment. Based on an advanced model for a man-machine-system, the Human Error Rate Assessment and Optimizing System (HEROS) and a corresponding expert system of the same name are introduced. This expert system enables the quantification of human error probabilities for plant operator actions on the one hand and is also capable of providing quantitative statements regarding the optimization of man-machine-system in terms of human error probability minimization on the other one. Three relevant evaluation levels, i.e. 'Management Structure', 'Working Environment' and 'Man-Machine-Interface', are derived from a model of the man-machine-system. Linguistic variables are assigned to all performance shaping factors at these levels. These variables are used to establish a rule-based expert system. The knowledge bases of this system are represented by rules. Processing of these rules is carried out by means of the fuzzy set theory, after provision of relevant data for a particular personal action to be evaluated. This procedure enables a simple and effective use of ergonomic studies as the relevant database, which is also transferable to other plants with any design. The expert system consist in total of 16 rule bases in which all ascertainable and

  10. Comprehensive Study of Human External Exposure to Organophosphate Flame Retardants via Air, Dust, and Hand Wipes: The Importance of Sampling and Assessment Strategy.

    Science.gov (United States)

    Xu, Fuchao; Giovanoulis, Georgios; van Waes, Sofie; Padilla-Sanchez, Juan Antonio; Papadopoulou, Eleni; Magnér, Jorgen; Haug, Line Småstuen; Neels, Hugo; Covaci, Adrian

    2016-07-19

    We compared the human exposure to organophosphate flame retardants (PFRs) via inhalation, dust ingestion, and dermal absorption using different sampling and assessment strategies. Air (indoor stationary air and personal ambient air), dust (floor dust and surface dust), and hand wipes were sampled from 61 participants and their houses. We found that stationary air contains higher levels of ΣPFRs (median = 163 ng/m(3), IQR = 161 ng/m(3)) than personal air (median = 44 ng/m(3), IQR = 55 ng/m(3)), suggesting that the stationary air sample could generate a larger bias for inhalation exposure assessment. Tris(chloropropyl) phosphate isomers (ΣTCPP) accounted for over 80% of ΣPFRs in both stationary and personal air. PFRs were frequently detected in both surface dust (ΣPFRs median = 33 100 ng/g, IQR = 62 300 ng/g) and floor dust (ΣPFRs median = 20 500 ng/g, IQR = 30 300 ng/g). Tris(2-butoxylethyl) phosphate (TBOEP) accounted for 40% and 60% of ΣPFRs in surface and floor dust, respectively, followed by ΣTCPP (30% and 20%, respectively). TBOEP (median = 46 ng, IQR = 69 ng) and ΣTCPP (median = 37 ng, IQR = 49 ng) were also frequently detected in hand wipe samples. For the first time, a comprehensive assessment of human exposure to PFRs via inhalation, dust ingestion, and dermal absorption was conducted with individual personal data rather than reference factors of the general population. Inhalation seems to be the major exposure pathway for ΣTCPP and tris(2-chloroethyl) phosphate (TCEP), while participants had higher exposure to TBOEP and triphenyl phosphate (TPHP) via dust ingestion. Estimated exposure to ΣPFRs was the highest with stationary air inhalation (median =34 ng·kg bw(-1)·day(-1), IQR = 38 ng·kg bw(-1)·day(-1)), followed by surface dust ingestion (median = 13 ng·kg bw(-1)·day(-1), IQR = 28 ng·kg bw(-1)·day(-1)), floor dust ingestion and personal air inhalation. The median dermal exposure on hand wipes was 0.32 ng·kg bw(-1)·day(-1) (IQR

  11. Step by Step: Biology Undergraduates’ Problem-Solving Procedures during Multiple-Choice Assessment

    Science.gov (United States)

    Prevost, Luanna B.; Lemons, Paula P.

    2016-01-01

    This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. PMID:27909021

  12. Beneficial effects of tai chi on women's skeletal status assessed by quantitative ultrasound at the hand phalanges - one-year follow-up study

    International Nuclear Information System (INIS)

    Bolanowski, M.; Skrzek, A.; Bolanowski, J.; Pluskiewicz, W.; Adamczyk, P.

    2007-01-01

    Objectives. The advantageous effect of physical exercise on bones has been proven. Quantitative ultrasound (QUS) at different skeletal sites is an accepted method for indirect and noninvasive assessment of bone quality and fracture risk. Earlier, the present authors showed higher values of ultrasound transmission in the hand phalanges of a group of Polish women practicing Tai Chi. The aim of the present study was a prospective assessment of skeletal status in women practicing Tai Chi. Material and Methods. One-year follow-up of skeletal status was assessed using QUS measurements at the hand phalanges in a group of 46 exercising women (mean age: 59.3 ± 8.7 years). Results. At follow-up, increases in the mean amplitude-dependent speed of sound (Ad-SoS) from 1995 ± 80 to 2012 ± 75 m/s (p = 0.001) and mean Z-score from 0.673 ± 1.054 to 1.053 ± 1.178 (p = 0.0005) were observed in the exercising subjects. These changes revealed statistically significant positive correlation with subject age (r = 0.39, p = 0.007 and r = 0.35, p 0.018, respectively). The increase in Ad-SoS exceeded the value of the '' least significant change '' in 19 subjects (41%) of the total group and in 2 (22%) incorporated into medithe pre- and postmenopausal subgroups, respectively. Conclusions. A beneficial effect of regular Tai Chi exercise on skeletal status as assessed by phalangeal QUS is observed in older women. Tai Chi gymnastics may be recommended in the prevention of postmenopausal osteoporosis, especially in older individuals. (authors)

  13. Use of a hand-held bladder ultrasound scanner in the assessment of dehydration and monitoring response to treatment in a paediatric emergency department.

    Science.gov (United States)

    Enright, Kevin; Beattie, Tom; Taheri, Sepideh

    2010-10-01

    Dehydration is a common concern in paediatric emergency care. Limited tools are available to assess reduced urine production, which is commonly cited as a reliable marker of dehydration. To evaluate the utility of a hand-held bladder ultrasound scanner in monitoring urine production in children attending the emergency department with suspected dehydration. A prospective pilot study was undertaken on a convenience sample of patients presenting with suspected dehydration. Serial bladder ultrasound scanning was performed to monitor urine output. Dehydration was assessed clinically using the WHO guide to dehydration assessment. Decisions about treatment and admission were made independently of the urine output measurements obtained using the bladder scanner. 45 children were studied. Using the WHO guide, 33 (73%) had mild dehydration, 8 (18%) had moderate dehydration and 4 (9%) had severe dehydration. There was a significant difference in estimated urine production between those admitted and those discharged (0.9±1.2 ml/kg/h vs 1.8±1.5 ml/kg/h, p=0.01) and between those with mild dehydration versus moderate/severe dehydration (2.3±1.5 ml/kg/h vs 0.6±0.7 ml/kg/h, p=0.0011). Urine output had been significantly reduced in those who had received an intravenous fluid bolus compared with those who had not (0.4±0.46 ml/kg/h vs 1.9±1.6 ml/kg/h, p=0.001). The hand-held bladder scanner is a convenient, non-invasive and objective adjunct in the assessment and management of children attending the emergency department with suspected dehydration.

  14. Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment

    Directory of Open Access Journals (Sweden)

    Ashwini Thimmarayappa

    2015-01-01

    Full Text Available Aims: The aim of the study was to measure airway patency objectively during dexmedetomidine sedation under radiographic guidance in spontaneously breathing pediatric patients scheduled for cardiac catheterization procedures. Subjects and Methods: Thirty-five patients in the age group 5-10 years scheduled for cardiac catheterization procedures were enrolled. All study patients were given loading dose of dexmedetomidine at 1 mg/kg/min for 10 min and then maintenance dose of 1.5 mg/kg/h. Radiographic airway patency was assessed at the start of infusion (0 min and after 30 min. Antero-posterior (AP diameters were measured manually at the nasopharyngeal and retroglossal levels. Dynamic change in airway between inspiration and expiration was considered a measure of airway collapsibility. Patients were monitored for hemodynamics, recovery time and complications. Statistical Analysis: Student paired t-test was used for data analysis. P < 0.05 was considered significant. Results: Minimum and maximum AP diameters were compared at 0 and 30 min. Nasopharyngeal level showed significant reduction in the minimum (6.27 ± 1.09 vs. 4.26 ± 1.03, P < 0.0001 and maximum (6.51 ± 1.14 vs. 5.99 ± 1.03, P < 0.0001 diameters. Similarly retroglossal level showed significant reduction in the minimum (6.98 ± 1.09 vs. 5.27 ± 1.15, P < 0.0001 and maximum (7.49 ± 1.22 vs. 6.92 ± 1.12, P < 0.0003 diameters. The degree of collapsibility was greater at 30 min than baseline ( P < 0.0001. There was a significant decrease in heart rate ( P < 0.0001, and the average recovery time was 39.86 ± 12.22 min. Conclusion: Even though airway patency was maintained in all children sedated with dexmedetomidine, there were significant reductions in the upper airway dimensions measured, so all precautions to manage the airway failure should be taken.

  15. Hand-related physical function in rheumatic hand conditions

    DEFF Research Database (Denmark)

    Klokker, Louise; Terwee, Caroline; Wæhrens, Eva Elisabet Ejlersen

    2016-01-01

    INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility...... and their psychometric qualities. We aim to develop a PROM instrument to assess hand-related physical function in rheumatic hand conditions. METHODS AND ANALYSIS: We will perform a systematic search to identify existing PROMs to rheumatic hand conditions, and select items relevant for hand-related physical function...... as well as those items from the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank that are relevant to patients with rheumatic hand conditions. Selection will be based on consensus among reviewers. Content validity of selected items will be established...

  16. Hand-related physical function in rheumatic hand conditions

    DEFF Research Database (Denmark)

    Klokker, Louise; Terwee, Caroline B; Wæhrens, Eva Ejlersen

    2016-01-01

    as well as those items from the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank that are relevant to patients with rheumatic hand conditions. Selection will be based on consensus among reviewers. Content validity of selected items will be established......INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility...... and their psychometric qualities. We aim to develop a PROM instrument to assess hand-related physical function in rheumatic hand conditions. METHODS AND ANALYSIS: We will perform a systematic search to identify existing PROMs to rheumatic hand conditions, and select items relevant for hand-related physical function...

  17. Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection

    Directory of Open Access Journals (Sweden)

    Feil Yvonne

    2008-10-01

    Full Text Available Abstract Background Recent data indicate that full efficacy of a hand rub preparation for hygienic hand disinfection can be achieved within 15 seconds (s. However, the efficacy test used for the European Norm (EN 1500 samples only the fingertips. Therefore, we investigated hand coverage using sixteen different application variations. The hand rub was supplemented with a fluorescent dye, and hands were assessed under UV light by a blind test, before and after application. Fifteen non-healthcare workers were used as subjects for each application variation apart from one test which was done with a group of twenty healthcare workers. All tests apart from the reference procedure were performed using 3 mL of hand rub. The EN 1500 reference procedure, which consists of 6 specific rub-in steps performed twice with an aliquot of 3 ml each time, served as a control. In one part of this study, each of the six steps was performed from one to five times before proceeding to the next step. In another part of the study, the entire sequence of six steps was performed from one to five times. Finally, all subjects were instructed to cover both hands completely, irrespective of any specific steps ("responsible application". Each rub-in technique was evaluated for untreated skin areas. Results The reference procedure lasted on average 75 s and resulted in 53% of subjects with at least one untreated area on the hands. Five repetitions of the rub-in steps lasted on average 37 s with 67% of subjects having incompletely treated hands. One repetition lasted on average 17 s, and all subjects had at least one untreated area. Repeating the sequence of steps lasted longer, but did not yield a better result. "Responsible application" was quite fast, lasting 25 s among non-healthcare worker subjects and 28 s among healthcare workers. It was also effective, with 53% and 55% of hands being incompletely treated. New techniques were as fast and effective as "responsible

  18. Clean Hands Count

    Medline Plus

    Full Text Available ... has been rented. This feature is not available right now. Please try again later. Published on May ... 34 How The Clean Hands - Safe Hands System Works - Duration: 3:38. Clean Hands-Safe Hands 5, ...

  19. How Do Learning Outcomes, Assessments and Student Engagement in a Fully Online Geoscience Laboratory Compare to Those Of The Original Hands-on Exercise?

    Science.gov (United States)

    Jones, F. M.

    2015-12-01

    In a third year geoscience elective for BSc majors, we adapted several active f2f learning strategies for an equivalent fully online version of the course. In particular, we converted a hands-on laboratory including analysis and interpretation of hand-specimens, sketching results and peer-to-peer discussion of scientific implications. This study compares learning outcomes in both formats and describes resources that make engaging, effective and efficient learning experiences for large classes in an asynchronous online environment. Our two hypotheses are: 1) a hands-on geology lab exercise can be converted for efficient fully online use without sacrificing feedback and assessment opportunities; 2) students find either the f2f or DE versions equally effective and enjoyable as learning experiences. Key components are an authentic context, interactive resources including sketching, strategies that enable efficient assessment and feedback on solo and group work, and asynchronous yet productive interaction with peers. Students in the f2f class handle real rock and fossil specimens, work with peers in the lab and classroom, and deliver most results including annotated figures on paper. DE students complete identical tasks using interactive high resolution figures and videos of specimens. Solo work is first delivered for automated assessment and feedback, then students engage asynchronously in small groups to improve results and discuss implications. Chronostratigraphy and other interpretations are sketched on prepared template images using a simple open-source sketching app that ensures equal access and consistent results that are efficient to assess by peers and instructors. Learning outcomes based on subsequent quizzes, sketches, and lab results (paper for f2f students and automated data entry for DE students), show that f2f and online students demonstrate knowledge and scientific interpretations of comparable quality. Effective engagement and group work are

  20. The Effect and Implications of a "Self-Correcting" Assessment Procedure

    Science.gov (United States)

    Francis, Alisha L.; Barnett, Jerrold

    2012-01-01

    We investigated Montepare's (2005, 2007) self-correcting procedure for multiple-choice exams. Findings related to memory suggest this procedure should lead to improved retention by encouraging students to distribute the time spent reviewing the material. Results from a general psychology class (n = 98) indicate that the benefits are not as…

  1. SINTAP: draft of a unified European failure assessment procedure. An introduction; SINTAP: Entwurf einer vereinheitlichten europaeischen Fehlerbewertungsprozedur. Eine Einfuehrung

    Energy Technology Data Exchange (ETDEWEB)

    Zerbst, U.; Kocak, M. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Werkstofforschung; Wiesner, C. [The Welding Institute (TWI), Cambridge (United Kingdom). Structural Integrity Dept.; Hodulak, L. [Fraunhofer-Institut fuer Werkstoffmechanik (IWM), Freiburg im Breisgau (Germany)

    1999-07-01

    Fracture mechanics based flaw assessment concepts are increasingly used in industrial regulations and standards. A considerable number of different guidelines and procedures are available which are partly based on each other but also exhibit significant differences. At this background, the EU sponsored SINTAP, an interdisciplinary Brite Euram project. SINTAP stands for 'Structural Integrity Assessment Procedures for European Industry'. From 1996 to 1999 seventeen organisations from nine European countries participated in the project the aim of which was to unify the available procedures. The present report is an introduction into the content, the structure and the scientific background of the procedure which was generated within SINTAP. (orig.) [German] Bruchmechanische Bewertungskonzepte werden international in zunehmendem Masse Bestandteil industrieller Regelwerke und Fachbereichsstandards. Bereits heute existiert eine Vielzahl derartiger Vorschriften und Rechnerprogramme, die teilweise aufeinander aufbauen, teilweise aber auch signifikante Unterschiede aufweisen. Vor diesem Hintergrund wurde durch die EU von 1996 bis 1999 SINTAP, ein interdisziplinaeres Brite-Euram-Projekt gefoerdert, dessen Ziel in einer Vereinheitlichung der vorhandenen Ansaetze bestand, und an dem siebzehn Institutionen aus neun europaeischen Laendern beteiligt waren. SINTAP steht fuer 'Structural Integrity Assessment Procedures for European Industry'. Der vorliegende Bericht ist eine Einfuehrung in Inhalt, Struktur und wissenschaftlichen Hintergrund der im Ergebnis des Projektes entstandenen SINTAP-Prozedur. (orig.)

  2. Assessment of the changes in the stress-related salivary cortisol levels to the various dental procedures in children

    Directory of Open Access Journals (Sweden)

    Sharmila J Patil

    2015-01-01

    Full Text Available Background: Fear and pain are the factors producing stress and there is evidence that dental fear acquired in childhood may persist to influence adult behavior. Dental treatment is often considered as anxiety producing and stressful. Aim: To assess the levels of stress displayed by the healthy children undergoing routine dental procedures like oral examination, restoration, and extraction by analyzing salivary levels of cortisol before, during, and after the procedures. Materials and Methods: Twenty healthy children aged between 4 and 8 years having their first dental visit and requiring at least one restoration and one extraction were selected. In each patient, three procedures were carried out: (i Routine dental examination, (ii restoration, and (iii extraction. Unstimulated salivary samples were collected 10 min before, during the procedure, and 30 min after each procedure at three different visits for comparison of cortisol production in response to anxiety and stress over time. Total 180 samples were collected to determine salivary cortisol levels using UBI-MAGIWEL TM kit and the readings were noted. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS software with paired t-test, two independent sample t-tests, and analysis of variance (ANOVA were used to analyze the findings. Results: A correlation between salivary cortisol and stress in dental procedure was noticed. Cavity preparation is more stressful procedure in children, so alternative methods can be used in anxious children. Stress associated with extraction persists to a postoperative period. No correlation exists in between Corah′s anxiety scale and salivary cortisol.

  3. Assessment of the application of an ecotoxicological procedure to screen illicit toxic discharges in domestic septic tank sludge.

    Science.gov (United States)

    López-Gastey, J; Choucri, A; Robidoux, P Y; Sunahara, G I

    2000-06-01

    An innovative screening procedure has been developed to detect illicit toxic discharges in domestic septic tank sludge hauled to the Montreal Urban Community waste-water treatment plant. This new means of control is based on an integrative approach, using bioassays and chemical analyses. Conservative criteria are applied to detect abnormal toxicity with great reliability while avoiding false positive results. The complementary data obtained from toxicity tests and chemical analyses support the use of this efficient and easy-to-apply procedure. This study assesses the control procedure in which 231 samples were analyzed over a 30-month period. Data clearly demonstrate the deterrent power of an efficient control procedure combined with a public awareness campaign among the carriers. In the first 15 months of application, between January 1996 and March 1997, approximately 30% of the 123 samples analyzed showed abnormal toxicity. Between April 1997 and June 1998, that is, after a public hearing presentation of this procedure, this proportion dropped significantly to approximately 9% based on 108 analyzed samples. The results of a 30-month application of this new control procedure show the superior efficiency of the ecotoxicological approach compared with the previously used chemical control procedure. To be able to apply it effectively and, if necessary, to apply the appropriate coercive measures, ecotoxicological criteria should be included in regulatory guidelines.

  4. Evaluation of the ISO standard 11063 DNA extraction procedure for assessing soil microbial abundance and community structure.

    Directory of Open Access Journals (Sweden)

    Pierre Plassart

    Full Text Available Soil DNA extraction has become a critical step in describing microbial biodiversity. Historically, ascertaining overarching microbial ecological theories has been hindered as independent studies have used numerous custom and commercial DNA extraction procedures. For that reason, a standardized soil DNA extraction method (ISO-11063 was previously published. However, although this ISO method is suited for molecular tools such as quantitative PCR and community fingerprinting techniques, it has only been optimized for examining soil bacteria. Therefore, the aim of this study was to assess an appropriate soil DNA extraction procedure for examining bacterial, archaeal and fungal diversity in soils of contrasting land-use and physico-chemical properties. Three different procedures were tested: the ISO-11063 standard; a custom procedure (GnS-GII; and a modified ISO procedure (ISOm which includes a different mechanical lysis step (a FastPrep ®-24 lysis step instead of the recommended bead-beating. The efficacy of each method was first assessed by estimating microbial biomass through total DNA quantification. Then, the abundances and community structure of bacteria, archaea and fungi were determined using real-time PCR and terminal restriction fragment length polymorphism approaches. Results showed that DNA yield was improved with the GnS-GII and ISOm procedures, and fungal community patterns were found to be strongly dependent on the extraction method. The main methodological factor responsible for differences between extraction procedure efficiencies was found to be the soil homogenization step. For integrative studies which aim to examine bacteria, archaea and fungi simultaneously, the ISOm procedure results in higher DNA recovery and better represents microbial communities.

  5. Occupational exposures from selected interventional radiological procedures

    International Nuclear Information System (INIS)

    Janeczek, J.; Beal, A.; James, D.

    2001-01-01

    The number of radiology and cardiology interventional procedures has significantly increased in recent years due to better diagnostic equipment resulting in an increase in radiation dose to the staff and patients. The assessment of staff doses was performed for cardiac catheterization and for three other non-cardiac procedures. The scattered radiation distribution resulting from the cardiac catheterization procedure was measured prior to the staff dose measurements. Staff dose measurements included those of the left shoulder, eye, thyroid and hand doses of the cardiologist. In non-cardiac procedures doses to the hands of the radiologist were measured for nephrostomy, fistulogram and percutaneous transluminal angioplasty procedures. Doses to the radiologist or cardiologist were found to be relatively high if correct protection was not observed. (author)

  6. The Implicit Relational Assessment Procedure as a Measure of Implicit Depression and the Role of Psychological Flexibility

    Science.gov (United States)

    Hussey, Ian; Barnes-Holmes, Dermot

    2012-01-01

    A broad implicit measure of depressive emotional reactions was created by mapping the content of the depression scale from the Depression Anxiety and Stress Scale (DASS) on to the Implicit Relational Assessment Procedure (IRAP). Participants were asked to relate pairings of antecedents and emotional reactions that followed the formula "When X…

  7. Assessment Procedures of Norwegian PhD Theses as Viewed by Examiners from the USA, the UK and Sweden

    Science.gov (United States)

    Kyvik, Svein

    2014-01-01

    This article focuses on the assessment procedures of Norwegian PhD theses as viewed by external members of evaluation committees from three countries with different examination systems; the USA, the UK and Sweden. Their viewpoints give useful information not only on the pros and cons with the Norwegian system, but also on the strengths and…

  8. Evaluating the Performance Diagnostic Checklist-Human Services to Assess Incorrect Error-Correction Procedures by Preschool Paraprofessionals

    Science.gov (United States)

    Bowe, Melissa; Sellers, Tyra P.

    2018-01-01

    The Performance Diagnostic Checklist-Human Services (PDC-HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC-HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error-correction procedures during discrete trial…

  9. Procedural Influence on Internal and External Assessment Scores of Undergraduate Vocational and Technical Education Research Projects in Nigerian Universities

    Science.gov (United States)

    A. C., John; Manabete, S. S.

    2015-01-01

    This study sought to determine the procedural influence on internal and external assessment scores of undergraduate research projects in vocational and technical education programmes in the university under study. A survey research design was used for the conduct of this study. The population consisted of 130 lecturers and 1,847 students in the…

  10. Step by Step: Biology Undergraduates' Problem-Solving Procedures during Multiple-Choice Assessment.

    Science.gov (United States)

    Prevost, Luanna B; Lemons, Paula P

    2016-01-01

    This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. © 2016 L. B. Prevost and P. P. Lemons. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  11. Severe Hand Injuries Caused by a Mole Gun

    Directory of Open Access Journals (Sweden)

    Serdar Düzgün

    2017-10-01

    Full Text Available Objective: Injuries by mole guns differ from other firearm injuries primarily because they are close-range, low-energy injuries that are highly contaminated owing to contact with contaminated surfaces and the presence of numerous residual foreign bodies within the wound. The aim of this article is to share our surgical experience regarding the repair of severe hand injuries caused by mole guns. Material and Methods: This retrospective study included 11 patients with hand injuries. Data obtained about the patients, including age, gender, dominant or non-dominant hand, injuries to all vital structures, and reconstructive procedures were assessed, categorized, and recorded. Results: Ten patients had defects in one or several common digital branches of the median nerve in areas ranging from the distal part of the carpal tunnel to the distal palmar crease. All patients had flexor and extensor tendon injuries in all fingers except for the first finger. Reconstruction of soft tissue and skin defects was carried out with an interpolation flap planned from a random-based subpectoral- paraumbilical region in five patients, a SCIA-based groin flap in four patients, a reverse-radial forearm flap in one patient, and an adipofascial flap planned from the forearm in one patient. Conclusion: Mole gun injuries typically include all structures of the hand, and repair procedures involve every anatomic structure of the hand. An early and effective surgical operation followed by prolonged and effective physical therapy protocols is vital for regaining the full spectrum of hand functions.

  12. Assessing the Health Impact of the following Measures in Schools in Maradi (Niger: Construction of Latrines, Clean Water Supply, Establishment of Hand Washing Stations, and Health Education

    Directory of Open Access Journals (Sweden)

    Halima Boubacar Maïnassara

    2014-01-01

    Full Text Available Objective. To assess the effect on health of the following measures in schools in Maradi (Niger: clean water supply, construction of latrines, establishment of hand washing stations, and health education. Methodology. It was a “before and after” intervention study on a sample of school children aged 7 to 12 years in the Maradi region. The interventions included building of latrines, supplying clean water, setting up hand washing stations, and teaching health education lessons. An individual questionnaire, analysis of stool samples, and a group questionnaire were administered to children and teachers, respectively. The threshold for significance was set at P<0.05. Results. A statistically significant reduction in cases of diarrhoea and abdominal pains was noted after the project. Overall, carriage of at least one parasite increased from 7.5% before the project to 10.2% after it (P=0.04. In the programme group schools, there was a statistically significant increase in the prevalence of Hymenolepis nana, from 0 to 1.9 (P=0.02. Pinworm prevalence remained stable in this group but increased significantly in the control group. Conclusions. Putting health infrastructure in place in schools obviously had an impact on hygiene-related habits in the beneficiary schools and communities.

  13. Assessment of Head-Injured Aircrew: Comparison of FAA and USAF Procedures

    National Research Council Canada - National Science Library

    Fiedler, Edna

    2001-01-01

    .... The purpose of this paper is to first explain the major differences in missions between the USAF and the FAA, and then outline these procedures and rules, note their similarities and differences...

  14. Innovation and practice on assessment of nuclear power engineering management procedures

    International Nuclear Information System (INIS)

    Li Shaogang; Sun Ying

    2011-01-01

    This article has introduced the innovative implementation method and process adopted by Shandong Nuclear Power Company in procedure management for AP1000 nuclear power project, summarized its effects, and also analyzed advantages and disadvantages of this management method. (authors)

  15. Ethical and educational considerations in coding hand surgeries.

    Science.gov (United States)

    Lifchez, Scott D; Leinberry, Charles F; Rivlin, Michael; Blazar, Philip E

    2014-07-01

    To assess treatment coding knowledge and practices among residents, fellows, and attending hand surgeons. Through the use of 6 hypothetical cases, we developed a coding survey to assess coding knowledge and practices. We e-mailed this survey to residents, fellows, and attending hand surgeons. In additionally, we asked 2 professional coders to code these cases. A total of 71 participants completed the survey out of 134 people to whom the survey was sent (response rate = 53%). We observed marked disparity in codes chosen among surgeons and among professional coders. Results of this study indicate that coding knowledge, not just its ethical application, had a major role in coding procedures accurately. Surgical coding is an essential part of a hand surgeon's practice and is not well learned during residency or fellowship. Whereas ethical issues such as deliberate unbundling and upcoding may have a role in inaccurate coding, lack of knowledge among surgeons and coders has a major role as well. Coding has a critical role in every hand surgery practice. Inconstancies among those polled in this study reveal that an increase in education on coding during training and improvement in the clarity and consistency of the Current Procedural Terminology coding rules themselves are needed. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Reliability assessment of a manual-based procedure towards learning curve modeling and fmea analysis

    Directory of Open Access Journals (Sweden)

    Gustavo Rech

    2013-03-01

    Full Text Available Separation procedures in drug Distribution Centers (DC are manual-based activities prone to failures such as shipping exchanged, expired or broken drugs to the customer. Two interventions seem as promising in improving the reliability in the separation procedure: (i selection and allocation of appropriate operators to the procedure, and (ii analysis of potential failure modes incurred by selected operators. This article integrates Learning Curves (LC and FMEA (Failure Mode and Effect Analysis aimed at reducing the occurrence of failures in the manual separation of a drug DC. LCs parameters enable generating an index to identify the recommended operators to perform the procedures. The FMEA is then applied to the separation procedure carried out by the selected operators in order to identify failure modes. It also deployed the traditional FMEA severity index into two sub-indexes related to financial issues and damage to company´s image in order to characterize failures severity. When applied to a drug DC, the proposed method significantly reduced the frequency and severity of failures in the separation procedure.

  17. Assessment of Patients Radiation Dose During Interventional Radiological Procedure in PPUKM

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Muhammad Isa

    2014-01-01

    Interventional Radiology (IR) is a relatively new subspecialty of radiology. It is subspecialty where minimally invasive procedures are performed under radiological guidance using X-ray. This procedure can deliver high radiation doses compared with other radiological method due to long screening time. Because of these it is important to determine radiation doses received by patients undergoing IR procedures. It is to ensure that the dose is within the range deemed to be saved. A total of 128 patients undergoing IR procedures in PPUKM between 2012 and 2013 were study retrospectively. Dose area product (DAP) meter were used to measure the integral dose for the whole procedures. Mean kerma-area products for abdomen, head, pelvis, and thorax were 243.1, 107.3, 39.05 and 45.7 Gycm 2 , respectively. This study may provide the useful information which can be use to establish baseline patient dose data for dose optimizing study and carried out a recommendation on effective method of patient dose reduction during IR procedures. A more detail results of this study are presented in this paper. (author)

  18. [Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

    Science.gov (United States)

    Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence

    2015-01-01

    An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.

  19. Hand washing promotion for preventing diarrhoea

    Science.gov (United States)

    Ejemot-Nwadiaro, Regina I; Ehiri, John E; Arikpo, Dachi; Meremikwu, Martin M; Critchley, Julia A

    2015-01-01

    Background Diarrhoea accounts for 1.8 million deaths in children in low- and middle-income countries (LMICs). One of the identified strategies to prevent diarrhoea is hand washing. Objectives To assess the effects of hand washing promotion interventions on diarrhoeal episodes in children and adults. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (27 May 2015); CENTRAL (published in the Cochrane Library 2015, Issue 5); MEDLINE (1966 to 27 May 2015); EMBASE (1974 to 27 May 2015); LILACS (1982 to 27 May 2015); PsycINFO (1967 to 27 May 2015); Science Citation Index and Social Science Citation Index (1981 to 27 May 2015); ERIC (1966 to 27 May 2015); SPECTR (2000 to 27 May 2015); Bibliomap (1990 to 27 May 2015); RoRe, The Grey Literature (2002 to 27 May 2015); World Health Organization (WHO) International Clinical Trial Registry Platform (ICTRP), metaRegister of Controlled Trials (mRCT), and reference lists of articles up to 27 May 2015. We also contacted researchers and organizations in the field. Selection criteria Individually randomized controlled trials (RCTs) and cluster-RCTs that compared the effects of hand washing interventions on diarrhoea episodes in children and adults with no intervention. Data collection and analysis Three review authors independently assessed trial eligibility, extracted data, and assessed risk of bias. We stratified the analyses for child day-care centres or schools, community, and hospital-based settings. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random-effects model with 95% confidence intervals (CIs). We used the GRADE approach to assess the quality of evidence. Main results We included 22 RCTs: 12 trials from child day-care centres or schools in mainly high-income countries (54,006 participants), nine community-based trials in LMICs (15,303 participants), and one hospital-based trial among people with acquired immune deficiency

  20. Procedures of assessment on the quantification of thoracic kyphosis and lumbar lordosis by radiography and photogrammetry: A literature review.

    Science.gov (United States)

    Porto, Alessandra Beggiato; Okazaki, Victor Hugo Alves

    2017-10-01

    The quantification of thoracic kyphosis and lumbar lordosis can be assessed in different ways; among them radiography and photogrammetry. However, the assessment procedures are not consistent in the literature for either method. The objective of this study was to conduct a literature review about postural assessment through radiography and photogrammetry, for delineating the procedures for both methods. In total 38 studies were selected by an online search in the MEDLINE and LILACS databases with the keywords: radiograph and posture, postural alignment, photogrammetry or photometry or biophotogrammetry. For the radiographic method, the results showed divergences in arm positioning and in the calculation of thoracic and lumbar angles. The photogrammetry demonstrated differences in relation to the camera, tripod, plumb line and feet positioning, angle calculation, software utilization, and the use of footwear. Standardization is proposed for both methods to help establish normative values and comparisons between diagnoses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Assessment of the radio-frequency electromagnetic fields induced in the human body from mobile phones used with hands-free kits

    International Nuclear Information System (INIS)

    Kuehn, Sven; Cabot, Eugenia; Christ, Andreas; Capstick, Myles; Kuster, Niels

    2009-01-01

    In this study, the radiation emission from mobile phones when used with wireless and wired hands-free kits (HFK) was evaluated to determine the necessity for a dedicated compliance procedure and the extent to which the use of wired and wireless HFK can reduce human exposure. The specific absorption rates (SAR) from wireless HFK were determined experimentally. Wired HFK were evaluated dosimetrically while connected to mobile phones (GSM900/1800, UMTS1950) under maximized current coupling onto the HFK cable and various wire routing configurations. In addition, experimentally validated simulations of a wired HFK and a mobile phone operating on anatomical whole-body models were performed. The maximum spatial peak SAR in the head when using wired HFK was more than five times lower than ICNIRP limits. The SAR in the head depends on the output power of the mobile phone, the coupling between the antenna and cable, external attenuation and potential cable specific attenuation. In general, a wired HFK considerably reduces the exposure of the entire head region compared to mobile phones operated at the head, even under unlikely worst-case coupling scenarios. However, wired HFK may cause a localized increase of the exposure in the region of the ear inside the head under worst-case conditions. Wireless HFK exhibit a low but constant exposure.

  2. Assessment of the radio-frequency electromagnetic fields induced in the human body from mobile phones used with hands-free kits

    Energy Technology Data Exchange (ETDEWEB)

    Kuehn, Sven; Cabot, Eugenia; Christ, Andreas; Capstick, Myles; Kuster, Niels [Foundation for Research on Information Technologies in Society (IT' IS), Zuerich (Switzerland)], E-mail: kuehn@itis.ethz.ch

    2009-09-21

    In this study, the radiation emission from mobile phones when used with wireless and wired hands-free kits (HFK) was evaluated to determine the necessity for a dedicated compliance procedure and the extent to which the use of wired and wireless HFK can reduce human exposure. The specific absorption rates (SAR) from wireless HFK were determined experimentally. Wired HFK were evaluated dosimetrically while connected to mobile phones (GSM900/1800, UMTS1950) under maximized current coupling onto the HFK cable and various wire routing configurations. In addition, experimentally validated simulations of a wired HFK and a mobile phone operating on anatomical whole-body models were performed. The maximum spatial peak SAR in the head when using wired HFK was more than five times lower than ICNIRP limits. The SAR in the head depends on the output power of the mobile phone, the coupling between the antenna and cable, external attenuation and potential cable specific attenuation. In general, a wired HFK considerably reduces the exposure of the entire head region compared to mobile phones operated at the head, even under unlikely worst-case coupling scenarios. However, wired HFK may cause a localized increase of the exposure in the region of the ear inside the head under worst-case conditions. Wireless HFK exhibit a low but constant exposure.

  3. Patient dose assessment in various Interventional radiology and cardiology procedures in Algeria (IAEA regional project results)

    International Nuclear Information System (INIS)

    Khelassi-Toutaoui, Nadia; Merad, Ahmed; Toutaoui, A.E.K.; Bairi, Souad

    2008-01-01

    Full text: Purpose: To evaluate patient doses in Interventional Radiology (IR) and Cardiology (IC) procedures in Algeria, within the framework of an International Atomic Energy Agency (IAEA) regional project on radiation protection of patients and medical exposure control (RAF 9033). Materials and Methods: Three public hospitals (CHU Bab el Oued, CHU Parnet and CHU Mustapha) and one specialised Cardiology Service (Clinique Maouche) were chosen for the study. For Maximum Skin Dose (MSD) evaluation, gafchromic films XR type R were used, placed on patient's back before the procedure. The Dose Area Product (DAP) and MSD were measured in 57 IR and IC procedures, either diagnostic or therapeutic. Results: The results revealed large variations in MSD (0.06-3.3 Gy) and DAP (5.5-332 mGycm 2 ). Mean MSD was 0.227 Gy in cerebral angiography, 0.202 Gy in coronary angiography, 1.162 Gy in Percutaneus Transluminal Coronary Angioplasty (PTCA) and 0.128 in abdominal angiography. The correlation of DAP and MSD was significant (r = 0.7). The correlation was DAP and fluoroscopy time was also significant (r = 0.8). Conclusion: The highest MSD values were found in PTCA which is a therapeutic procedure. Two PTCAs out of the 57 procedures measured in total had MSD over the threshold of 2 Gy for deterministic effects (MSD 1 = 3.0 Gy and MSD 2 3.3 Gy). The large variations in MSD reveal the need to continuously monitor patient doses in IR and IC procedures with special emphasis in PTCA procedure. (author)

  4. Procedure for the characterization of radon potential in existing dwellings and to assess the annual average indoor radon concentration

    International Nuclear Information System (INIS)

    Collignan, Bernard; Powaga, Emilie

    2014-01-01

    Risk assessment due to radon exposure indoors is based on annual average indoor radon activity concentration. To assess the radon exposure in a building, measurement is generally performed during at least two months during heating period in order to be representative of the annual average value. This is because radon presence indoors could be very variable during time. This measurement protocol is fairly reliable but may be a limiting in the radon risk management, particularly during a real estate transaction due to the duration of the measurement and the limitation of the measurement period. A previous field study defined a rapid methodology to characterize radon entry in dwellings. The objective of this study was at first, to test this methodology in various dwellings to assess its relevance with a daily test. At second, a ventilation model was used to assess numerically the air renewal of a building, the indoor air quality all along the year and the annual average indoor radon activity concentration, based on local meteorological conditions, some building characteristics and in-situ characterization of indoor pollutant emission laws. Experimental results obtained on thirteen individual dwellings showed that it is generally possible to obtain a representative characterization of radon entry into homes. It was also possible to refine the methodology defined in the previous study. In addition, numerical assessments of annual average indoor radon activity concentration showed generally a good agreement with measured values. These results are encouraging to allow a procedure with a short measurement time to be used to characterize long-term radon potential in dwellings. - Highlights: • Test of a daily procedure to characterize radon potential in dwellings. • Numerical assessment of the annual radon concentration. • Procedure applied on thirteen dwellings, characterization generally satisfactory. • Procedure useful to manage radon risk in dwellings, for real

  5. To Establish the Validity of Dental Age Assessment using Nolla′s Method on Comparing with Skeletal Age assessed by Hand-Wrist Radiographs

    Directory of Open Access Journals (Sweden)

    Kiran Sachan

    2013-01-01

    Conclusion: Females were more advanced in skeletal maturation than males. Chronological age showed inconsistent correlation with dental and skeletal ages. It was concluded that canine calcification stages can also be used for assessing skeletal maturity.

  6. Determining the quality of Competence Assessment Programs: A self-evaluation procedure

    NARCIS (Netherlands)

    Baartman, L.K.J.; Prins, F.J.; Kirschner, P.A.; Vleuten, van der C.P.M.

    2007-01-01

    As assessment methods are changing, the way to determine their quality needs to be changed accordingly. This article argues for the use Competence Assessment Programs (CAPs), combinations of traditional tests and new assessment methods which involve both formative and summative assessments. To

  7. Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

    Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. An automated sensitivity analysis procedure for the performance assessment of nuclear waste isolation systems

    International Nuclear Information System (INIS)

    Pin, F.G.; Worley, B.A.; Oblow, E.M.; Wright, R.Q.; Harper, W.V.

    1986-01-01

    To support an effort in making large-scale sensitivity analyses feasible, cost efficient and quantitatively complete, the authors have developed an automated procedure making use of computer calculus. The procedure, called GRESS (GRadient Enhanced Software System), is embodied in a precompiler that can process Fortran computer codes and add derivative-taking capabilities to the normal calculation scheme. In this paper, the automated GRESS procedure is described and applied to the code UCB-NE-10.2, which simulates the migration through a sorption medium of the radionuclide members of a decay chain. The sensitivity calculations for a sample problem are verified using comparison with analytical and perturbation analysis results. Conclusions are drawn relative to the applicability of GRESS for more general large-scale sensitivity studies, and the role of such techniques in an overall sensitivity and uncertainty analysis program is discussed

  9. Exploring procedures for the rapid assessment of optically stimulated luminescence range-finder ages

    International Nuclear Information System (INIS)

    Roberts, Helen M.; Durcan, Julie A.; Duller, Geoff A.T.

    2009-01-01

    Optically stimulated luminescence (OSL) dating of sediments is a lengthy, labour-intensive, and time-consuming procedure. However, in some situations a rough approximation of the OSL age is all that is necessary e.g. for a pilot field campaign, to plan a sampling strategy, or to determine the resolution required for a dating campaign. Thus, it would be useful to establish an approximate OSL age without the lengthy and involved processes normally used. This paper explores how the standard procedures involved in OSL age determinations can be simplified to yield range-finder ages. Three areas are examined, namely, laboratory preparation, D e estimation, and dose-rate determination. The consequences of circumventing some of the preparation and measurement steps of conventional OSL dating are examined for a variety of sediments, by comparing the OSL range-finder ages to those obtained using full quartz OSL preparation and measurement procedures.

  10. Hand Surgery: Anesthesia

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Hand Surgery Anesthesia Email to a friend * required ...

  11. Assessment of passive drag in swimming by numerical simulation and analytical procedure.

    Science.gov (United States)

    Barbosa, Tiago M; Ramos, Rui; Silva, António J; Marinho, Daniel A

    2018-03-01

    The aim was to compare the passive drag-gliding underwater by a numerical simulation and an analytical procedure. An Olympic swimmer was scanned by computer tomography and modelled gliding at a 0.75-m depth in the streamlined position. Steady-state computer fluid dynamics (CFD) analyses were performed on Fluent. A set of analytical procedures was selected concurrently. Friction drag (D f ), pressure drag (D pr ), total passive drag force (D f +pr ) and drag coefficient (C D ) were computed between 1.3 and 2.5 m · s -1 by both techniques. D f +pr ranged from 45.44 to 144.06 N with CFD, from 46.03 to 167.06 N with the analytical procedure (differences: from 1.28% to 13.77%). C D ranged between 0.698 and 0.622 by CFD, 0.657 and 0.644 by analytical procedures (differences: 0.40-6.30%). Linear regression models showed a very high association for D f +pr plotted in absolute values (R 2  = 0.98) and after log-log transformation (R 2  = 0.99). The C D also obtained a very high adjustment for both absolute (R 2  = 0.97) and log-log plots (R 2  = 0.97). The bias for the D f +pr was 8.37 N and 0.076 N after logarithmic transformation. D f represented between 15.97% and 18.82% of the D f +pr by the CFD, 14.66% and 16.21% by the analytical procedures. Therefore, despite the bias, analytical procedures offer a feasible way of gathering insight on one's hydrodynamics characteristics.

  12. X-ray findings in the skeleton of the hand to prove renal osteopathy. Soft ray immersions radiography versus standard procedures; Roentgendiagnostik der renalen Osteopathie am Handskelett. Weichstrahl-Immersions-Radiographie kontra Standardtechnik

    Energy Technology Data Exchange (ETDEWEB)

    Pollack, T. [Radiologische Klinik, Krankenhaus Dresden-Friedrichstadt, Staedtisches Klinikum (Germany); Friedberg, R. [Radiologische Klinik, Krankenhaus Dresden-Friedrichstadt, Staedtisches Klinikum (Germany); Heinicke, H.J. [1. Medizinische Klinik, Krankenhaus Dresden-Friedrichstadt, Staedtisches Klinikum (Germany)

    1994-11-01

    In examinations of the hand skeleton, findings typical of renal osteopathy are much more readily revealed by soft ray immersions radiography than by images obtained using conventional techniques. In combination with microradioscopy the method is highly suitable for the primary diagnosis and follow-up of renal osteopathy. The information provided eliminates the need for examinations of other skeletal sections and thus justifies the slightly increased dose requirements. The fact that unchanged parathormone can be determined simultaneously adds to the sensitivity of this non-invasive technique. Histological assessments of the skeleton can, however, not always be avoided. (orig.) [Deutsch] Die Untersuchung des Handskeletts mit Hilfe der Weichstrahl-Immersions-Radiographie (WIR) ist fuer typische Befunde der renalen Osteopathie wesentlich sensitiver als die Aufnahmen in Standardtechnik. In Kombination mit der Mikroradioskopie ist sie fuer die roentgenologische Basisdiagnostik und Verlaufskontrolle der renalen Osteopathie sehr gut geeignet. Der Informationsgewinn und die Moeglichkeit der Einsparung von Roentgenuntersuchungen anderer Skelettabschnitte rechtfertigt den etwas hoeheren Dosisbedarf der WIR. Die gleichzeitige Bestimmung des intakten Parathormons erhoeht die Sensitivitaet der nichtinvasiven Diagnostik. Dennoch laesst sich auf eine Knochenhistologie nicht in jedem Fall verzichten. (orig.)

  13. A dinamometria manual e seu uso na avaliação nutricional Hand grip strength test and its use in nutritional assessment

    Directory of Open Access Journals (Sweden)

    Michael Maia Schlüssel

    2008-04-01

    Full Text Available Esta revisão de literatura aborda aspectos metodológicos e fisiológicos da dinamometria manual. A dinamometria manual é um teste funcional do músculo esquelético que vem recebendo uma crescente atenção de clínicos e pesquisadores da área de saúde nos últimos anos. Recentemente, tem merecido atenção como indicador do estado nutricional, particularmente para pacientes internados. Dentre os principais fatores que influenciam esta medida, destacam-se o sexo, a idade, a estatura, a massa corporal e a mão dominante dos indivíduos. Os resultados desta revisão demonstram ainda que diversos outros fatores, relacionados ao protocolo de aferição, como a posição do indivíduo, o tipo de instrumento utilizado, o número de aferições realizadas, o intervalo de descanso entre as aferições, a presença de estímulo verbal e de um pré-teste, também podem influenciar os valores alcançados por um indivíduo em uma avaliação da dinamometria manual. Dessa forma, é importante que um protocolo de aferição padronizado seja desenvolvido, para que se obtenham medidas válidas de dinamometria manual. Ainda são escassos os estudos que propõem valores de referência para a dinamometria manual e a literatura ainda se ressente de valores de referência baseados em dados obtidos a partir de amostras de base populacional.This paper reviews the methodological and physiological aspects of hand grip strength measurement. Hand grip strength assesses skeletal muscle function and has received increasing attention from physicians and health-related researchers in the last years. Recently, it has deserved particular attention as an indicator of nutritional status, particularly in hospitalized patients. Sex, age, height, body mass and the dominant hand of the subjects are the main factors that influence the measure. The results of this review demonstrate that many other factors associated with the assessment protocol, such as the position of the

  14. Default values for assessment of potential dermal exposure of the hands to industrial chemicals in the scope of regulatory risk assessments

    NARCIS (Netherlands)

    Marquart, H.; Warren, N.D.; Laitinen, J.; Hemmen, J.J. van

    2006-01-01

    Dermal exposure needs to be addressed in regulatory risk assessment of chemicals. The models used so far are based on very limited data. The EU project RISKOFDERM has gathered a large number of new measurements on dermal exposure to industrial chemicals in various work situations, together with

  15. 40 CFR 63.1104 - Process vents from continuous unit operations: applicability assessment procedures and methods.

    Science.gov (United States)

    2010-07-01

    ...) Necessitating that the owner or operator make product in excess of demand. (e) TOC or Organic HAP concentration....306×10 −2 a Use according to procedures outlined in this section. MJ/scm = Mega Joules per standard cubic meter. scm/min = Standard cubic meters per minute. (2) Nonhalogenated process vents. The owner or...

  16. Evaluation of Procedural Simulation as a Training and Assessment Tool in General Surgery

    DEFF Research Database (Denmark)

    Bjerrum, Flemming; Strandbygaard, Jeanett; Rosthøj, Susanne

    2017-01-01

    BACKGROUND: Laparoscopic appendectomy is a commonly performed surgical procedure, but few training models have been described for it. We examined a virtual reality module for practising a laparoscopic appendectomy. METHODS: A prospective cohort study with the following 3 groups of surgeons (n = 45...

  17. Are impact assessment procedures actually promoting sustainable development? Institutional perspectives on barriers and opportunities found in the Swedish committee system

    International Nuclear Information System (INIS)

    Nykvist, Bjoern; Nilsson, Mans

    2009-01-01

    Impact assessment frameworks are gaining increasing attention as a procedure to integrate sustainability concerns in European and national policy-making. The gap between political visions on sustainable development and the reality of policy-making is, however, still pronounced, and a very limited range and scope of available assessment methods are used in practice. This study examines why this pattern prevails, in this case within the Swedish Committees of Inquiry, with a focus on institutional factors determining the function of Impact Assessments. The findings suggest that assessment procedures have little value when not accompanied by clear specific instructions on priorities. A range of institutional constraints emerge in the interface between policy makers and knowledge providers in committees. Dominant professional, organisational, and disciplinary cultures constrain the assessment, and socio-economic priorities are by tradition most important. Based on our analysis, we conclude that to enhance the potential for integrating sustainability concerns, it seems less fruitful to develop more advanced and complex assessment frameworks and models than strengthening institutional arenas for social learning. Such arenas should be; defined by a broad mandate and instructions, characterised by key personal skills and resources, and build institutional capacity for a range of stakeholders to engage with them

  18. Design and Construction of a Bilateral Haptic System for the Remote Assessment of the Stiffness and Range of Motion of the Hand

    Directory of Open Access Journals (Sweden)

    Fabio Oscari

    2016-10-01

    Full Text Available The use of haptic devices in the rehabilitation of impaired limbs has become rather popular, given the proven effectiveness in promoting recovery. In a standard framework, such devices are used in rehabilitation centers, where patients interact with virtual tasks, presented on a screen. To track their sessions, kinematic/dynamic parameters or performance scores are recorded. However, as Internet access is now available at almost every home and in order to reduce the hospitalization time of the patient, the idea of doing rehabilitation at home is gaining wide consent. Medical care programs can be synchronized with the home rehabilitation device; patient data can be sent to the central server that could redirect to the therapist laptop (tele-healthcare. The controversial issue is that the recorded data do not actually represent the clinical conditions of the patients according to the medical assessment scales, forcing them to frequently undergo clinical tests at the hospital. To respond to this demand, we propose the use of a bilateral master/slave haptic system that could allow the clinician, who interacts with the master, to assess remotely and in real time the clinical conditions of the patient that uses the home rehabilitation device as the slave. In this paper, we describe a proof of concept to highlight the main issues of such an application, limited to one degree of freedom, and to the measure of the stiffness and range of motion of the hand.

  19. Assessment of job stress factors and organizational personality types for procedure-based jobs in nuclear power plants

    International Nuclear Information System (INIS)

    Kim, Dae-Ho; Lee, Yong-Hee; Lee, Jung-Woon

    2008-01-01

    The purpose of this study is to assess the organizational types and the job stress factors that affect procedure-based job performances in nuclear power plants. We derived 24 organizational factors affecting job stress level in nuclear power plants from the job stress analysis models developed by NIOSH, JDI, and IOR. Considering the safety characteristics in the operating tasks of nuclear power plants, we identified the job contents and characteristics through the analyses of job assignments that appeared in the organizational chart and the results of an activity-based costing. By using questionnaire surveys and structured interviews with the plant personnel and expert panels, we assessed 70 jobs among the 777 jobs managed officially in accordance with the procedures. They consist of the representative jobs of each department and are directly related to safety. We utilized the organizational personality type indicators to characterize the personality types of each organization in nuclear power plants. (author)

  20. ASSESSING GOING CONCERN ASSUMPTION BY USING RATING VALUATION MODELS BASED UPON ANALYTICAL PROCEDURES IN CASE OF FINANCIAL INVESTMENT COMPANIES

    OpenAIRE

    Tatiana Danescu; Ovidiu Spatacean; Paula Nistor; Andrea Cristina Danescu

    2010-01-01

    Designing and performing analytical procedures aimed to assess the rating of theFinancial Investment Companies are essential activities both in the phase of planning a financialaudit mission and in the phase of issuing conclusions regarding the suitability of using by themanagement and other persons responsible for governance of going concern, as the basis forpreparation and disclosure of financial statements. The paper aims to examine the usefulness ofrecognized models used in the practice o...

  1. Second-hand signals

    DEFF Research Database (Denmark)

    Bergenholtz, Carsten

    2014-01-01

    Studies of signaling theory have traditionally focused on the dyadic link between the sender and receiver of the signal. Within a science‐based perspective this framing has led scholars to investigate how patents and publications of firms function as signals. I explore another important type...... used by various agents in their search for and assessment of products and firms. I conclude by arguing how this second‐hand nature of signals goes beyond a simple dyadic focus on senders and receivers of signals, and thus elucidates the more complex interrelations of the various types of agents...

  2. The hand and wrist

    International Nuclear Information System (INIS)

    Wood, M.B.; Berquist, T.H.

    1985-01-01

    Trauma is the most common etiologic factor leading to disability in the hand and wrist. Judicious radiographic evaluation is required for accurate assessment in practically all but the most minor of such injuries. Frequently serial radiographic evaluation is essential for directing the course of treatment and for following the healing process. A meaningful radiographic evaluation requires a comprehensive knowledge of the normal radiographic anatomy, an overview of the spectrum of pathology, and an awareness of the usual mechanisms of injury, appropriate treatment options, and relevant array of complications

  3. Assessment of exposure Lo scattered radiation in interventional procedures using special proLecLive bismuth

    International Nuclear Information System (INIS)

    Soto Bua, M.; Medina Jimenez, E.; Vazquez Vazquez, R.; Santamaria Vazquez, F.; Otero Martinez, C.; Lobato Busto, R.; Luna Vega, V.; Mosquera Suero, J.; Sanchez Garcia, M.; Pombar Camean, M.

    2011-01-01

    There are currenLly marketed specific producta aimed aL reducing personnel exposure Lo radiation scatLered in cardiac catheLerization procedures, intervenLional radiology or elecLrophysiology. Our service has been proposed Lo study Lhe aLLenuation characLeristics of Lhe producL ''Drape Armour'' manufactured by Lhe company ''MicroLek'' IL ja flexible devices consLructed from an alloy of bismuth and sLeriliLy characLeristics and infection conLrol and fluid makes Lhem particularly suiLable for incorporaLing into Lhe operative field of the patient. To sLudy their behavior, Lhere have been staff dose measurementa representaLive of Lhe moaL common siLuaLions of exposure to scattered radiaLion in a typical procedure of intervenLion.

  4. Automated Neuropsychological Assessment Metrics, Version 4 (ANAM4): Examination of Select Psychometric Properties and Administration Procedures

    Science.gov (United States)

    2018-03-01

    301 Minnesota 306 Kentucky 193 Texas 188 Total 1461 14 Task 27 (Months 85-96) Continue data quality control checks and preliminary...research hypotheses – COMPLETED Data management and data quality control checks have been completed with all data collected as part of this effort...summarizing data from Studies 1-3 are being finalized. Data management procedures for Study 4 are completed and analyses and manuscript preparations are

  5. Advanced procedure for the assessments of the lifetime of solar absorber coatings

    OpenAIRE

    Köhl, M.; Heck, M.; Brunold, S.; Frei, U.; Carlsson, B.; Möller, K.

    2003-01-01

    New solar absorber coatings are developed and used in advanced collector designs with improved efficiency. The operation temperature as well as the stagnation temperature as the main durability load for the absorbers were increasing during the past due to these innovations. Especially the highly selective new coatings have to suffer by these stronger loads. The service life estimation procedure developed in the framework of research activities of the IEA Solar Heating and Cooling Programme (T...

  6. Remediation strategies after nuclear or radiological accidents: part 2 - accident scenarios for assessing effectiveness of cleanup procedures

    International Nuclear Information System (INIS)

    Rochedo, Elaine R.R.

    2009-01-01

    The selection of protective measures and remediation strategies after an accident needs to be based on previously established criteria, to minimize unnecessary stress and the exposures involved in cleanup operations that are not effective in reducing doses to the public. In a first stage, a database describing the countermeasures has been developed including their efficiency on removing contamination from surfaces. However, to assess the effectiveness of cleanup procedures in reducing doses to members of the public, it was necessary to derive specific scenarios in order to simulate the long term behavior of the material in the environment, since the contribution of different surfaces to doses changes with time after contamination. A basic release and exposure scenario was developed to assess the dose reduction due to the mostly used procedures. Exposure scenarios were selected to fit the surroundings of the Brazilian nuclear power plants in Angra dos Reis. Simulations were performed using SIEM, the integrated system for dose assessment after contamination events, developed at IRD. The contamination of urban environments was assessed for Cs-137, as this was found to be the most relevant long term radionuclide to contribute to doses to member of the public. The effects on reducing external exposures were assessed for periods up to 50 years after the contamination. For agricultural areas, the focus was on ingestion doses from contamination with I-131 for periods up to 1 year after contamination. Results will be complemented on the database in order to support multi-criteria decision making processes after accidents. (author)

  7. An engineering assessment methodology for non-sharp defects in steel structures – Part I: Procedure development

    International Nuclear Information System (INIS)

    Horn, A.J.; Sherry, A.H.

    2012-01-01

    This Part I paper describes a new engineering assessment methodology for ferritic steel structures containing non-sharp defects within the context of a Failure Assessment Diagram (FAD) approach. Although the modification of the FAD for non-sharp defects can be applied whether the initiating failure mechanism is cleavage or ductile tearing, this paper focuses on cleavage fracture. The parameters describing the sensitivity of the material toughness to the notch effect can either be measured by testing notched specimens of the same thickness as the structure, or for cleavage fracture they can be obtained using look-up tables generated using the Weibull stress toughness scaling model. The other parameters in the procedure can either be conservatively estimated using simple equations or they can be determined more accurately using finite element analysis. Validation of the new method is presented in the companion Part II paper: this shows that assessments of U-notched SE(B) specimens have significantly reduced conservatism when using the new assessment methodology compared to the standard FAD approach for sharp cracks. - Highlights: ► Development of a new procedure for predicting failure from non-sharp defects. ► Based on a modification of the Failure Assessment Diagram (FAD) approach. ► Applicable to cleavage and ductile tearing initiation although paper focuses on cleavage. ► Validation provided in a companion Part II paper.

  8. Remediation strategies after nuclear or radiological accidents: part 2 - accident scenarios for assessing effectiveness of cleanup procedures

    Energy Technology Data Exchange (ETDEWEB)

    Rochedo, Elaine R.R. [Comissao Nacional de Energia Nuclear (CNEN-RJ), Rio de Janeiro, RJ (Brazil). Coordenacao de Instalacoes Nucleares], e-mail: erochedo@cnen.gov.br; Silva, Diogo N.G.; Wasserman, Maria A.V.; Conti, Luiz F.C. [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)], e-mail: dneves@ird.gov.br, e-mail: angelica@ird.gov.br, e-mail: lfcconti@ird.gov.br

    2009-07-01

    The selection of protective measures and remediation strategies after an accident needs to be based on previously established criteria, to minimize unnecessary stress and the exposures involved in cleanup operations that are not effective in reducing doses to the public. In a first stage, a database describing the countermeasures has been developed including their efficiency on removing contamination from surfaces. However, to assess the effectiveness of cleanup procedures in reducing doses to members of the public, it was necessary to derive specific scenarios in order to simulate the long term behavior of the material in the environment, since the contribution of different surfaces to doses changes with time after contamination. A basic release and exposure scenario was developed to assess the dose reduction due to the mostly used procedures. Exposure scenarios were selected to fit the surroundings of the Brazilian nuclear power plants in Angra dos Reis. Simulations were performed using SIEM, the integrated system for dose assessment after contamination events, developed at IRD. The contamination of urban environments was assessed for Cs-137, as this was found to be the most relevant long term radionuclide to contribute to doses to member of the public. The effects on reducing external exposures were assessed for periods up to 50 years after the contamination. For agricultural areas, the focus was on ingestion doses from contamination with I-131 for periods up to 1 year after contamination. Results will be complemented on the database in order to support multi-criteria decision making processes after accidents. (author)

  9. The safety assessment of OPR-1000 nuclear power plant for station blackout accident applying the combined deterministic and probabilistic procedure

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dong Gu, E-mail: littlewing@kins.re.kr [Korea Institute of Nuclear Safety, 62 Gwahak-ro, Yuseong-gu, Daejeon 305-338 (Korea, Republic of); Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Chang, Soon Heung [Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2014-08-15

    Highlights: • The combined deterministic and probabilistic procedure (CDPP) was proposed for safety assessment of the BDBAs. • The safety assessment of OPR-1000 nuclear power plant for SBO accident is performed by applying the CDPP. • By estimating the offsite power restoration time appropriately, the SBO risk is reevaluated. • It is concluded that the CDPP is applicable to safety assessment of BDBAs without significant erosion of the safety margin. - Abstract: Station blackout (SBO) is a typical beyond design basis accident (BDBA) and significant contributor to overall plant risk. The risk analysis of SBO could be important basis of rulemaking, accident mitigation strategy, etc. Recently, studies on the integrated approach of deterministic and probabilistic method for nuclear safety in nuclear power plants have been done, and among them, the combined deterministic and probabilistic procedure (CDPP) was proposed for safety assessment of the BDBAs. In the CDPP, the conditional exceedance probability obtained by the best estimate plus uncertainty method acts as go-between deterministic and probabilistic safety assessments, resulting in more reliable values of core damage frequency and conditional core damage probability. In this study, the safety assessment of OPR-1000 nuclear power plant for SBO accident was performed by applying the CDPP. It was confirmed that the SBO risk should be reevaluated by eliminating excessive conservatism in existing probabilistic safety assessment to meet the targeted core damage frequency and conditional core damage probability. By estimating the offsite power restoration time appropriately, the SBO risk was reevaluated, and it was finally confirmed that current OPR-1000 system lies in the acceptable risk against the SBO. In addition, it is concluded that the CDPP is applicable to safety assessment of BDBAs in nuclear power plants without significant erosion of the safety margin.

  10. The Use of Functional Assessment and Frequency Building Procedures to Increase Product Knowledge and Data Entry Skills among Foremen in a Construction Organization

    Science.gov (United States)

    Pampino, Ralph N.; Wilder, David A.; Binder, Carl

    2005-01-01

    A functional assessment procedure, which was designed to identify insufficient skills that may have been responsible for employee performance problems, was administered to four foremen employed in a large construction organization. Results of this assessment procedure identified two skill areas, product knowledge and data entry, as deficient.…

  11. Subjective versus objective assessment in early clinical outcome of modified Lapidus procedure for hallux valgus deformity.

    Science.gov (United States)

    Chopra, S; Moerenhout, K; Crevoisier, X

    2016-02-01

    Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity. This study aimed, to assess the outcome of modified Lapidus at 6 months postoperatively, using gait assessment method, to determine if the nine specified gait parameters effectively relates with the clinical scores and the radiological results or add information missed by these commonly used clinical assessments. We assessed 21 participants including 11 controls and 10 patients with moderate to severe hallux valgus deformity. The patient group was followed 6 months postoperatively. The ambulatory gait assessment was performed utilizing pressure insoles and inertial sensors. Clinical assessment includes foot and ankle questionnaires along with radiographic results. Comparison was made using non parametric tests, Phallux valgus surgeries. The existing clinical assessment overestimates the functional outcome at the early postoperative phase. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Osteoarthritis of the Hand

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Osteoarthritis Email to a friend * required fields From * ...

  13. Hands in Systemic Disease

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... hands, being composed of many types of tissue, including blood vessels, nerves, skin and skin-related tissues, bones, and muscles/tendons/ligaments, may show changes that reflect a ...

  14. Hand eczema severity and quality of life

    DEFF Research Database (Denmark)

    Agner, Tove; Andersen, Klaus E; Brandao, Francisco M

    2008-01-01

    Background and Objectives: Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. Methods: A total of 416 patients with hand eczema from 10 European patch...

  15. Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures.

    Science.gov (United States)

    Morrell, R E; Rogers, A T

    2006-07-01

    Patient skin doses were measured using Kodak EDR2 film for 20 coronary angiography (CA) and 32 percutaneous transluminal coronary angioplasty (PTCA) procedures. For CA, all skin doses were well below 1 Gy. However, 23% of PTCA patients received skin doses of 1 Gy or more. Dose-area product (DAP) was also recorded and was found to be an inadequate indicator of maximum skin dose. Practical compliance with ICRP recommendations requires a robust method for skin dosimetry that is more accurate than DAP and is applicable over a wider dose range than EDR2 film.

  16. Health Impact Assessment for Second-Hand Smoke Exposure in Germany—Quantifying Estimates for Ischaemic Heart Diseases, COPD, and Stroke

    Directory of Open Access Journals (Sweden)

    Florian Fischer

    2016-02-01

    Full Text Available Evidence of the adverse health effects attributable to second-hand smoke (SHS exposure is available. This study aims to quantify the impact of SHS exposure on ischaemic heart diseases (IHD, chronic obstructive pulmonary diseases (COPD, and stroke in Germany. Therefore, this study estimated and forecasted the morbidity for the three outcomes in the German population. Furthermore, a health impact assessment was performed using DYNAMO-HIA, which is a generic software tool applying a Markov model. Overall 687,254 IHD cases, 231,973 COPD cases, and 288,015 stroke cases were estimated to be attributable to SHS exposure in Germany for 2014. Under the assumption that the population prevalence of these diseases and the prevalence of SHS exposure remain constant, the total number of cases will increase due to demographic aging. Assuming a total eradication of SHS exposure beginning in 2014 leads to an estimated reduction of 50% in cases, compared to the reference scenario in 2040 for all three diseases. The results highlight the relevance of SHS exposure because it affects several chronic disease conditions and has a major impact on the population’s health. Therefore, public health campaigns to protect non-smokers are urgently needed.

  17. Assessing the Therapeutic Effect of 630 nm Light-Emitting Diodes Irradiation on the Recovery of Exercise-Induced Hand Muscle Fatigue with Surface Electromyogram

    Directory of Open Access Journals (Sweden)

    Dandan Yang

    2012-01-01

    Full Text Available This paper aims to investigate the effect of light emitting diode therapy (LEDT on exercise-induced hand muscle fatigue by measuring the surface electromyography (sEMG of flexor digitorum superficialis. Ten healthy volunteers were randomly placed in the equal sized LEDT group and control group. All subjects performed a sustained fatiguing isometric contraction with the combination of four fingertips except thumb at 30% of maximal voluntary contraction (MVC until exhaustion. The active LEDT or an identical passive rest therapy was then applied to flexor digitorum superficialis. Each subject was required to perform a re-fatigue task immediately after therapy which was the same as the pre-fatigue task. Average rectified value (ARV and fractal dimension (FD of sEMG were calculated. ARV and FD were significantly different between active LEDT and passive rest groups at 20%–50%, 70%–80%, and 100% of normalized contraction time (P<0.05. Compared to passive rest, active LEDT induced significantly smaller increase in ARV values and decrease in FD values, which shows that LEDT is effective on the recovery of muscle fatigue. Our preliminary results also suggest that ARV and FD are potential replacements of biochemical markers to assess the effects of LEDT on muscle fatigue.

  18. A Study to Assess Knowledge and Attitude Regarding Hand Hygiene amongst Residents and Nursing Staff in a Tertiary Health Care Setting of Bhopal City

    OpenAIRE

    Maheshwari, Veena; kaore, Navin Chandra M; Ramnani, Vijay Kumar; Gupta, Sanjay Kumar; Borle, Amod; Kaushal, Rituja

    2014-01-01

    Background: Infection due to hospital-acquired microbes is an evolving problem worldwide, and horizontal transmission of bacterial organism continues to cause a high nosocomial infection rate in health care settings. Most nosocomial infections are thought to be transmitted by the hands of health care workers.The application of hand hygiene is effective in reducing infection rates.

  19. Denmark: HAND in HAND Policy Questionnaire

    DEFF Research Database (Denmark)

    Laursen, Hilmar Dyrborg; Nielsen, Birgitte Lund

    2018-01-01

    Som del af det internationale EU finansierede projekt Hand in Hand, der fokuserer på de såkaldte SEI-kompetencer (Social, Emotional, Intercultural), er dansk policy i relation til elevernes sociale, emotionelle og interkulturelle læring kortlagt i denne rapport. Der refereres bl.a. til "elevernes...

  20. Defining System Requirements: a critical assessment of the Niam conceptual design procedure

    Directory of Open Access Journals (Sweden)

    Peta Darke

    1995-05-01

    Full Text Available Requirements definition is a fundamental activity within information systems development. Social and organisational issues are at the centre of many of the problems experienced during the development and implementation of information systems, and these need to be explored during requirements definition. The NIAM Conceptual Schema Design Procedure (CSDP is a method for identifying and describing information requirements using fact types. This paper discusses some limitations of the information requirements definition step of the CSDP which result from its lack of focus on the socio-organisational dimension of information systems development. Four different approaches to exploring the socio-organisational contexts of systems are discussed. It is proposed that one of these, viewpoint development, be incorporated into the NIAM CSDP to provide a means of exploring and understanding a system's socio organisational context and to ensure that contextual information is a major input to the requirements definition process. This results in an enhanced design procedure. Future and current research areas are identified.

  1. A novel procedure for the assessment of the antioxidant capacity of food components.

    Science.gov (United States)

    Yoshimura, Toshihiro; Harashima, Mai; Kurogi, Katsuhisa; Suiko, Masahito; Liu, Ming-Cheh; Sakakibara, Yoichi

    2016-08-15

    Carbonylation, an oxidative modification of the amino group of arginine and lysine residues caused by reactive oxygen species, has emerged as a new type of oxidative damage. Protein carbonylation has been shown to exert adverse effects on various protein functions. Recently, the role of food components in the attenuation of oxidative stress has been the focus of many studies. Most of these studies focused on the chemical properties of food components. However, it is also important to determine their effects on protein functions via post-translational modifications. In this study, we developed a novel procedure for evaluating the antioxidant capacity of food components. Hydrogen peroxide (H2O2)-induced protein carbonylation in HL-60 cells was quantitatively analyzed by using fluorescent dyes (Cy5-hydrazide dye and IC3-OSu dye), followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and fluorescence determination. Among a panel of food components tested, quinic acid, kaempferol, saponin, squalene, trigonelline, and mangiferin were shown to be capable of suppressing protein carbonylation in HL-60 cells. Our results demonstrated that this fluorescence labeling/SDS-PAGE procedure allows for the detection of oxidative stress-induced protein carbonylation with high sensitivity and quantitative accuracy. This method should be useful for the screening of new antioxidant food components as well as the analysis of their suppression mechanism. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Performance of OCT segmentation procedures to assess morphology and extension in geographic atrophy.

    Science.gov (United States)

    Schütze, Christopher; Ahlers, Christian; Sacu, Stefan; Mylonas, Georgios; Sayegh, Ramzi; Golbaz, Isabelle; Matt, Gerlinde; Stock, Géraldine; Schmidt-Erfurth, Ursula

    2011-05-01

    Investigating segmentation procedures and morphological findings in time domain (TD) and current spectral domain (SD) optical coherence tomography (OCT) devices in patients with geographic atrophy (GA). Fifty eyes of 46 patients with GA secondary to AMD and 15 control eyes were examined in this prospective noninterventional comparative case series. All patients underwent Stratus (model 3000), Cirrus (Carl Zeiss Meditec), Spectralis (Spectralis HRA+OCT; Heidelberg Engineering) and 3D-OCT-1000 (Topcon). Automated segmentation analyses were compared. An overlay of scanning laser ophthalmoscope (SLO) and three-dimensional retinal thickness (RT) maps were used to investigate whether areas of retinal thinning correspond to areas of retinal pigment epithelium (RPE) atrophy. Geographic atrophy areas identified in SLO scans were significantly larger than areas of retinal thinning in RT maps. No convincing topographic correlation could be found between areas of retinal thinning and actual GA size as identified in SLO and fundus photography. Spectralis OCT showed significantly more mild and severe segmentation errors than 3D and Cirrus OCT. This study showed substantial limitations in identifying zones of GA reliably when using automatic segmentation procedures in current SD-OCT devices. This limitation should be addressed to visualize and document RPE loss realistically in a frequent disease like GA. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

  3. A procedure for grouping food consumption data for use in food allergen risk assessment

    DEFF Research Database (Denmark)

    Birot, Sophie; Madsen, Charlotte Bernhard; Kruizinga, Astrid G.

    2017-01-01

    Food allergic subjects need to avoid the allergenic food that triggers their allergy. However, foods can also contain unintended allergens. Food manufacturers or authorities need to perform a risk assessment to be able to decide if unintended allergen presence constitutes a risk to food allergic...... consumers. One of the input parameters in risk assessment is the amount of a given food consumed in a meal. There has been little emphasis on how food consumption data can be used in food allergen risk assessment. The aim of the study was to organize the complex datasets from National Food Consumption...... Surveys from different countries (France, Netherlands and Denmark) to be manageable in food allergen risk assessment. To do this, a two-step method was developed. First, based on initial groups of similar food items, the homogeneity of consumption was evaluated using a customized clustering method. Then...

  4. Determining the suitability of materials for disposal at sea under the London Convention 1972: A radiological assessment procedure

    International Nuclear Information System (INIS)

    2003-10-01

    on conducting specific assessments to determine whether candidate materials for disposal at sea contained de minimis levels of radioactivity. This report contains guidance on performing specific assessments of candidate materials to determine whether the materials are de minimis in the meaning of the London Convention 1972. It follows the guidelines adopted by the Twenty-first Consultative Meeting of the London Convention 1972 that incorporate a Stepwise Evaluation Procedure for screening candidate material to determine if it can be treated as 'non-radioactive' (i.e. de minimis) under the Convention. Material that cannot be readily defined as de minimis on the basis of Steps 1 to 5 of the Stepwise Evaluation Procedure require a specific assessment at Step 6. Such an assessment is the subject of this report. The assessment process described in this report is based on an inherently conservative procedure consistent with the precautionary approach, provided for under the London Convention 1972. Its purpose is to ensure the use of conservative models and cautious assumptions that result in the overestimation of the doses due to candidate materials that might be disposed of at sea in near coastal waters under de minimis provisions. Accordingly, the radiological consequences of disposal at sea of de minimis materials in other areas of the continental shelf and deeper waters will result in much lower radiation exposures than those considered here. It must be stressed that any candidate materials designated as de minimis must comply with all other provisions of the Convention. Section 2 provides a summary of the Stepwise Evaluation Procedure as detailed in the guidelines and background information necessary to understand the context of this guidance. Section 3 describes in detail a procedure to conduct the specific radiological assessment of the disposal of a candidate material. It contains a schematic diagram illustrating the specific assessment process and components of

  5. Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

    Science.gov (United States)

    Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

    2011-10-01

    To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004

  6. Example of an application of an assessment procedure for defects in plant operating in the creep range

    International Nuclear Information System (INIS)

    Ainsworth, R.; Coleman, M.C.

    1986-10-01

    A worked example is presented to illustrate the application of a CEGB procedure for the assessment of defects in plant that operates within the creep range. The example chosen is a large cylindrical pressure vessel with a fully circumferential crack for which experimental results are available. The example demonstrates that it is straightforward to perform the calculations required in the procedure for the time for structural failure by continuum damage mechanisms, the time for crack incubation and the time for crack growth. It is predicted that crack incubation in the pressure vessel occurs at about one-third of life with the remaining life being taken up by crack growth. The predictions are in close agreement with the experimentally observed incubation, growth and final failure times. (UK)

  7. The Impact of Complications on Patients’ Assessment of the Outcome of Tension-Free Vaginal Tape Procedure

    Directory of Open Access Journals (Sweden)

    David Shaker

    2017-11-01

    Full Text Available Introduction: Our study aimed to assess the impact of managed complications of tension-free vaginal tape (TVT on the patients’ assessment of the results as measured by Patient Global Impression of Improvement (PGI-I. Materials and methods: This was a retrospective study, supplemented with a telephone interview, comparing patients who had complications of TVT procedures with those where no complications recorded. The primary outcome was the PGI-I score in the 2 groups. Results: A total of 118 invitations were sent. In all, 60 patients returned the signed consent and completed the telephone interview with one of the authors (response rate = 50.8%. Complications were recorded in 21 patients (group 1 and no complications in 39 patients (group 2. There was no statistically significant difference between PGI-I in both groups. Conclusions: Managed complications of TVT do not seem to affect patients’ assessment of outcome as measured by PGI-I score.

  8. Modifications of Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany based upon new version of Emergency Operating Procedures

    International Nuclear Information System (INIS)

    Aldorf, R.

    1997-01-01

    In the frame of 'living Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany Project' being performed by Nuclear Research Institute Rez during 1997 is planned to reflect on Probabilistic Safety Assessment-1 basis on impact of Emergency Response Guidelines (as one particular event from the list of other modifications) on Plant Safety. Following highlights help to orient the reader in main general aspects, findings and issues of the work that currently continues on. Older results of Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany have revealed that human behaviour during accident progression scenarios represent one of the most important aspects in plant safety. Current effort of Nuclear Power Plants Dukovany (Czech Republic) and Bohunice (Slovak Republic) is focussed on development of qualitatively new symptom-based Emergency Operating Procedures called Emergency Response Guidelines Supplier - Westinghouse Energy Systems Europe, Brussels works in cooperation with teams of specialist from both Nuclear Power Plants. In the frame of 'living Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany Project' being performed by Nuclear Research Institute Rez during 1997 is planned to prove on Probabilistic Safety Assessment -1 basis an expected - positive impact of Emergency Response Guidelines on Plant Safety, Since this contract is currently still in progress, it is possible to release only preliminary conclusions and observations. Emergency Response Guidelines compare to original Emergency Operating Procedures substantially reduce uncertainty of general human behaviour during plant response to an accident process. It is possible to conclude that from the current scope Probabilistic Safety Assessment Dukovany point of view (until core damage), Emergency Response Guidelines represent adequately wide basis for mitigating any initiating event

  9. Probabilistic Risk Assessment Procedures Guide for NASA Managers and Practitioners (Second Edition)

    Science.gov (United States)

    Stamatelatos,Michael; Dezfuli, Homayoon; Apostolakis, George; Everline, Chester; Guarro, Sergio; Mathias, Donovan; Mosleh, Ali; Paulos, Todd; Riha, David; Smith, Curtis; hide

    2011-01-01

    Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and logical analysis method aimed at identifying and assessing risks in complex technological systems for the purpose of cost-effectively improving their safety and performance. NASA's objective is to better understand and effectively manage risk, and thus more effectively ensure mission and programmatic success, and to achieve and maintain high safety standards at NASA. NASA intends to use risk assessment in its programs and projects to support optimal management decision making for the improvement of safety and program performance. In addition to using quantitative/probabilistic risk assessment to improve safety and enhance the safety decision process, NASA has incorporated quantitative risk assessment into its system safety assessment process, which until now has relied primarily on a qualitative representation of risk. Also, NASA has recently adopted the Risk-Informed Decision Making (RIDM) process [1-1] as a valuable addition to supplement existing deterministic and experience-based engineering methods and tools. Over the years, NASA has been a leader in most of the technologies it has employed in its programs. One would think that PRA should be no exception. In fact, it would be natural for NASA to be a leader in PRA because, as a technology pioneer, NASA uses risk assessment and management implicitly or explicitly on a daily basis. NASA has probabilistic safety requirements (thresholds and goals) for crew transportation system missions to the International Space Station (ISS) [1-2]. NASA intends to have probabilistic requirements for any new human spaceflight transportation system acquisition. Methods to perform risk and reliability assessment in the early 1960s originated in U.S. aerospace and missile programs. Fault tree analysis (FTA) is an example. It would have been a reasonable extrapolation to expect that NASA would also become the world leader in the application of PRA. That was

  10. A comparison between Japanese and French A16 defect assessment procedures for thermal fatigue crack growth

    International Nuclear Information System (INIS)

    Wakai, T.; Horikiri, M.; Poussard, C.; Drubay, B.

    2005-01-01

    This paper presents the results of a benchmark on thermal fatigue crack growth evaluation for a thick-wall cylinder subjected to cyclic thermal transients. The simplified crack growth evaluation methods of both JNC in JAPAN and A16 procedures proposed by CEA in France are presented. The predictions obtained using both methods are compared with the experimental data. The JNC method, which accounts for the non-linear stress component provides predictions of crack advance in a good agreement with the experimental data. In contrast, significant differences are observed between the A16 predictions and the experimental data. The discrepancies are mainly due to the non-linear stress component which is not accounted for in the A16 method. When using the JNC stress intensity factor solution determined by finite element analysis to account for the non-linear stress component, the A16 method well predicts the thermal fatigue crack growth behavior

  11. Assessment of exposure to hand-arm vibration and its related health effects in workers employed in stone cutting workshops of Hamadan city

    Directory of Open Access Journals (Sweden)

    Roya Bayat

    2016-06-01

    Full Text Available Introduction: The workers employed in stone cutting workplace are exposed to hand-arm vibration and its complications. The aim of this study was to evaluate the exposure to hand-arm vibration and its health effects on workers in the stone cutting workshops. Methods: In this descriptive-analytic study, 40 workers of Hamadan city stone cutting who worked with stone cutting machines were examined. Measuring exposure to hand-arm vibration was performed by standard methods ISO 5349. Symptoms related hand-arm vibration syndrome using a questionnaire construction was studied. Data were analyzed using SPSS software. Results: Results showed that 8-hour equivalent acceleration of hand-arm vibration exposure in stonecuttingworkers was exceeds the permissible exposure levels of country (Pv<0.05. Most average hand and arm vibration acceleration was measured in the Z axis. The average vibration acceleration hand-arm and cutting transverse and longitudinal cutting significant difference was observed (Pv<0.05. Conclusion: In regard to exposure level of stone cutting workers compared with the national exposure limit, the training of health care, non-smoking, and use of anti-vibration gloves, work rotations canthe effective in reducing the risk of health effects. Furthermore, it seems essential to track the health effects associated with human vibration by use of screening tests in the work place seem.

  12. Mapping cortical hand motor representation using TMS: A method to assess brain plasticity and a surrogate marker for recovery of function after stroke?

    Science.gov (United States)

    Lüdemann-Podubecká, Jitka; Nowak, Dennis Alexander

    2016-10-01

    Stroke is associated with reorganization within motor areas of both hemispheres. Mapping the cortical hand motor representation using transcranial magnetic stimulation may help to understand the relationship between motor cortex reorganization and motor recovery of the affected hand after stroke. A standardized review of the pertinent literature was performed. We identified 20 trials, which analyzed the relationship between the extent and/or location of cortical hand motor representation using transcranial magnetic stimulation and motor function and recovery of the affected hand. Several correlations were found between cortical reorganization and measures of hand motor impairment and recovery. A better understanding of the relationships between the extent and location of cortical hand motor representation and the motor impairment and motor recovery of the affected hand after stroke may contribute to a targeted use of non-invasive brain stimulation protocols. In the future motor mapping may help to guide brain stimulation techniques to the most effective motor area in an affected individual. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Assessment of the effects of different sample perfusion procedures on phase-contrast tomographic images of mouse spinal cord

    Science.gov (United States)

    Stefanutti, E.; Sierra, A.; Miocchi, P.; Massimi, L.; Brun, F.; Maugeri, L.; Bukreeva, I.; Nurmi, A.; Begani Provinciali, G.; Tromba, G.; Gröhn, O.; Giove, F.; Cedola, A.; Fratini, M.

    2018-03-01

    Synchrotron X-ray Phase Contrast micro-Tomography (SXrPCμT) is a powerful tool in the investigation of biological tissues, including the central nervous system (CNS), and it allows to simultaneously detect the vascular and neuronal network avoiding contrast agents or destructive sample preparations. However, specific sample preparation procedures aimed to optimize the achievable contrast- and signal-to-noise ratio (CNR and SNR, respectively) are required. Here we report and discuss the effects of perfusion with two different fixative agents (ethanol and paraformaldehyde) and with a widely used contrast medium (MICROFIL®) on mouse spinal cord. As a main result, we found that ethanol enhances contrast at the grey/white matter interface and increases the contrast in correspondence of vascular features and fibres, thus providing an adequate spatial resolution to visualise the vascular network at the microscale. On the other hand, ethanol is known to induce tissue dehydration, likely reducing cell dimensions below the spatial resolution limit imposed by the experimental technique. Nonetheless, neurons remain well visible using either perfused paraformaldehyde or MICROFIL® compound, as these latter media do not affect tissues with dehydration effects. Paraformaldehyde appears as the best compromise: it is not a contrast agent, like MICROFIL®, but it is less invasive than ethanol and permits to visualise well both cells and blood vessels. However, a quantitative estimation of the relative grey matter volume of each sample has led us to conclude that no significant alterations in the grey matter extension compared to the white matter occur as a consequence of the perfusion procedures tested in this study.

  14. Biomechanical procedure to assess sleep restriction on motor control and learning.

    Science.gov (United States)

    Umemura, G S; Noriega, C L; Soares, D F; Forner-Cordero, A

    2017-07-01

    The analysis of sleep quality during long periods and its impact on motor control and learning performance are crucial aspects for human health. The aim of this study is to analyze effects of chronic sleep restriction on motor performance. It is intended to establish motor control indicators in sleep quality analysis. A wearable actigraphy that records accelerometry, ambient light, and body temperature was used to monitor the sleep habits of 12 healthy subjects for two weeks before performing motor control and learning tests. The day of the motor test, the subjects filled two questionnaires about the quality of sleep (Pittsburgh Sleep Quality Index - PSQI) and sleepiness (Epworth Sleepiness Scale - ESS). Afterwards they performed a coincident timing task that consisted of hitting a virtual target falling on the screen with the hand. An elbow flexion in the horizontal plane had to be performed on the correct time to reach the real target on a table at the same time as the virtual target on the screen. The subjects performed three sets of acquisition and transfer blocks of the coincident timing task. The subjects were clustered in two groups based on the PSQI and ESS scores. Actigraphy and motor control parameters (L5, correct responses, time variance) were compared between groups and experimental sets. The group with better sleep parameters did show a constant performance across blocks of task acquisition while the bad sleeper group improved from the first to the second acquisition block. Despite of this improvement, their performance is not better than the one of the good sleepers group. Although the number of subjects is low and it should be increased, these results indicate that the subjects with better sleep converged rapidly to a high level of performance, while the worse sleepers needed more trials to learn the task and their performance was not superior to the other group.

  15. Management of post burn hand deformities

    Directory of Open Access Journals (Sweden)

    Sabapathy S

    2010-10-01

    Full Text Available The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor.

  16. Interviewing to assess credibility in the Swedish asylum procedure: analyzing question style, type and theme

    NARCIS (Netherlands)

    van Veldhuizen, T.S.; Horselenberg, R.; Landström, S.; Granhag, P.A.; van Koppen, P.J.

    2017-01-01

    The aim of the current vignette study is to map the style, type, and themes of questions that are asked when assessing the credibility of asylum seekers' claims. Sixty-five officials from the Swedish Migration Agency (Migrationsverket), were asked to respond to one out of four different vignettes

  17. Study on Design and Implementation of JAVA Programming Procedural Assessment Standard

    Science.gov (United States)

    Tingting, Xu; Hua, Ma; Xiujuan, Wang; Jing, Wang

    2015-01-01

    The traditional JAVA course examination is just a list of questions from which we cannot know students' skills of programming. According to the eight abilities in curriculum objectives, we designed an assessment standard of JAVA programming course that is based on employment orientation and apply it to practical teaching to check the teaching…

  18. Automated Neuropsychological Assessment Metrics Version 4 (ANAM4): Select Psychometric Properties and Administration Procedures

    Science.gov (United States)

    2013-12-01

    disorders (including attention deficit hyperac- tivity disorder [ ADHD ]), and no gross visual (no worse than 20/30 corrected or uncorrected) or hearing...of conscious- ness, substance abuse problems/treatment, known neuro- logical disorders , major psychiatric disorders (including attention deficit ... hyperactivity disorder ), vision worse than 20/30 after correction, and hearing problems. Family his- tory of psychiatric disorders was not assessed.

  19. Guide for Regional Integrated Assessments: Handbook of Methods and Procedures, Version 5.1. Appendix 1

    Science.gov (United States)

    Rosenzweig, Cynthia E.; Jones, James W.; Hatfield, Jerry; Antle, John; Ruane, Alex; Boote, Ken; Thorburn, Peter; Valdivia, Roberto; Porter, Cheryl; Janssen, Sander; hide

    2015-01-01

    The purpose of this handbook is to describe recommended methods for a trans-disciplinary, systems-based approach for regional-scale (local to national scale) integrated assessment of agricultural systems under future climate, bio-physical and socio-economic conditions. An earlier version of this Handbook was developed and used by several AgMIP Regional Research Teams (RRTs) in Sub-Saharan Africa (SSA) and South Asia (SA)(AgMIP handbook version 4.2, www.agmip.org/regional-integrated-assessments-handbook/). In contrast to the earlier version, which was written specifically to guide a consistent set of integrated assessments across SSA and SA, this version is intended to be more generic such that the methods can be applied to any region globally. These assessments are the regional manifestation of research activities described by AgMIP in its online protocols document (available at www.agmip.org). AgMIP Protocols were created to guide climate, crop modeling, economics, and information technology components of its projects.

  20. Assessment of bone formation capacity using in vivo transplantation assays: procedure and tissue analysis

    DEFF Research Database (Denmark)

    Abdallah, Basem; Ditzel, Nicholas; Kassem, Moustapha

    2008-01-01

    In vivo assessment of bone formation (osteogenesis) potential by isolated cells is an important method for analysis of cells and factors control ling bone formation. Currently, cell implantation mixed with hydroxyapa-tite/tricalcium phosphate in an open system (subcutaneous implantation) in immun...

  1. Implications of Deafblindness on Visual Assessment Procedures: Considerations for Audiologists, Ophthalmologists, and Interpreters

    Science.gov (United States)

    Hyvärinen, Lea

    2007-01-01

    Visual assessment of deaf persons presents a challenge to the ophthalmologist and the optometrist. At the time they want to measure visual function, the interpreter uses visual communication, competing for the patient's attention. Important rules of good assessment of visual functioning include taking turns and giving the interpreter sufficient time to convey the questions related to each test. This has implications for audiologists working with this population as well. Communication should be tailored to the varying needs of people who may have long-standing deafness and good sign language, may have lost their hearing at an advanced age and have limited or no sign language, or may be young persons or children who have congenital or progressive loss of hearing combined with congenital or progressive vision loss. Individuals with sudden hearing and vision loss, as well as those with intellectual disabilities and limited language, are particularly challenging groups for the assessment of vision and require special communication skills for ophthalmologists and audiologists. The ophthalmologist usually knows the nature of vision changes typical of disorders that the patient has. For the clinical follow-up of a condition, a few measurements are usually taken. For a comprehensive assessment of visual functioning for rehabilitation and education, many more measurements, observations, and questions are needed so that vision for communication, orientation in the environment, and performance of near-vision tasks can be reported and the effects of the environment can be evaluated. Testing should cover ocular disorders and vision loss caused by brain damage. PMID:18003866

  2. Differentiation of ileostomy from colostomy procedures: assessing the accuracy of current procedural terminology codes and the utility of natural language processing.

    Science.gov (United States)

    Vo, Elaine; Davila, Jessica A; Hou, Jason; Hodge, Krystle; Li, Linda T; Suliburk, James W; Kao, Lillian S; Berger, David H; Liang, Mike K

    2013-08-01

    Large databases provide a wealth of information for researchers, but identifying patient cohorts often relies on the use of current procedural terminology (CPT) codes. In particular, studies of stoma surgery have been limited by the accuracy of CPT codes in identifying and differentiating ileostomy procedures from colostomy procedures. It is important to make this distinction because the prevalence of complications associated with stoma formation and reversal differ dramatically between types of stoma. Natural language processing (NLP) is a process that allows text-based searching. The Automated Retrieval Console is an NLP-based software that allows investigators to design and perform NLP-assisted document classification. In this study, we evaluated the role of CPT codes and NLP in differentiating ileostomy from colostomy procedures. Using CPT codes, we conducted a retrospective study that identified all patients undergoing a stoma-related procedure at a single institution between January 2005 and December 2011. All operative reports during this time were reviewed manually to abstract the following variables: formation or reversal and ileostomy or colostomy. Sensitivity and specificity for validation of the CPT codes against the mastery surgery schedule were calculated. Operative reports were evaluated by use of NLP to differentiate ileostomy- from colostomy-related procedures. Sensitivity and specificity for identifying patients with ileostomy or colostomy procedures were calculated for CPT codes and NLP for the entire cohort. CPT codes performed well in identifying stoma procedures (sensitivity 87.4%, specificity 97.5%). A total of 664 stoma procedures were identified by CPT codes between 2005 and 2011. The CPT codes were adequate in identifying stoma formation (sensitivity 97.7%, specificity 72.4%) and stoma reversal (sensitivity 74.1%, specificity 98.7%), but they were inadequate in identifying ileostomy (sensitivity 35.0%, specificity 88.1%) and colostomy (75

  3. Comparability of river quality assessment using macrophytes: a multi-step procedure to overcome biogeographical differences.

    Science.gov (United States)

    Aguiar, F C; Segurado, P; Urbanič, G; Cambra, J; Chauvin, C; Ciadamidaro, S; Dörflinger, G; Ferreira, J; Germ, M; Manolaki, P; Minciardi, M R; Munné, A; Papastergiadou, E; Ferreira, M T

    2014-04-01

    This paper exposes a new methodological approach to solve the problem of intercalibrating river quality national methods when a common metric is lacking and most of the countries share the same Water Framework Directive (WFD) assessment method. We provide recommendations for similar works in future concerning the assessment of ecological accuracy and highlight the importance of a good common ground to make feasible the scientific work beyond the intercalibration. The approach herein presented was applied to highly seasonal rivers of the Mediterranean Geographical Intercalibration Group for the Biological Quality Element Macrophytes. The Mediterranean Group of river macrophytes involved seven countries and two assessment methods with similar acquisition data and assessment concept: the Macrophyte Biological Index for Rivers (IBMR) for Cyprus, France, Greece, Italy, Portugal and Spain, and the River Macrophyte Index (RMI) for Slovenia. Database included 318 sites of which 78 were considered as benchmarks. The boundary harmonization was performed for common WFD-assessment methods (all countries except Slovenia) using the median of the Good/Moderate and High/Good boundaries of all countries. Then, whenever possible, the Slovenian method, RMI was computed for the entire database. The IBMR was also computed for the Slovenian sites and was regressed against RMI in order to check the relatedness of methods (R(2)=0.45; p<0.00001) and to convert RMI boundaries into the IBMR scale. The boundary bias of RMI was computed using direct comparison of classification and the median boundary values following boundary harmonization. The average absolute class differences after harmonization is 26% and the percentage of classifications differing by half of a quality class is also small (16.4%). This multi-step approach to the intercalibration was endorsed by the WFD Regulatory Committee. © 2013 Elsevier B.V. All rights reserved.

  4. H12: Examination of safety assessment aims, procedures and results from a wider perspective

    International Nuclear Information System (INIS)

    Neall, F.B; Smith, P.A.

    2004-04-01

    Safety assessment (SA) are a familiar tool for the evaluation of disposal concepts for radioactive waste. There is, however, often confusion in the wider community about the aims, methods and results used in SA. This report aims to present the H12 SA in a way that makes the assessment process clearer and the implications of the results more meaningful both to workers within the SA field and to a wider technical audience. The reasonableness of the assessment results, the quality of the models and databases and redundancy within the natural and engineered barrier system have been considered. A number of recent and somewhat older SAs that address a range of different waste types, host rocks and disposal concepts have been considered, and comparisons made to H12. A further aim is to put both doses and timescales in a more meaningful context. It has been necessary to: consider ways of demonstrating the meaningfulness of calculations that give results for many thousands of years in the future; provide a framework timescale as a context for SA results over long times; demonstrate the smallness of the risk associated with the doses by comparison with other radiological and non-radiological risks. The perception of risk, which is a critical issue for public acceptance of radioactive waste disposal and must be considered when seeking to present safety assessment results 'in perspective' to a wider audience, is also discussed. It is concluded that H12 is comparable in many ways to assessments carried out internationally. Some assumptions are somewhat arbitrary reflecting the generic stage of the Japanese programme, and are likely to become better founded in future exercises. Nevertheless, H12 provides a clear and well-founded message that it is feasible to site and construct a safe repository from HLW in Japan. (author)

  5. Robotic hand project

    OpenAIRE

    Karaçizmeli, Cengiz; Çakır, Gökçe; Tükel, Dilek

    2014-01-01

    In this work, the mechatronic based robotic hand is controlled by the position data taken from the glove which has flex sensors mounted to capture finger bending of the human hand. The angular movement of human hand’s fingers are perceived and processed by a microcontroller, and the robotic hand is controlled by actuating servo motors. It has seen that robotic hand can simulate the movement of the human hand that put on the glove, during tests have done. This robotic hand can be used not only...

  6. Selectivity assessment of an arsenic sequential extraction procedure for evaluating mobility in mine wastes

    International Nuclear Information System (INIS)

    Drahota, Petr; Grösslová, Zuzana; Kindlová, Helena

    2014-01-01

    Highlights: • Extraction efficiency and selectivity of phosphate and oxalate were tested. • Pure As-bearing mineral phases and mine wastes were used. • The reagents were found to be specific and selective for most major forms of As. • An optimized sequential extraction scheme for mine wastes has been developed. • It has been tested over a model mineral mixtures and natural mine waste materials. - Abstract: An optimized sequential extraction (SE) scheme for mine waste materials has been developed and tested for As partitioning over a range of pure As-bearing mineral phases, their model mixtures, and natural mine waste materials. This optimized SE procedure employs five extraction steps: (1) nitrogen-purged deionized water, 10 h; (2) 0.01 M NH 4 H 2 PO 4 , 16 h; (3) 0.2 M NH 4 -oxalate in the dark, pH3, 2 h; (4) 0.2 M NH 4 -oxalate, pH3/80 °C, 4 h; (5) KClO 3 /HCl/HNO 3 digestion. Selectivity and specificity tests on natural mine wastes and major pure As-bearing mineral phases showed that these As fractions appear to be primarily associated with: (1) readily soluble; (2) adsorbed; (3) amorphous and poorly-crystalline arsenates, oxides and hydroxosulfates of Fe; (4) well-crystalline arsenates, oxides, and hydroxosulfates of Fe; as well as (5) sulfides and arsenides. The specificity and selectivity of extractants, and the reproducibility of the optimized SE procedure were further verified by artificial model mineral mixtures and different natural mine waste materials. Partitioning data for extraction steps 3, 4, and 5 showed good agreement with those calculated in the model mineral mixtures (<15% difference), as well as that expected in different natural mine waste materials. The sum of the As recovered in the different extractant pools was not significantly different (89–112%) than the results for acid digestion. This suggests that the optimized SE scheme can reliably be employed for As partitioning in mine waste materials

  7. Improvement of skills and knowledge by a hands-on cardiac CT course. Before and after evaluation with a validated questionnaire and self-assessment

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, E.; Germershausen, C.; Greupner, J.; Schnapauff, D.; Rief, M.; Grigoryev, M.; Wollenberg, U.; Dewey, Marc [Inst. fuer Radiologie, Charite-Univ. Berlin (Germany)

    2010-07-15

    Purpose: cardiac computed tomography (CT) is becoming increasingly important in noninvasive imaging. To meet this demand, there are a growing number of short training courses for cardiac CT. Whether such courses improve the knowledge and skills of participants is not known. Materials and methods: the concept of a two-day cardiac CT course consisting of introductory lectures, live patient examinations, and hands-on exercises for interpreting cardiac CT scans on workstations was analyzed using participant evaluations (scales from 1 = excellent to 6 = very poor). Participants rated their increase in knowledge and completed a validated questionnaire with 20 questions. Results: a total of 102 participants attended the courses. There were significant differences in the number of correctly answered test questions between cardiac CT experts and participants at the beginning of the course (91.5 {+-} 6.3% vs. 62.4 {+-} 16.1% p < 0.001). The number of questions answered correctly by the participants increased significantly after completion of the course (mean increase of 4 correctly answered questions, 81.8 {+-} 11.4%. vs. 62.4 {+-} 16.1% p < 0.001). This objective increase in knowledge was in good agreement with participant self-assessments (76.4 {+-} 12.6% vs. 81.8 {+-} 11.4%). The quality of the course received good to very good scores, ranging from 1.8 {+-} 0.7 for speed of presentation to 1.4 {+-} 0.5 for lecturer competence. The score for overall course quality was 1.4 {+-} 0.6. Conclusion: A relatively short cardiac CT course can significantly improve the quantifiable knowledge of participants. The overall quality of the course was rated as very good. (orig.)

  8. Improvement of skills and knowledge by a hands-on cardiac CT course. Before and after evaluation with a validated questionnaire and self-assessment

    International Nuclear Information System (INIS)

    Zimmermann, E.; Germershausen, C.; Greupner, J.; Schnapauff, D.; Rief, M.; Grigoryev, M.; Wollenberg, U.; Dewey, Marc

    2010-01-01

    Purpose: cardiac computed tomography (CT) is becoming increasingly important in noninvasive imaging. To meet this demand, there are a growing number of short training courses for cardiac CT. Whether such courses improve the knowledge and skills of participants is not known. Materials and methods: the concept of a two-day cardiac CT course consisting of introductory lectures, live patient examinations, and hands-on exercises for interpreting cardiac CT scans on workstations was analyzed using participant evaluations (scales from 1 = excellent to 6 = very poor). Participants rated their increase in knowledge and completed a validated questionnaire with 20 questions. Results: a total of 102 participants attended the courses. There were significant differences in the number of correctly answered test questions between cardiac CT experts and participants at the beginning of the course (91.5 ± 6.3% vs. 62.4 ± 16.1% p < 0.001). The number of questions answered correctly by the participants increased significantly after completion of the course (mean increase of 4 correctly answered questions, 81.8 ± 11.4%. vs. 62.4 ± 16.1% p < 0.001). This objective increase in knowledge was in good agreement with participant self-assessments (76.4 ± 12.6% vs. 81.8 ± 11.4%). The quality of the course received good to very good scores, ranging from 1.8 ± 0.7 for speed of presentation to 1.4 ± 0.5 for lecturer competence. The score for overall course quality was 1.4 ± 0.6. Conclusion: A relatively short cardiac CT course can significantly improve the quantifiable knowledge of participants. The overall quality of the course was rated as very good. (orig.)

  9. Is one trial enough for repeated testing? Same-day assessments of walking, mobility and fine hand use in people with myotonic dystrophy type 1.

    Science.gov (United States)

    Kierkegaard, Marie; Petitclerc, Emilie; Hébert, Luc J; Gagnon, Cynthia

    2017-02-01

    Performance-based assessments of physical function are essential in people with myotonic dystrophy type 1 (DM1) to monitor disease progression and evaluate interventions. Commonly used are the six-minute walk test, the 10 m-walk test, the timed up-and-go test, the timed-stands test, grip strength tests and the nine-hole peg test. The number of trials needed on a same-day test occasion and whether the first, best or average of trials should be reported as result is unknown. Thus, the aim was to describe and explore differences between trials in these measures of walking, mobility and fine hand use in 70 adults with DM1. Three trials were performed for each test except for the six-minute walk test where two trials were allowed. There were statistical significant differences over trials in all tests except for the 10 m-walk test and grip strength tests. Pair-wise comparisons showed that the second and third trials were in general better than the first, although effect sizes were small. At which trial the individuals performed their best differed between individuals and tests. People with severe muscular impairment had difficulties to perform repeated trials. Intraclass correlation coefficients were all high in analyses exploring how to report results. The conclusion and clinical implication is that, for a same-day test occasion, one trial is sufficient for the 10 m-walk test and grip strength tests, and that repeated trials should be allowed in the timed up-and-go test, timed-stands test and nine-hole peg tests. We recommend that two trials are performed for these latter tests as such a protocol could accommodate people with various levels of impairments and physical limitations. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Design procedure for formulating and assessing the durability of particulate grouts

    International Nuclear Information System (INIS)

    Okonkwo, I.O.; Altschaeff, A.G.

    1989-01-01

    The current disposal plans for low-level wastes call for stabilizing or encapsulating and storing of these wastes in steel drums which in turn are buried in shallow trenches. Complete sealing is accomplished with grout, a liquid injection comprising principally of cement and fly ash, etc. Upon solidification, the grout forms a rigid mass around the drum, thereby eliminating access of groundwater into or out of the waste barrier, or leaching of radionuclides. Since the primary mechanism for the likely introduction of hazardous and/or radioactive elements into the biosphere in this situation, is through physical or chemical deterioration of the waste barrier, it is necessary that the effect of adverse environments on the durability of the grouts be examined and incorporated in barrier design. Currently, procedures for formulating grout mixes to assure a given impermeability or durability of the grout over its service period is lacking, and so are the techniques for monitoring the in-service performance of waste barrier systems. This paper depicts a serious limitation in waste barrier system technology, for it is time that optimization in design be possible. To allow this, a method is needed that creates the grout formulation specification for an optimization of behavior parameters in the resulting product. These considerations suggest a strong need for improvement in the grout formulation specification to allow a focus upon behavior properties desired by the engineer in the creation of optimum performance. This paper addresses these problems

  11. Rapid assessment procedures in environmental sanitation research: a case study from the northern border of Mexico.

    Science.gov (United States)

    Cifuentes, Enrique; Alamo, Urinda; Kendall, Tamil; Brunkard, Joan; Scrimshaw, Susan

    2006-01-01

    There is a need to enhance the quality and sustainability of environmental health programs in Mexico. What socio-cultural factors influenced the adoption or rejection of Clean Water in Homes programs in this population? We applied rapid appraisal procedures (RAP) to evaluate these community-based programs. Qualitative study conducted in communities along Mexico's northern border. We conducted informal dialogues, semi-structured interviews, field notes and observations. Home visits used a checklist to observe: sources of water, handwashing, as well as human waste and garbage disposal patterns. Data analysis was conducted using ATLAS.ti, which facilitated comparison and illustration of discrepancies, the elaboration of emerging issues and relationships between them. Community members perceived that the Clean Water program was a top-down intervention. Water is perceived as a political issue and a matter of corruption. Inequity also limits solidarity activities involved in environmental sanitation. Migration to the United States of America (US) contributes to community fragmentation, which in turn dilutes communal efforts to improve water and sanitation infrastructure. While targeting women as program "recipients", the Clean Water program did not take gendered spheres of decision-making into account. Community members and authorities discussed the main results in "assemblies", particularly addressing the needs of excluded groups. The oversight of not exploring community members' needs and priorities prior to program implementation resulted in interventions that did not address the structural (economic, infrastructure) and socio-cultural barriers faced by community members to undertake the health-promoting behaviour change, and provoked resentment.

  12. Inspection procedure of buildings for the purpose of subsequent assessment of their residual life

    Directory of Open Access Journals (Sweden)

    Zolina Tat’yana Vladimirovna

    2014-12-01

    Full Text Available This paper considers and asserts the need to obtain the results of inspection of a building at the stage of its commissioning in order to apply comprehensive methodology for assessing its residual life. The author proposes to build regression relationship by correlating the levels of the time series dynamics of stress at certain points of the object calculation scheme considering the results of subsequent surveys. It allows estimating the wear rate of structural elements. The assessment of the reliability and durability of the building frame in a deterministic form is based on the limit states method. The application of this method allows taking into account the random nature of not only the combination of existing loads, but also the strength properties of construction materials by creating a system of safety factors.

  13. Procedures for conducting probabilistic safety assessments of nuclear power plants (Level 1)

    International Nuclear Information System (INIS)

    1992-01-01

    This report provides guidance for conducting a Level 1 of probabilistic safety assessment (PSA), that is a PSA concerned with events leading to core damage. The scope of this report is confined to internal initiating events (excluding internal fires and floods). A particular aim is to promote a standardized framework, terminology and form of documentation for PSAs so as to facilitate external review of the results of such studies. The report is divided into the following major sections: management and organization; identification of sources of radioactive releases and accident initiators; accident sequence modelling; data assessment and parameter estimation; accident sequence quantification; documentation of the analysis: display and interpretation of result. 45 refs, 7 figs, 23 tabs

  14. In vivo MRI assessment of permanent middle cerebral artery occlusion by electrocoagulation: pitfalls of procedure

    Science.gov (United States)

    2010-01-01

    Permanent middle cerebral artery (MCA) occlusion (pMCAO) by electrocoagulation is a commonly used model but with potential traumatic lesions. Early MRI monitoring may assess pMCAO for non-specific brain damage. The surgical steps of pMCAO were evaluated for traumatic cerebral injury in 22 Swiss mice using diffusion and T2-weighted MRI (7T) performed within 1 h and 24 h after surgery. Temporal muscle cauterization without MCA occlusion produced an early T2 hyperintensity mimicking an infarct. No lesion was visible after temporal muscle incision or craniotomy. Early MRI monitoring is useful to identify non-specific brain injury that could hamper neuroprotective drugs assessment. PMID:20298536

  15. Expertise, following the 5.7.1977 decree: assessment of the procedure; Expertise, arrete du 5.7.77 - bilan de la procedure

    Energy Technology Data Exchange (ETDEWEB)

    Maillard, M. [Ministere de l`Industrie, des Postes et Telecommunications, 75 - Paris (France)

    1996-12-31

    The French Government decree concerning the periodical inspection and extensive examination procedure for plants and buildings where thermal energy is consumed, is presented. The inspection procedure is intended to control the thermal and electrical equipment, the regulation systems, the pollutant emission control systems and the waste heat recovery systems. Design recommendations, fuel substitution, pollution abatement, waste heat up-grading, etc. may be proposed by the expert

  16. The European Community Directive -- An Alternative Environmental Impact Assessment Procedure after Massey?

    Science.gov (United States)

    1993-09-30

    competitive conditions, thereby directly affecting the functioning of the common market .’l B. Environmental Impact Assessment 1. Background The Preamble to the...of the conmon market ." Treaty of Rome, supra note 120, art. 100. ’"EC Directive, supra note 22, Preamble. 14Id. art. 1.2. 16Id. 51 member states...dairy products. (d) Brewing and malting. (e) Confectionery and syrup manufacture. (f) Installations for the slaughter of animals. 86 0 0 (g

  17. Application of the standard options of the FITNET procedure to the structural integrity assessment of welded specimens containing cracks

    International Nuclear Information System (INIS)

    Dzioba, Ihor; Neimitz, Andrzej

    2007-01-01

    In this paper, the structural integrity of welded specimens is assessed. The specimens were welded using a conventional technique, MAG, and an unconventional one, laser technology. Welded specimens were of the central crack under tension (CCT) type. The elements were loaded, the maximum load was recorded, and the second and the third options of the FITNET procedure were utilized to estimate the critical loading. Estimated and recorded loads were compared to verify the conservatism of the estimated results. For comparison, the results obtained using Option 1 of the FITNET procedure (not recommended in the case analysed) are also presented. Results of the mechanical properties, hardness, fracture toughness for the base and the weld material and residual stress distributions are reported for both MAG and laser welding techniques. The results obtained confirm that the FITNET procedures were properly deigned. The higher the level of analysis, the smaller the conservatism of predictions observed. The overconservative conclusions, following from the lower level of analysis, suggest that the structural element is endangered, do not have to exclude it from exploitation. The higher level of analysis can, in some cases, confirm that the structural element containing a crack can still be exploited

  18. Legal Assessment of the Legal Force Exclusion of the 1st Prudential Procedure in the Act on Public Finance

    Directory of Open Access Journals (Sweden)

    Marcin Tyniewicki

    2014-03-01

    Full Text Available By the amendment of the Act on Public Finance of 26 July 2013, Polish legislature made a temporary suspension – till the end of 2013 – of the application of the provisions governing the Ist prudential procedure. This procedure has a crucial meaning for reducing the growth of budget deficit and in consequence – reducing public debt growth. In case of such crucial provisions for public finance, any amendments should be carried out in situations really justified and exceptional as well as with careful respecting of principles of proper legislation. In these aspects mentioned amendment rises a number of objections. For example, rapid pace of parliamentary works causes doubts about correctness of the legislative process. Therefore, in this article the author tries to make a legal assessment of the amendment of the Act on Public Finance of 26 July 2013, both from the formal and legal point of view and taking into the consideration the importance of provisions governing the prudential procedure for whole sphere of Polish public finance.

  19. Hand washing promotion for preventing diarrhoea.

    Science.gov (United States)

    Ejemot-Nwadiaro, Regina I; Ehiri, John E; Arikpo, Dachi; Meremikwu, Martin M; Critchley, Julia A

    2015-09-03

    Diarrhoea accounts for 1.8 million deaths in children in low- and middle-income countries (LMICs). One of the identified strategies to prevent diarrhoea is hand washing. To assess the effects of hand washing promotion interventions on diarrhoeal episodes in children and adults. We searched the Cochrane Infectious Diseases Group Specialized Register (27 May 2015); CENTRAL (published in the Cochrane Library 2015, Issue 5); MEDLINE (1966 to 27 May 2015); EMBASE (1974 to 27 May 2015); LILACS (1982 to 27 May 2015); PsycINFO (1967 to 27 May 2015); Science Citation Index and Social Science Citation Index (1981 to 27 May 2015); ERIC (1966 to 27 May 2015); SPECTR (2000 to 27 May 2015); Bibliomap (1990 to 27 May 2015); RoRe, The Grey Literature (2002 to 27 May 2015); World Health Organization (WHO) International Clinical Trial Registry Platform (ICTRP), metaRegister of Controlled Trials (mRCT), and reference lists of articles up to 27 May 2015. We also contacted researchers and organizations in the field. Individually randomized controlled trials (RCTs) and cluster-RCTs that compared the effects of hand washing interventions on diarrhoea episodes in children and adults with no intervention. Three review authors independently assessed trial eligibility, extracted data, and assessed risk of bias. We stratified the analyses for child day-care centres or schools, community, and hospital-based settings. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random-effects model with 95% confidence intervals (CIs). We used the GRADE approach to assess the quality of evidence. We included 22 RCTs: 12 trials from child day-care centres or schools in mainly high-income countries (54,006 participants), nine community-based trials in LMICs (15,303 participants), and one hospital-based trial among people with acquired immune deficiency syndrome (AIDS) (148 participants).Hand washing promotion (education activities, sometimes with

  20. Clean Hands Count

    Medline Plus

    Full Text Available ... to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  1. Clean Hands Count

    Medline Plus

    Full Text Available ... intended to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... also aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  2. Clean Hands Count

    Science.gov (United States)

    ... intended to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... also aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  3. Wash Your Hands

    Science.gov (United States)

    ... hand sanitizers might not remove harmful chemicals like pesticides and heavy metals from hands. Be cautious when ... Health Promotion Materials Fact Sheets Podcasts Posters Stickers Videos Web Features Training & Education Our Partners Publications, Data & ...

  4. A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease

    Directory of Open Access Journals (Sweden)

    Lianfa Li

    2018-02-01

    Full Text Available Abstract Background As a common infectious disease, hand, foot and mouth disease (HFMD is affected by multiple environmental and socioeconomic factors, and its pathogenesis is complex. Furthermore, the transmission of HFMD is characterized by strong spatial clustering and autocorrelation, and the classical statistical approach may be biased without consideration of spatial autocorrelation. In this paper, we propose to embed spatial characteristics into a spatiotemporal additive model to improve HFMD incidence assessment. Methods Using incidence data (6439 samples from 137 monitoring district for Shandong Province, China, along with meteorological, environmental and socioeconomic spatial and spatiotemporal covariate data, we proposed a spatiotemporal mixed model to estimate HFMD incidence. Geo-additive regression was used to model the non-linear effects of the covariates on the incidence risk of HFMD in univariate and multivariate models. Furthermore, the spatial effect was constructed to capture spatial autocorrelation at the sub-regional scale, and clusters (hotspots of high risk were generated using spatiotemporal scanning statistics as a predictor. Linear and non-linear effects were compared to illustrate the usefulness of non-linear associations. Patterns of spatial effects and clusters were explored to illustrate the variation of the HFMD incidence across geographical sub-regions. To validate our approach, 10-fold cross-validation was conducted. Results The results showed that there were significant non-linear associations of the temporal index, spatiotemporal meteorological factors and spatial environmental and socioeconomic factors with HFMD incidence. Furthermore, there were strong spatial autocorrelation and clusters for the HFMD incidence. Spatiotemporal meteorological parameters, the normalized difference vegetation index (NDVI, the temporal index, spatiotemporal clustering and spatial effects played important roles as predictors in

  5. A procedure to identify and to assess risk parameters in a SCR (Steel Catenary Riser) due to the fatigue failure

    Energy Technology Data Exchange (ETDEWEB)

    Stefane, Wania [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Faculdade de Engenharia Mecanica; Morooka, Celso K. [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Dept. de Engenharia de Petroleo. Centro de Estudos de Petroleo; Pezzi Filho, Mario [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil). E and P. ENGP/IPMI/ES; Matt, Cyntia G.C.; Franciss, Ricardo [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil). Centro de Pesquisas (CENPES)

    2009-12-19

    The discovery of offshore fields in ultra deep water and the presence of reservoirs located in great depths below the seabed requires innovative solutions for offshore oil production systems. Many riser configurations have emerged as economically viable technological solutions for these scenarios. Therefore the study and the development of methodologies applied to riser design and procedures to calculate and to dimension production risers, taken into account the effects of mete ocean conditions, such as waves, current and platform motion in the fatigue failure is fundamental. The random nature of these conditions as well as the mechanical characteristics of the riser components are critical to a probabilistic treatment to ensure the greatest reliability for risers and minimum risks associated to different aspects of the operation like the safety of the installation, economical concerns and the environment. The current work presents a procedure of the identification and the assessment of main parameters of risk when considering fatigue failure. Static and dynamic behavior of Steel Catenary Riser (SCR) under the effects of mete ocean conditions and uncertainties related to total cumulative damage (Miner-Palmgren's rule) are taken into account. The methodology adopted is probabilistic and the approach is analytical. The procedure is based on the First Order Reliability Method (FORM) which usually presents low computational effort and acceptable accuracy. The procedure suggested is applied for two practical cases, one using data available from the literature and the second with data collected from an actual Brazilian offshore field operation. For both cases, results of the probability of failure due to fatigue were obtained for different locations along the SCR length connected to a semi-submersible platform. From these results, the sensitivity of the probability of failure due to fatigue for a SCR could be verified, and the most effective parameter could also be

  6. Hand hygiene strategies

    OpenAIRE

    Yazaji, Eskandar Alex

    2011-01-01

    Hand hygiene is one of the major players in preventing healthcare associated infections. However, healthcare workers compliance with hand hygiene continues to be a challenge. This article will address strategies to help improving hand hygiene compliance. Keywords: hand hygiene; healthcare associated infections; multidisciplinary program; system change; accountability; education; feedback(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 72...

  7. Rehand: Realistic electric prosthetic hand created with a 3D printer.

    Science.gov (United States)

    Yoshikawa, Masahiro; Sato, Ryo; Higashihara, Takanori; Ogasawara, Tsukasa; Kawashima, Noritaka

    2015-01-01

    Myoelectric prosthetic hands provide an appearance with five fingers and a grasping function to forearm amputees. However, they have problems in weight, appearance, and cost. This paper reports on the Rehand, a realistic electric prosthetic hand created with a 3D printer. It provides a realistic appearance that is same as the cosmetic prosthetic hand and a grasping function. A simple link mechanism with one linear actuator for grasping and 3D printed parts achieve low cost, light weight, and ease of maintenance. An operating system based on a distance sensor provides a natural operability equivalent to the myoelectric control system. A supporter socket allows them to wear the prosthetic hand easily. An evaluation using the Southampton Hand Assessment Procedure (SHAP) demonstrated that an amputee was able to operate various objects and do everyday activities with the Rehand.

  8. Using Procedure Based on Item Response Theory to Evaluate Classification Consistency Indices in the Practice of Large-Scale Assessment

    Directory of Open Access Journals (Sweden)

    Shanshan Zhang

    2017-09-01

    Full Text Available In spite of the growing interest in the methods of evaluating the classification consistency (CC indices, only few researches are available in the field of applying these methods in the practice of large-scale educational assessment. In addition, only few studies considered the influence of practical factors, for example, the examinee ability distribution, the cut score location and the score scale, on the performance of CC indices. Using the newly developed Lee's procedure based on the item response theory (IRT, the main purpose of this study is to investigate the performance of CC indices when practical factors are taken into consideration. A simulation study and an empirical study were conducted under comprehensive conditions. Results suggested that with negatively skewed distribution, the CC indices were larger than with other distributions. Interactions occurred among ability distribution, cut score location, and score scale. Consequently, Lee's IRT procedure is reliable to be used in the field of large-scale educational assessment, and when reporting the indices, it should be treated with caution as testing conditions may vary a lot.

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

    Science.gov (United States)

    Mandel, Lene; Worm, Lise

    2007-01-01

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

  10. About Hand Surgery

    Science.gov (United States)

    ... Find a hand surgeon near you. © 2009 American Society for Surgery of the Hand. Definition developed by ASSH Council. Other Links CME Mission Statement and Disclaimer Policies and Technical Requirements Exhibits and Partners ASSH 822 W. Washington Blvd. ... 2018 by American Society for Surgery of the Hand × Search Tips Tip ...

  11. Robotic hand and fingers

    Science.gov (United States)

    Salisbury, Curt Michael; Dullea, Kevin J.

    2017-06-06

    Technologies pertaining to a robotic hand are described herein. The robotic hand includes one or more fingers releasably attached to a robotic hand frame. The fingers can abduct and adduct as well as flex and tense. The fingers are releasably attached to the frame by magnets that allow for the fingers to detach from the frame when excess force is applied to the fingers.

  12. Procedural Pain in Palliative Care: Is It Breakthrough Pain? A Multicenter National Prospective Study to Assess Prevalence, Intensity, and Treatment of Procedure-related Pain in Patients With Advanced Disease.

    Science.gov (United States)

    Magnani, Caterina; Giannarelli, Diana; Casale, Giuseppe

    2017-08-01

    To assess the prevalence of breakthrough pain (BTP) provoked by 6 common procedures in patients with advanced disease. A prospective, cross-sectional, multicenter, national study was performed in 23 palliative care units in Italy. Patients were recruited if they were undergoing one of the following procedures as part of normal care: turning, personal hygiene care, transfer from bed to chair, bladder catheterization, pressure ulcer care, and subcutaneous drug administration. The Numerical Rating Scale was used to measure pain intensity before, during, and after the procedure. One thousand seventy-nine eligible patients were enrolled: 49.7% were male and their mean age was 78.0±11.2 years. Of all patients, 20.9% had experienced a BTP episode within the 24 hours before recruitment. The overall prevalence of procedure-induced BTP was 11.8%, and the mean intensity score (Numeric Rating Scale) was 4.72±1.81. Notably, patients experienced a significant increase in pain intensity during all procedures (Ppatients (12.7%) received analgesics before undergoing any of the procedures, and almost none (1.7%) received analgesics during the procedures to alleviate acute pain. Our findings highlight that simple daily care procedures can lead to BTP among patients with advanced disease. Because such procedures are performed very often during palliative care, more individualized attention to procedural pain control is necessary. Additional research on procedural pain in patients with advanced disease should be encouraged to provide further evidence-based guidance on the use of the available medication for predictable pain flares.

  13. Component fragility analysis methodology for seismic risk assessment projects. Proven PSA safety document processing and assessment procedures

    International Nuclear Information System (INIS)

    Kolar, Ladislav

    2013-03-01

    The seismic risk task assessment task should be structured as follows: (i) Define all reactor unit building structures, components and equipment involved in the creation of an initiating event (IE) induced by an seismic event or contributing to the reliability of reactor unit response to an IE; (ii) construct and estimate of the fragility curves for the building and component groups sub (i); (iii) determine the HCLPF for each group of buildings, components or equipment; (iv) determine the nuclear source's seismic resistance (SME) as the minimum HCLPF from the group of equipment in the risk-dominant scenarios; (v) define the risk-limiting group of components, equipment and building structures to the SME value; (vi) based on the fragility levels, identify component groups for which a more detailed fragility analysis is needed; and (vii) recommend groups of equipment or building structures that should be taken into account with respect to the seismic risk, i.e. such groups of equipment or building structures as exhibit a low seismic resistance (HCLPF) and, at the same time, are involved to a significant extent in the reactor unit's seismic risk (are present in the dominant risk scenarios). (P.A.)

  14. Efficient Noninferiority Testing Procedures for Simultaneously Assessing Sensitivity and Specificity of Two Diagnostic Tests

    Directory of Open Access Journals (Sweden)

    Guogen Shan

    2015-01-01

    Full Text Available Sensitivity and specificity are often used to assess the performance of a diagnostic test with binary outcomes. Wald-type test statistics have been proposed for testing sensitivity and specificity individually. In the presence of a gold standard, simultaneous comparison between two diagnostic tests for noninferiority of sensitivity and specificity based on an asymptotic approach has been studied by Chen et al. (2003. However, the asymptotic approach may suffer from unsatisfactory type I error control as observed from many studies, especially in small to medium sample settings. In this paper, we compare three unconditional approaches for simultaneously testing sensitivity and specificity. They are approaches based on estimation, maximization, and a combination of estimation and maximization. Although the estimation approach does not guarantee type I error, it has satisfactory performance with regard to type I error control. The other two unconditional approaches are exact. The approach based on estimation and maximization is generally more powerful than the approach based on maximization.

  15. Research on the development of advan