WorldWideScience

Sample records for health based guidance

  1. Mobile phone-based clinical guidance for rural health providers in India.

    Science.gov (United States)

    Gautham, Meenakshi; Iyengar, M Sriram; Johnson, Craig W

    2015-12-01

    There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance. © The Author(s) 2014.

  2. The impact of guidance on Internet-based mental health interventions — A systematic review

    Directory of Open Access Journals (Sweden)

    H. Baumeister

    2014-10-01

    Conclusions: Guidance is a beneficial feature of Internet-based interventions, although its effect is smaller than reported before when compared to unguided interventions. The qualification of the e-coaches seems of minor importance. However, methodological limitations need to be considered when interpreting these findings. Overall, the number of studies was small and mainly limited to depression and social phobia restricting the generalizability of the findings.

  3. Health Service use of ionising radiations: Guidance

    International Nuclear Information System (INIS)

    1995-01-01

    This booklet gives outline guidance on the use of ionising radiations in the Health Service in the United Kingdom. Extensive reference is made to documents where more detailed information may be found. The guidance covers general advice on the medical use of ionising radiations, statutory requirements, and guidance on selected Health Service issues such as patient identification procedures, information management systems, deviations from prescribed radiation dose, imaging and radiotherapy. (57 references) (U.K.)

  4. Career Guidance and Public Mental Health

    Science.gov (United States)

    Robertson, Peter J.

    2013-01-01

    Career guidance may have the potential to promote public health by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…

  5. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

    When working with traffic planning or guidance it is common practice to view the vehicles as a combined mass. >From this models are employed to specify the vehicle supply and demand for each region. As the models are complex and the calculations are equally demanding the regions and the detail...... of the road network is aggregated. As a result the calculations reveal only what the mass of vehicles are doing and not what a single vehicle is doing. This is the crucial difference to ABIT (Agent Based Individual Trafficguidance). ABIT is based on the fact that information on the destination of each vehicle...

  6. Agent Based Individual Traffic Guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen

    of the project were not previously considered. We define a special inseparable cost function and develop a solution complex capable of using this cost function. In relation to calibration and estimation of statistical models used for dynamic route guidance we worked with generating random number sequences...

  7. Health and thermal comfort: From WHO guidance to housing strategies

    International Nuclear Information System (INIS)

    Ormandy, David; Ezratty, Véronique

    2012-01-01

    There are many references to the WHO guidance on thermal comfort in housing, but not to the original source material. Based on archive material, this paper gives the evidential basis for the WHO guidance. It then reports on evidence that some groups may be more susceptible to high or low indoor temperatures than others. It examines different methods for measuring thermal comfort, such as air temperature measurement, assessing residents' perception, and predicting satisfaction. Resident's perception was used effectively in the WHO LARES project, showing that self-reported poor health was significantly associated with poor thermal comfort. Tools to inform strategies directed at dealing with cold homes and fuel poverty are considered, including Energy Performance Certificates, Fuel Poverty Indicators, and the English Housing Health and Safety Rating System. Conclusions from a WHO Workshop on Housing, Energy and Thermal Comfort are also summarised. The WHO view of thermal comfort, which is driven by protecting health from both high and low indoor temperatures, should be recognised in energy efficiency, fuel poverty and climate change strategies. While this is a major challenge, it could provide both health gains for individuals, and economic benefits for society. - Highlights: ► WHO guidance on thermal comfort is directed to protecting health in the home environment. ► In particular, the WHO guidance aims to protect the health of the most susceptible and fragile. ► Housing energy efficiency strategies protect health, and attack inequities. ► Housing energy efficiency strategies also have economic benefits for society.

  8. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

    Directory of Open Access Journals (Sweden)

    Xavier Bosch-Capblanch

    Full Text Available In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

  9. Guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health

    DEFF Research Database (Denmark)

    Tetens, Inge

    2011-01-01

    The Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked by the European Food Safety Authority (EFSA) t to draft guidance on scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health. This guidance has been drawn from scientific...... opinions of the NDA Panel on such health claims. Thus, this guidance document represents the views of the NDA Panel based on the experience gained to date with the evaluation of health claims in these areas. It is not intended that the document should include an exhaustive list of beneficial effects...

  10. Regulatory systems-based licensing guidance documentation

    International Nuclear Information System (INIS)

    Delligatti, M.S.

    1991-01-01

    The US Nuclear Regulatory Commission (NRC) has developed a series of licensing guidance documents based on the regulatory requirements in Part 60 of Title 10 of the Code of Federal Regulations (10 CFR Part 60). This regulatory systems-based approach to licensing guidance documentation relies on the definition of the high-level waste repository in 10 CFR Part 60. A document which is important for the frame-work it gives to other programmatic licensing guidance is the Draft Regulatory Guide open-quotes Format and Content for the License Application for the High-Level Waste Repositoryclose quotes (FCRG). The FCRG describes a format and content acceptable to NRC for a high-level waste repository license application pursuant to the requirements of 10 CFR Part 60. Other licensing guidance documents will be compatible with the FCRG

  11. StaR Child Health: developing evidence-based guidance for the design, conduct and reporting of paediatric trials.

    Science.gov (United States)

    Van't Hoff, William; Offringa, Martin

    2015-02-01

    There has been a huge upsurge in clinical research in children in the last decade, stimulated in England by dedicated research infrastructure and support through the National Institute for Health Research. This infrastructure offering research design, expert review, trial management, research nurse, data support and dedicated facilities enables paediatricians to conduct more and better research. The challenge is how to design and conduct trials that will make a real difference to children's health. Standards for Research (StaR) in Child Health was founded in 2009 to address the paucity and shortcomings of paediatric clinical trials. This global initiative involves methodologists, clinicians, patient advocacy groups and policy makers dedicated to developing practical, evidence-based standards for enhancing the reliability and relevance of paediatric clinical research. In this overview, we highlight the contribution of StaR to this agenda, describe the international context, and suggest how StaR's future plans could be integrated with new and existing support for research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Toxicity assessment strategies, data requirements, and risk assessment approaches to derive health based guidance values for non-relevant metabolites of plant protection products.

    Science.gov (United States)

    Dekant, Wolfgang; Melching-Kollmuss, Stephanie; Kalberlah, Fritz

    2010-03-01

    In Europe, limits for tolerable concentrations of "non-relevant metabolites" for active ingredients (AI) of plant protection products in drinking water between 0.1 and 10 microg/L are discussed depending on the toxicological information available. "Non-relevant metabolites" are degradation products of AIs, which do not or only partially retain the targeted toxicities of AIs. For "non-relevant metabolites" without genotoxicity (to be confirmed by testing in vitro), the application of the concept of "thresholds of toxicological concern" results in a health-based drinking water limit of 4.5 microg/L even for Cramer class III compounds, using the TTC threshold of 90 microg/person/day (divided by 10 and 2). Taking into account the thresholds derived from two reproduction toxicity data bases a drinking water limit of 3.0 microg/L is proposed. Therefore, for "non-relevant metabolites" whose drinking water concentration is below 3.0 microg/L, no toxicity testing is necessary. This work develops a toxicity assessment strategy as a basis to delineate health-based limits for "non-relevant metabolites" in ground and drinking water. Toxicological testing is recommended to investigate, whether the metabolites are relevant or not, based on the hazard properties of the parent AIs, as outlined in the SANCO Guidance document. Also, genotoxicity testing of the water metabolites is clearly recommended. In this publication, tiered testing strategies are proposed for non-relevant metabolites, when drinking water concentrations >3.0 microg/L will occur. Conclusions based on structure-activity relationships and the detailed toxicity database on the parent AI should be included. When testing in animals is required for risk assessment, key aspects are studies along OECD-testing guidelines with "enhanced" study designs addressing additional endpoints such as reproductive toxicity and a developmental screening test to derive health-based tolerable drinking water limits with a limited number

  13. 基于互联网的生殖健康指导系统的建立%Establishment of Reproductive Health Guidance System Based on the Internet

    Institute of Scientific and Technical Information of China (English)

    王书汉; 龙肖玉; 黄颖冰

    2012-01-01

    Objective: To realize automated management and guidance of reproductive health through the development of prenatal and postnatal care information service platform based on ASP mode. Method: Relevant information of couple is obtained with questionnaire. Through classification, query and other logic operation, abnormal information is sorted out. Based on the abnormal information, with professional medical knowledge, necessary advices are given to the users. Multimedia communication technology is used to realize service development function. Customer service telephone, SMS, E-mail and other methods are used to realize the function of service development. Through management of customers and sales statistics, marketing is managed. Results: The system developed gives a targeted and personalized guidance report for reproductive health problem of couples with the specific guidance database from time biology, medical genetics, obstetrics and gynecology, psychology, nutrition, sports medicine, preventive medicine, and other professional perspectives. Conclusion: After 1 year of market operation, it proves that operation mode of this system is feasible. There is plenty of reasonable content. The purpose of management and guidance of reproductive health has been achieved.%目的:通过“基于ASP模式的优生优育信息服务平台”的开发,实现对生殖健康部分环节的自动化管理和指导.方法:以调查问卷的方式获取夫妇双方的相关信息,通过一定的分类、查询等逻辑运算分拣出异常信息,并针对这些异常信息根据医学专业知识对使用者给出必要的建议,并运用客服电话、手机短信、电子邮件等方式实现其服务拓展功能,通过对客户的管理和销售统计两大功能实现对市场营销的管理.结果:开发出的系统通过针对性的指导数据库从时间生物学、遗传医学、妇产科学、心理学、营养学、运动医学、预防医学等专业角度对夫妇生殖

  14. StaR Child Health: developing evidence-based guidance for the design, conduct and reporting of paediatric trials

    NARCIS (Netherlands)

    van't Hoff, William; Offringa, Martin

    2015-01-01

    There has been a huge upsurge in clinical research in children in the last decade, stimulated in England by dedicated research infrastructure and support through the National Institute for Health Research. This infrastructure offering research design, expert review, trial management, research nurse,

  15. Observability-Based Guidance and Sensor Placement

    Science.gov (United States)

    Hinson, Brian T.

    Control system performance is highly dependent on the quality of sensor information available. In a growing number of applications, however, the control task must be accomplished with limited sensing capabilities. This thesis addresses these types of problems from a control-theoretic point-of-view, leveraging system nonlinearities to improve sensing performance. Using measures of observability as an information quality metric, guidance trajectories and sensor distributions are designed to improve the quality of sensor information. An observability-based sensor placement algorithm is developed to compute optimal sensor configurations for a general nonlinear system. The algorithm utilizes a simulation of the nonlinear system as the source of input data, and convex optimization provides a scalable solution method. The sensor placement algorithm is applied to a study of gyroscopic sensing in insect wings. The sensor placement algorithm reveals information-rich areas on flexible insect wings, and a comparison to biological data suggests that insect wings are capable of acting as gyroscopic sensors. An observability-based guidance framework is developed for robotic navigation with limited inertial sensing. Guidance trajectories and algorithms are developed for range-only and bearing-only navigation that improve navigation accuracy. Simulations and experiments with an underwater vehicle demonstrate that the observability measure allows tuning of the navigation uncertainty.

  16. General scientific guidance for stakeholders on health claim applications

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2016-01-01

    of Article 13.1 claims except for claims put on hold by the European Commission, and has evaluated additional health claim applications submitted pursuant to Articles 13.5, 14 and also 19. In addition, comments received from stakeholders indicate that general issues that are common to all health claims need...... based on the experience gained to date with the evaluation of health claims, and it may be further updated, as appropriate, when additional issues are addressed.......The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products Nutrition and Allergies (NDA) to update the General guidance for stakeholders on the evaluation of Article 13.1, 13.5 and 14 health claims published in March 2011. Since then, the NDA Panel has completed the evaluation...

  17. Scientific Opinion on the appropriateness to set a group health based guidance value for nivalenol and its modified forms

    DEFF Research Database (Denmark)

    Petersen, Annette

    The EFSA Panel on Contaminants in the Food Chain (CONTAM) reviewed new studies on nivalenol since the previous opinion on nivalenol published in 2013, but as no new relevant data were identified the tolerable daily intake (TDI) for nivalenol (NIV) of 1.2 μg/kg body weight (bw) established on bases...

  18. Vehicle health management for guidance, navigation and control systems

    Science.gov (United States)

    Radke, Kathleen; Frazzini, Ron; Bursch, Paul; Wald, Jerry; Brown, Don

    1993-01-01

    The objective of the program was to architect a vehicle health management (VHM) system for space systems avionics that assures system readiness for launch vehicles and for space-based dormant vehicles. The platforms which were studied and considered for application of VHM for guidance, navigation and control (GN&C) included the Advanced Manned Launch System (AMLS), the Horizontal Landing-20/Personnel Launch System (HL-20/PLS), the Assured Crew Return Vehicle (ACRV) and the Extended Duration Orbiter (EDO). This set was selected because dormancy and/or availability requirements are driving the designs of these future systems.

  19. Comparison of AIHA ISO 9001-based occupational health and safety management system guidance document with a manufacturer's occupational health and safety assessment instrument.

    Science.gov (United States)

    Dyjack, D T; Levine, S P; Holtshouser, J L; Schork, M A

    1998-06-01

    Numerous manufacturing and service organizations have integrated or are considering integration of their respective occupational health and safety management and audit systems into the International Organization for Standardization-based (ISO) audit-driven Quality Management Systems (ISO 9000) or Environmental Management Systems (ISO 14000) models. Companies considering one of these options will likely need to identify and evaluate several key factors before embarking on such efforts. The purpose of this article is to identify and address the key factors through a case study approach. Qualitative and quantitative comparisons of the key features of the American Industrial Hygiene Association ISO-9001 harmonized Occupational Health and Safety Management System with The Goodyear Tire & Rubber Co. management and audit system were conducted. The comparisons showed that the two management systems and their respective audit protocols, although structured differently, were not substantially statistically dissimilar in content. The authors recommend that future studies continue to evaluate the advantages and disadvantages of various audit protocols. Ideally, these studies would identify those audit outcome measures that can be reliably correlated with health and safety performance.

  20. [Health guidance through theater: an experience account].

    Science.gov (United States)

    Nazima, Tue Jollo; Codo, Carla Regina Bianchi; Paes, Irani Aparecida Dalla Costa; Bassinello, Greicelene Aparecida Hespanhol

    2008-03-01

    Theater could be considered as a dramatic game and as an educational method, because it reaches the child as a whole, encompassing creativity and learning through entertainment. This article is a report of nursing students' experience in guiding children through theater in a public nursery located in the interior of São Paulo state. The objective was to report on the benefits of using theatre with children. The methodology to develop the study was a dialogue based on literature review articulated with the account of experience. It was concluded that theater can be used as an important educational tool, diversifying the way of teaching children, surpassing the simple pass on of knowledge, increasing involvement and integration.

  1. Nuclear power: Accidental releases - practical guidance for public health action

    International Nuclear Information System (INIS)

    1987-01-01

    The disaster at Chernobyl, USSR, has caused a major crisis of confidence in nuclear safety, and highlighted the need for comprehensive contingency planning for - and emergency response to - such accidents. This report gives practical guidance on how the authorities should deal with an accident in any type of nuclear installation, whether it involves accidental releases to the air or into water. It is based on principles developed in a previous WHO report published in 1984. It summarizes the range of accidents for which plans need to be made to protect the public, the measures to be taken and the levels of dose at which they should be applied. It indicates how to measure the levels of exposure and what are the most likely routes of exposure. It then outlines the problems faced by public health authorities and medical practitioners, and the administrative arrangements that will have to be made. The example used is of a standard pressurized light water reactor of the type currently used for electricity generation, but many of the features will be common to other nuclear installations as well. This report is addressed to those organizations and individuals responsible for public health in the event of a nuclear accident. It will also be of use to those medical practitioners who are not administratively responsible in an accident, but who may need to be aware of the consequences and of the action to be taken in the aftermath of an accident. Coordination is vital between the public health administration and the organizations with direct responsibilities in the event of an accident, and this report is essential reading for them all. 29 refs, 2 figs, 7 tabs

  2. Guidance concepts for time-based flight operations

    Science.gov (United States)

    Vicroy, Dan D.

    1990-01-01

    Airport congestion and the associated delays are severe in today's airspace system and are expected to increase. NASA and the FAA is investigating various methods of alleviating this problem through new technology and operational procedures. One concept for improving airspace productivity is time-based control of aircraft. Research to date has focused primarily on the development of time-based flight management systems and Air Traffic Control operational procedures. Flight operations may, however, require special onboard guidance in order to satisfy the Air Traffic Control imposed time constraints. The results are presented of a simulation study aimed at evaluating several time-based guidance concepts in terms of tracking performance, pilot workload, and subjective preference. The guidance concepts tested varied in complexity from simple digital time-error feedback to an advanced time-referenced-energy guidance scheme.

  3. Health systems guidance appraisal--a critical interpretive synthesis.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-22

    Health systems guidance (HSG) are systematically developed statements that assist with decisions about options for addressing health systems challenges, including related changes in health systems arrangements. However, the development, appraisal, and reporting of HSG poses unique conceptual and methodological challenges related to the varied types of evidence that are relevant, the complexity of health systems, and the pre-eminence of contextual factors. To address this gap, we are conducting a program of research that aims to create a tool to support the appraisal of HSG and further enhance HSG development and reporting. The focus of this paper was to conduct a knowledge synthesis of the published and grey literatures to determine quality criteria (concepts) relevant for this process. We applied a critical interpretive synthesis (CIS) approach to knowledge synthesis that enabled an iterative, flexible, and dynamic analysis of diverse bodies of literature in order to generate a candidate list of concepts that will constitute the foundational components of the HSG tool. Using our review questions as compasses, we were able to guide the search strategy to look for papers based on their potential relevance to HSG appraisal, development, and reporting. The search strategy included various electronic databases and sources, subject-specific journals, conference abstracts, research reports, book chapters, unpublished data, dissertations, and policy documents. Screening the papers and data extraction was completed independently and in duplicate, and a narrative approach to data synthesis was executed. We identified 43 papers that met eligibility criteria. No existing review was found on this topic, and no HSG appraisal tool was identified. Over one third of the authors implicitly or explicitly identified the need for a high-quality tool aimed to systematically evaluate HSG and contribute to its development/reporting. We identified 30 concepts that may be relevant to the

  4. Air pollution and public health: a guidance document for risk managers.

    Science.gov (United States)

    Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

    2008-01-01

    This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

  5. Healthy habits: what kind of guidance the elderly population is receiving from health professionals?

    Science.gov (United States)

    Flores, Thaynã Ramos; Nunes, Bruno Pereira; Assunção, Maria Cecília Formoso; Bertoldi, Andréa Dâmaso

    2016-03-01

    To describe the prevalence of guidance on healthy habits received from health professionals by elderly and its relation to socioeconomic demographic, behavioral and health indicators, and the type of services. Cross sectional population based study including individuals aged 60 years or more in the urban area of Pelotas, Rio Grande do Sul, Brazil. Seven guidance on healthy habits were evaluated: weight control, reduction in salt, sugar and fat intake, physical activity practice, not smoking and not drinking alcohol. Among the 1,451 elderly interviewed, 1,281 (88.3%) consulted in the last year. The orientations more refereed were to fat (61.7%) and salt (61.5%) intake reduction and physical activity (58.2%). Elderly who consulted three times or more and in services financed by the Unified Health System received more guidance. Those elderly from the socioeconomic classes A/B were more likely to receive guidance for weight control (RP = 1.27; 95%CI 1.06 - 1.70) and physical activity (RP = 1.34; 95%CI 1.06 - 1.69). The orientation from health professionals were uncommon and, in some cases, unfocused.

  6. A Fuzzy Rule-based Controller For Automotive Vehicle Guidance

    OpenAIRE

    Hessburg, Thomas; Tomizuka, Masayoshi

    1991-01-01

    A fuzzy rule-based controller is applied to lateral guidance of a vehicle for an automated highway system. The fuzzy rules, based on human drivers' experiences, are developed to track the center of a lane in the presence of external disturbances and over a range of vehicle operating conditions.

  7. 76 FR 78545 - Guidance Regarding Foreign Base Company Sales Income

    Science.gov (United States)

    2011-12-19

    ... Regarding Foreign Base Company Sales Income AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final... provide guidance relating to foreign base company sales income when personal property sold by a controlled... sales income (FBCSI) rules. Written comments were received in response to the notice of proposed...

  8. A Framework For Agent-Based Educational Guidance And ...

    African Journals Online (AJOL)

    This work applies principles of artificial intelligence and agent development of educational guidance and counselling. An agent – based expert system is developed. The system supports the storage and intelligent interactive processing of the knowledge acquired by study and experience of the human expert in the domain ...

  9. Physiological Based Simulator Fidelity Design Guidance

    Science.gov (United States)

    Schnell, Thomas; Hamel, Nancy; Postnikov, Alex; Hoke, Jaclyn; McLean, Angus L. M. Thom, III

    2012-01-01

    The evolution of the role of flight simulation has reinforced assumptions in aviation that the degree of realism in a simulation system directly correlates to the training benefit, i.e., more fidelity is always better. The construct of fidelity has several dimensions, including physical fidelity, functional fidelity, and cognitive fidelity. Interaction of different fidelity dimensions has an impact on trainee immersion, presence, and transfer of training. This paper discusses research results of a recent study that investigated if physiological-based methods could be used to determine the required level of simulator fidelity. Pilots performed a relatively complex flight task consisting of mission task elements of various levels of difficulty in a fixed base flight simulator and a real fighter jet trainer aircraft. Flight runs were performed using one forward visual channel of 40 deg. field of view for the lowest level of fidelity, 120 deg. field of view for the middle level of fidelity, and unrestricted field of view and full dynamic acceleration in the real airplane. Neuro-cognitive and physiological measures were collected under these conditions using the Cognitive Avionics Tool Set (CATS) and nonlinear closed form models for workload prediction were generated based on these data for the various mission task elements. One finding of the work described herein is that simple heart rate is a relatively good predictor of cognitive workload, even for short tasks with dynamic changes in cognitive loading. Additionally, we found that models that used a wide range of physiological and neuro-cognitive measures can further boost the accuracy of the workload prediction.

  10. Exploring pathways linking greenspace to health: Theoretical and methodological guidance.

    Science.gov (United States)

    Markevych, Iana; Schoierer, Julia; Hartig, Terry; Chudnovsky, Alexandra; Hystad, Perry; Dzhambov, Angel M; de Vries, Sjerp; Triguero-Mas, Margarita; Brauer, Michael; Nieuwenhuijsen, Mark J; Lupp, Gerd; Richardson, Elizabeth A; Astell-Burt, Thomas; Dimitrova, Donka; Feng, Xiaoqi; Sadeh, Maya; Standl, Marie; Heinrich, Joachim; Fuertes, Elaine

    2017-10-01

    In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear. During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research. Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration. While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations. Copyright © 2017 Elsevier Inc

  11. From career guidance to the labor insertion of users of mental health services in solidarity economy enterprises

    Directory of Open Access Journals (Sweden)

    Letícia Gomes da Silva

    2014-09-01

    Full Text Available With the psychiatric reform movement, reflecting on the rehabilitation of users of mental health services in society has become essential. Aiming to include users of mental health services in solidarity economy enterprises and seeking ways to promote this inclusion, career guidance was taken as a potential tool. This research project aimed to investigate the potential of the process of career guidance as a strategy for the inclusion of these users in solidary economy enterprises. Semi-structured interviews were used for data collection. The participants were two users of mental health services that were members of the career orientation program held in 2010, the technician responsible for the solidarity economy enterprise, and two non-users of mental health services. We also carried out an analysis of the minutes of the career guidance meetings, and the data from this analysis were used to complement the data obtained in the interviews. Data analysis was based on the theoretical assumptions of solidarity economics and guidance for vocation and deinstitutionalization. The results converge toward career guidance as a facilitator of the insertion of users of mental health services in solidarity economy enterprises. Although some limitations have been found indicating the need to conduct new studies, results suggest that career guidance is a viable alternative to facilitate the inclusion of this population.

  12. Consideration of health inequalities in systematic reviews: a mapping review of guidance.

    Science.gov (United States)

    Maden, Michelle

    2016-11-28

    Given that we know that interventions shown to be effective in improving the health of a population may actually widen the health inequalities gap while others reduce it, it is imperative that all systematic reviewers consider how the findings of their reviews may impact (reduce or increase) on the health inequality gap. This study reviewed existing guidance on incorporating considerations of health inequalities in systematic reviews in order to examine the extent to which they can help reviewers to incorporate such issues. A mapping review was undertaken to identify guidance documents that purported to inform reviewers on whether and how to incorporate considerations of health inequalities. Searches were undertaken in Medline, CINAHL and The Cochrane Library Methodology Register. Review guidance manuals prepared by international organisations engaged in undertaking systematic reviews, and their associated websites were scanned. Studies were included if they provided an overview or discussed the development and testing of guidance for dealing with the incorporation of considerations of health inequalities in evidence synthesis. Results are summarised in narrative and tabular forms. Twenty guidance documents published between 2009 and 2016 were included. Guidance has been produced to inform considerations of health inequalities at different stages of the systematic review process. The Campbell and Cochrane Equity Group have been instrumental in developing and promoting such guidance. Definitions of health inequalities and guidance differed across the included studies. All but one guidance document were transparent in their method of production. Formal methods of evaluation were reported for six guidance documents. Most of the guidance was operationalised in the form of examples taken from published systematic reviews. The number of guidance items to operationalise ranges from 3 up to 26 with a considerable overlap noted. Adhering to the guidance will require more

  13. Scientific opinion on the appropriateness to set a group health based guidance value for T2 and HT2 toxin and its modified forms

    DEFF Research Database (Denmark)

    Petersen, Annette

    The EFSA Panel on Contaminants in the Food Chain (CONTAM) established a tolerable daily intake (TDI) for T2 and HT2 of 0.02 μg/kg body weight (bw) per day based on a new in vivo subchronic toxicity study in rats that confirmed that immune- and haematotoxicity are the critical effects of T2...

  14. Health system guidance appraisal--concept evaluation and usability testing.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-05

    Health system guidance (HSG) provides recommendations aimed to address health system challenges. However, there is a paucity of methods to direct, appraise, and report HSG. Earlier research identified 30 candidate criteria (concepts) that can be used to evaluate the quality of HSG and guide development and reporting requirements. The objective of this paper was to describe two studies aimed at evaluating the importance of these 30 criteria, design a draft HSG appraisal tool, and test its usability. This study involved a two-step survey process. In step 1, respondents rated the 30 concepts for appropriateness to, relevance to, and priority for health system decisions and HSG. This led to a draft tool. In step 2, respondents reviewed HSG documents, appraised them using the tool, and answered a series of questions. Descriptive analyses were computed. Fifty participants were invited in step 1, and we had a response rate of 82 %. The mean response rates for each concept within each survey question were universally favorable. There was also an overall agreement about the need for a high-quality tool to systematically direct the development, appraisal, and reporting of HSG. Qualitative feedback and a consensus process by the team led to refinements to some of the concepts and the creation of a beta (draft) version of the HSG tool. In step 2, 35 participants were invited and we had a response rate of 74 %. Exploratory analyses showed that the quality of the HSGs reviewed varied as a function of the HSG item and the specific document assessed. A favorable consensus was reached with participants agreeing that the HSG items were easy to understand and easy to apply. Moreover, the overall agreement was high for the usability of the tool to systematically direct the development (85 %), appraisal (92 %), and reporting (81 %) of HSG. From this process, version 1.0 of the HSG appraisal tool was generated complete with 32 items (and their descriptions) and 4 domains. The final

  15. A Terminal Guidance Law Based on Motion Camouflage Strategy of Air-to-Ground Missiles

    Directory of Open Access Journals (Sweden)

    Chang-sheng Gao

    2016-01-01

    Full Text Available A guidance law for attacking ground target based on motion camouflage strategy is proposed in this paper. According to the relative position between missile and target, the dual second-order dynamics model is derived. The missile guidance condition is given by analyzing the characteristic of motion camouflage strategy. Then, the terminal guidance law is derived by using the relative motion of missile and target and the guidance condition. In the process of derivation, the three-dimensional guidance law could be designed in a two-dimensional plane and the difficulty of guidance law design is reduced. A two-dimensional guidance law for three-dimensional space is derived by bringing the estimation for target maneuver. Finally, simulation for the proposed guidance law is taken and compared with pure proportional navigation. The simulation results demonstrate that the proposed guidance law can be applied to air-to-ground missiles.

  16. Adapting haptic guidance authority based on user grip

    NARCIS (Netherlands)

    Smisek, J.; Mugge, W.; Smeets, J.B.J.; Van Paassen, M.M.; Schiele, A

    2014-01-01

    Haptic guidance systems support the operator in task execution using additional forces on the input device. Scaling of the guidance forces determines the control authority of the support system. As task complexity may vary, one level of the guidance scaling may be insufficient, and adaptation of the

  17. EPA guidance on building trust in mental health services.

    Science.gov (United States)

    Gaebel, W; Muijen, M; Baumann, A E; Bhugra, D; Wasserman, D; van der Gaag, R J; Heun, R; Zielasek, J

    2014-02-01

    To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. We performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process. We developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization. Trust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust. Evidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. A Two-Dimensional Solar Tracking Stationary Guidance Method Based on Feature-Based Time Series

    Directory of Open Access Journals (Sweden)

    Keke Zhang

    2018-01-01

    Full Text Available The amount of satellite energy acquired has a direct impact on operational capacities of the satellite. As for practical high functional density microsatellites, solar tracking guidance design of solar panels plays an extremely important role. Targeted at stationary tracking problems incurred in a new system that utilizes panels mounted in the two-dimensional turntable to acquire energies to the greatest extent, a two-dimensional solar tracking stationary guidance method based on feature-based time series was proposed under the constraint of limited satellite attitude coupling control capability. By analyzing solar vector variation characteristics within an orbit period and solar vector changes within the whole life cycle, such a method could be adopted to establish a two-dimensional solar tracking guidance model based on the feature-based time series to realize automatic switching of feature-based time series and stationary guidance under the circumstance of different β angles and the maximum angular velocity control, which was applicable to near-earth orbits of all orbital inclination. It was employed to design a two-dimensional solar tracking stationary guidance system, and a mathematical simulation for guidance performance was carried out in diverse conditions under the background of in-orbit application. The simulation results show that the solar tracking accuracy of two-dimensional stationary guidance reaches 10∘ and below under the integrated constraints, which meet engineering application requirements.

  19. Guidance on the scientific requirements for health claims related to gut and immune function

    DEFF Research Database (Denmark)

    Tetens, Inge

    2011-01-01

    The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products Nutrition and Allergies (NDA) to draft guidance on scientific requirements for health claims related to gut and immune function. This guidance has been drawn from scientific opinions of the NDA Panel on such health......, was subjected to public consultation (28 September 2010 to 22 October 2010), and was also discussed at a technical meeting with experts in the field on 2 December 2010 in Amsterdam....

  20. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) ; Guidance on the scientific requirements for health claims related to physical performance

    DEFF Research Database (Denmark)

    Tetens, Inge

    The Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked by the European Food Safety Authority (EFSA) to draft guidance on scientific requirements for health claims related to physical performance. This guidance has been drawn from scientific opinions of the NDA Panel on such health...... claims. Thus, this guidance document represents the views of the NDA Panel based on the experience gained to date with the evaluation of health claims in this area. It is not intended that the document should include an exhaustive list of beneficial effects and studies/outcome measures which...

  1. Trajectory reshaping based guidance with impact time and angle constraints

    Directory of Open Access Journals (Sweden)

    Zhao Yao

    2016-08-01

    Full Text Available This study presents a novel impact time and angle constrained guidance law for homing missiles. The guidance law is first developed with the prior-assumption of a stationary target, which is followed by the practical extension to a maneuvering target scenario. To derive the closed-form guidance law, the trajectory reshaping technique is utilized and it results in defining a specific polynomial function with two unknown coefficients. These coefficients are determined to satisfy the impact time and angle constraints as well as the zero miss distance. Furthermore, the proposed guidance law has three additional guidance gains as design parameters which make it possible to adjust the guided trajectory according to the operational conditions and missile’s capability. Numerical simulations are presented to validate the effectiveness of the proposed guidance law.

  2. How did the public respond to the 2015 expert consensus public health guidance statement on workplace sedentary behaviour? A qualitative analysis

    Directory of Open Access Journals (Sweden)

    Benjamin Gardner

    2017-02-01

    Full Text Available Abstract Background In June 2015, an expert consensus guidance statement was published recommending that office workers accumulate 2–4 h of standing and light activity daily and take regular breaks from prolonged sitting. This paper describes public responses to media coverage of the guidance, so as to understand public acceptability of the recommendations within the guidance, and perceptions of sitting and standing as health behaviours. Methods UK news media websites that had reported on the sedentary workplace guidance statement, and permitted viewers to post comments responding to the story, were identified. 493 public comments, posted in a one-month period to one of six eligible news media websites, were thematically analysed. Results Three themes were extracted: (1 challenges to the credibility of the sedentary workplace guidance; (2 challenges to the credibility of public health; and (3 the guidance as a spur to knowledge exchange. Challenges were made to the novelty of the guidance, the credibility of its authors, the strength of its evidence base, and its applicability to UK workplaces. Public health was commonly mistrusted and viewed as a tool for controlling the public, to serve a paternalistic agenda set by a conspiracy of stakeholders with hidden non-health interests. Knowledge exchanges focused on correcting others’ misinterpretations, raising awareness of historical or scientific context, debating current workplace health policies, and sharing experiences around sitting and standing. Conclusions The guidance provoked exchanges of health-promoting ideas among some, thus demonstrating the potential for sitting reduction messages to be translated into everyday contexts by lay champions. However, findings also demonstrated confusion, misunderstanding and misapprehension among some respondents about the health value of sitting and standing. Predominantly unfavourable, mistrusting responses reveal significant hostility towards

  3. Design Guidance for Computer-Based Procedures for Field Workers

    Energy Technology Data Exchange (ETDEWEB)

    Oxstrand, Johanna [Idaho National Lab. (INL), Idaho Falls, ID (United States); Le Blanc, Katya [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bly, Aaron [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    on other sources of additional information to ensure a functional and accurate understanding of the current plant status (Converse, 1995; Fink, Killian, Hanes, and Naser, 2009; Le Blanc, Oxstrand, and Waicosky, 2012). This report provides design guidance to be used when designing the human-system interaction and the design of the graphical user interface for a CBP system. The guidance is based on human factors research related to the design and usability of CBPs conducted by Idaho National Laboratory, 2012 - 2016.

  4. Guidance for the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health (Revision 1)

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2018-01-01

    of additional health claim applications related to antioxidants, oxidative damage and cardiovascular health, and the information collected from a Grant launched in 2014. This guidance is intended to assist applicants in preparing applications for the authorisation of health claims related to the antioxidants......EFSA asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to update the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011. The update takes into accounts experiences gained with evaluation......, oxidative damage and cardiovascular health. The document was subject to public consultation (from 12 July to 3 September 2017). This document supersedes the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011...

  5. Scientific and technical guidance for the preparation and presentation of an application for authorisation of a health claim (revision 1)

    DEFF Research Database (Denmark)

    Tetens, Inge

    2011-01-01

    The scientific and technical guidance of the EFSA Panel on Dietetic Products, Nutrition and Allergies for the preparation and presentation of an application for authorisation of a health claim presents a common format for the organisation of information for the preparation of a well......-structured application for authorisation of health claims which fall under Article 14 (referring to children’s development and health, and to disease risk reduction claims), or 13(5) (which are based on newly developed scientific evidence and/or which include a request for the protection of proprietary data......), or for the modification of an existing authorisation in accordance with Article 19 of Regulation (EC) No 1924/2006 on nutrition and health claims made on foods. This guidance outlines: the information and scientific data which must be included in the application, the hierarchy of different types of data and study designs...

  6. A review of Grey and academic literature of evaluation guidance relevant to public health interventions.

    Science.gov (United States)

    Denford, Sarah; Abraham, Charles; Callaghan, Margaret; Aighton, Peter; De Vocht, Frank; Arris, Steven

    2017-09-12

    Public Health evaluation is essential to understanding what does and does not work, and robust demonstration of effectiveness may be crucial to securing future funding. Despite this, programs are often implemented with poor, incomplete or no evaluation. Public health practitioners are frequently required to provide evidence for the effectiveness of their services; thus, there is a growing need for evaluation guidance on how to evaluate public health programs. The aim of this study is to identify accessible high-quality, evaluation guidance, available to researchers and practitioners and to catalogue, summarise and categorise the content of a subset of accessible, quality guides to evaluation. We systematically reviewed grey and academic literature for documents providing support for evaluation of complex health interventions. Searches were conducted January to March 2015, and included academic databases, internet search engines, and consultations with academic and practicing public health experts. Data were extracted by two authors and sent to the authors of the guidance documents for comments. Our initial search identified 402 unique documents that were screened to identify those that were (1) developed by or for a national or international organization (2) freely available to all (3) published during or after 2000 (4) specific to public health. This yielded 98 documents from 43 organisations. Of these, 48 were reviewed in detail. This generated a detailed catalogue of quality evaluation guidance. The content included in documents covers 37 facets of evaluation. A wide range of guidance on evaluation of public health initiatives is available. Time and knowledge constraints may mean that busy practitioners find it challenging to access the most, up-to-date, relevant and useful guidance. This review presents links to and reviews of 48 quality guides to evaluation as well as categorising their content. This facilitates quick and each access to multiple selected

  7. Dual effects of guide-based guidance on pedestrian evacuation

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yi, E-mail: yima23-c@my.cityu.edu.hk; Lee, Eric Wai Ming; Shi, Meng

    2017-06-15

    This study investigates the effects of guide-based guidance on the pedestrian evacuation under limited visibility via the simulations based on an extended social force model. The results show that the effects of guides on the pedestrian evacuation under limited visibility are dual, and related to the neighbor density within the visual field. On the one hand, in many cases, the effects of guides are positive, particularly when the neighbor density within the visual field is moderate; in this case, a few guides can already assist the evacuation effectively and efficiently. However, when the neighbor density within the visual field is particularly small or large, the effects of guides may be adverse and make the evacuation time longer. Our results not only provide a new insight into the effects of guides on the pedestrian evacuation under limited visibility, but also give some practical suggestions as to how to assign guides to assist the evacuation under different evacuation conditions. - Highlights: • Extended social force model is used to simulate guided pedestrian evacuation. • Effects of guides on pedestrian evacuation under limited visibility are dual. • Effects of guides on pedestrian evacuation under limited visibility are related to neighbor density within visual field.

  8. Quantitative Guidance for Stove Usage and Performance to Achieve Health and Environmental Targets.

    Science.gov (United States)

    Johnson, Michael A; Chiang, Ranyee A

    2015-08-01

    Displacing the use of polluting and inefficient cookstoves in developing countries is necessary to achieve the potential health and environmental benefits sought through clean cooking solutions. Yet little quantitative context has been provided on how much displacement of traditional technologies is needed to achieve targets for household air pollutant concentrations or fuel savings. This paper provides instructive guidance on the usage of cooking technologies required to achieve health and environmental improvements. We evaluated different scenarios of displacement of traditional stoves with use of higher performing technologies. The air quality and fuel consumption impacts were estimated for these scenarios using a single-zone box model of indoor air quality and ratios of thermal efficiency. Stove performance and usage should be considered together, as lower performing stoves can result in similar or greater benefits than a higher performing stove if the lower performing stove has considerably higher displacement of the baseline stove. Based on the indoor air quality model, there are multiple performance-usage scenarios for achieving modest indoor air quality improvements. To meet World Health Organization guidance levels, however, three-stone fire and basic charcoal stove usage must be nearly eliminated to achieve the particulate matter target (< 1-3 hr/week), and substantially limited to meet the carbon monoxide guideline (< 7-9 hr/week). Moderate health gains may be achieved with various performance-usage scenarios. The greatest benefits are estimated to be achieved by near-complete displacement of traditional stoves with clean technologies, emphasizing the need to shift in the long term to near exclusive use of clean fuels and stoves. The performance-usage scenarios are also provided as a tool to guide technology selection and prioritize behavior change opportunities to maximize impact.

  9. Tiered guidance for risk-informed environmental health and safety testing of nanotechnologies

    International Nuclear Information System (INIS)

    Collier, Zachary A.; Kennedy, Alan J.; Poda, Aimee R.; Cuddy, Michael F.; Moser, Robert D.; MacCuspie, Robert I.; Harmon, Ashley; Plourde, Kenton; Haines, Christopher D.; Steevens, Jeffery A.

    2015-01-01

    Provided the rapid emergence of novel technologies containing engineered nanomaterials, there is a need to better understand the potential environmental, health, and safety effects of nanotechnologies before wide-scale deployment. However, the unique properties of nanomaterials and uncertainty regarding applicable test methods have led to a lack of consensus regarding the collection and evaluation of data related to hazard and exposure potentials. Often, overly conservative approaches to characterization and data collection result in prolonged, unfocused, or irrelevant testing, which increases costs and delays deployment. In this paper, we provide a novel testing guidance framework for determining whether a nanotechnology has the potential to release material with nano-specific parameters that pose a risk to humans or the environment. The framework considers methods to categorize nanotechnologies by their structure and within their relevant-use scenarios to inform testing in a time- and resource-limited reality. Based on the precedent of dredged sediment testing, a five-tiered approach is proposed in which opportunities are presented to conclude testing once sufficient risk-related information has been collected, or that the technology in question does not require nano-specific scrutiny. A series of screening stages are suggested, covering relevant aspects including size, surface area, distribution, unique behaviors, and release potential. The tiered, adaptive guidance approach allows users to concentrate on collecting the most relevant data, thus accelerating technology deployment while minimizing risk

  10. Integrated software health management for aerospace guidance, navigation, and control systems: A probabilistic reasoning approach

    Science.gov (United States)

    Mbaya, Timmy

    Embedded Aerospace Systems have to perform safety and mission critical operations in a real-time environment where timing and functional correctness are extremely important. Guidance, Navigation, and Control (GN&C) systems substantially rely on complex software interfacing with hardware in real-time; any faults in software or hardware, or their interaction could result in fatal consequences. Integrated Software Health Management (ISWHM) provides an approach for detection and diagnosis of software failures while the software is in operation. The ISWHM approach is based on probabilistic modeling of software and hardware sensors using a Bayesian network. To meet memory and timing constraints of real-time embedded execution, the Bayesian network is compiled into an Arithmetic Circuit, which is used for on-line monitoring. This type of system monitoring, using an ISWHM, provides automated reasoning capabilities that compute diagnoses in a timely manner when failures occur. This reasoning capability enables time-critical mitigating decisions and relieves the human agent from the time-consuming and arduous task of foraging through a multitude of isolated---and often contradictory---diagnosis data. For the purpose of demonstrating the relevance of ISWHM, modeling and reasoning is performed on a simple simulated aerospace system running on a real-time operating system emulator, the OSEK/Trampoline platform. Models for a small satellite and an F-16 fighter jet GN&C (Guidance, Navigation, and Control) system have been implemented. Analysis of the ISWHM is then performed by injecting faults and analyzing the ISWHM's diagnoses.

  11. Scientific and technical guidance for the preparation and presentation of a health claim application (Revision 2)

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2017-01-01

    EFSA asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to update the scientific and technical guidance for the preparation and presentation of an application for authorisation of a health claim published in 2011. Since then, the NDA Panel has gained considerable experience...... developments in this area. This guidance document presents a common format for the organisation of information for the preparation of a well-structured application for authorisation of health claims which fall under Articles 13(5), 14 and 19 of Regulation (EC) No 1924/2006. This guidance outlines...... the information and scientific data which must be included in the application, the hierarchy of different types of data and study designs, and the key issues which should be addressed in the application to substantiate the health claim....

  12. Knowledge-based operation guidance system for nuclear power plants based on generic task methodology

    International Nuclear Information System (INIS)

    Yamada, Naoyuki; Chandrasekaran, B.; Bhatnager, R.

    1989-01-01

    A knowledge-based system for operation guidance of nuclear power plants is proposed. The Dynamic Procedure Management System (DPMS) is designed and developed to assist human operators interactively by selecting and modifying predefined operation procedures in a dynamic situation. Unlike most operation guidance systems, DPMS has been built based on Generic Task Methodology, which makes the overall framework of the system perspicuous and also lets domain knowledge be represented in a natural way. This paper describes the organization of the system, the definition of each task, and the form and organization of knowledge, followed by an application example. (author)

  13. EPA guidance on building trust in mental health services

    NARCIS (Netherlands)

    Gaebel, W.; Muijen, M.; Baumann, A.E.; Bhugra, D.; Wasserman, D.; Gaag, R.J. van der; Heun, R.; Zielasek, J.

    2014-01-01

    PURPOSE: To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. METHODS: We

  14. Stall Recovery Guidance Algorithms Based on Constrained Control Approaches

    Science.gov (United States)

    Stepanyan, Vahram; Krishnakumar, Kalmanje; Kaneshige, John; Acosta, Diana

    2016-01-01

    Aircraft loss-of-control, in particular approach to stall or fully developed stall, is a major factor contributing to aircraft safety risks, which emphasizes the need to develop algorithms that are capable of assisting the pilots to identify the problem and providing guidance to recover the aircraft. In this paper we present several stall recovery guidance algorithms, which are implemented in the background without interfering with flight control system and altering the pilot's actions. They are using input and state constrained control methods to generate guidance signals, which are provided to the pilot in the form of visual cues. It is the pilot's decision to follow these signals. The algorithms are validated in the pilot-in-the loop medium fidelity simulation experiment.

  15. Public health guidance on cardiovascular benefits and risks related to fish consumption

    Directory of Open Access Journals (Sweden)

    Stern Alan H

    2007-10-01

    Full Text Available Abstract Historically, concerns with fish consumption have addressed risks from contaminants (e.g., methylmercury (MeHg, and PCBs. More recently public health concerns have widened in appreciation of the specific benefits of fish consumption such as those arising from polyunsaturated fatty acids (PUFAs in fish oil. Fish contains varying levels of PUFAs and MeHg. Since both address the same health outcomes (in opposite directions and occur together in fish, great care must be exercised in providing public health guidance. Mozaffarian and Rimm in a recent article (JAMA. 2006, 296:1885–99 have made a strong case for the beneficial effects of PUFAs in reducing the risk of coronary heart disease, but at the same time, have also broadly discounted the increased risks of coronary heart disease posed by MeHg in fish, stating that "... among adults... the benefits of fish intake exceed the potential risks." This conclusion appears to be based on an inaccurate and insufficiently critical analysis of the literature. This literature is re-examined in light of their conclusions, and the available and appropriate public health options are considered.

  16. Ultrasound-based guidance of intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Fung, Albert Y.C.; Ayyangar, Komanduri M.; Djajaputra, David; Nehru, Ramasamy M.; Enke, Charles A.

    2006-01-01

    In ultrasound-guided intensity-modulated radiation therapy (IMRT) of prostate cancer, ultrasound imaging ascertains the anatomical position of patients during x-ray therapy delivery. The ultrasound transducers are made of piezoelectric ceramics. The same crystal is used for both ultrasound production and reception. Three-dimensional (3D) ultrasound devices capture and correlate series of 2-dimensional (2D) B-mode images. The transducers are often arranged in a convex array for focusing. Lower frequency reaches greater depth, but results in low resolution. For clear image, some gel is usually applied between the probe and the skin contact surface. For prostate positioning, axial and sagittal scans are performed, and the volume contours from computed tomography (CT) planning are superimposed on the ultrasound images obtained before radiation delivery at the linear accelerator. The planning volumes are then overlaid on the ultrasound images and adjusted until they match. The computer automatically deduces the offset necessary to move the patient so that the treatment area is in the correct location. The couch is translated as needed. The currently available commercial equipment can attain a positional accuracy of 1-2 mm. Commercial manufacturer designs differ in the detection of probe coordinates relative to the isocenter. Some use a position-sensing robotic arm, while others have infrared light-emitting diodes or pattern-recognition software with charge-couple-device cameras. Commissioning includes testing of image quality and positional accuracy. Ultrasound is mainly used in prostate positioning. Data for 7825 daily fractions of 234 prostate patients indicated average 3D inter-fractional displacement of about 7.8 mm. There was no perceivable trend of shift over time. Scatter plots showed slight prevalence toward superior-posterior directions. Uncertainties of ultrasound guidance included tissue inhomogeneities, speckle noise, probe pressure, and inter

  17. Physics-based shape matching for intraoperative image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Suwelack, Stefan, E-mail: suwelack@kit.edu; Röhl, Sebastian; Bodenstedt, Sebastian; Reichard, Daniel; Dillmann, Rüdiger; Speidel, Stefanie [Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Adenauerring 2, Karlsruhe 76131 (Germany); Santos, Thiago dos; Maier-Hein, Lena [Computer-assisted Interventions, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Wagner, Martin; Wünscher, Josephine; Kenngott, Hannes; Müller, Beat P. [General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, Heidelberg 69120 (Germany)

    2014-11-01

    Purpose: Soft-tissue deformations can severely degrade the validity of preoperative planning data during computer assisted interventions. Intraoperative imaging such as stereo endoscopic, time-of-flight or, laser range scanner data can be used to compensate these movements. In this context, the intraoperative surface has to be matched to the preoperative model. The shape matching is especially challenging in the intraoperative setting due to noisy sensor data, only partially visible surfaces, ambiguous shape descriptors, and real-time requirements. Methods: A novel physics-based shape matching (PBSM) approach to register intraoperatively acquired surface meshes to preoperative planning data is proposed. The key idea of the method is to describe the nonrigid registration process as an electrostatic–elastic problem, where an elastic body (preoperative model) that is electrically charged slides into an oppositely charged rigid shape (intraoperative surface). It is shown that the corresponding energy functional can be efficiently solved using the finite element (FE) method. It is also demonstrated how PBSM can be combined with rigid registration schemes for robust nonrigid registration of arbitrarily aligned surfaces. Furthermore, it is shown how the approach can be combined with landmark based methods and outline its application to image guidance in laparoscopic interventions. Results: A profound analysis of the PBSM scheme based on in silico and phantom data is presented. Simulation studies on several liver models show that the approach is robust to the initial rigid registration and to parameter variations. The studies also reveal that the method achieves submillimeter registration accuracy (mean error between 0.32 and 0.46 mm). An unoptimized, single core implementation of the approach achieves near real-time performance (2 TPS, 7–19 s total registration time). It outperforms established methods in terms of speed and accuracy. Furthermore, it is shown that the

  18. Bayesian Software Health Management for Aircraft Guidance, Navigation, and Control

    Science.gov (United States)

    Schumann, Johann; Mbaya, Timmy; Menghoel, Ole

    2011-01-01

    Modern aircraft, both piloted fly-by-wire commercial aircraft as well as UAVs, more and more depend on highly complex safety critical software systems with many sensors and computer-controlled actuators. Despite careful design and V&V of the software, severe incidents have happened due to malfunctioning software. In this paper, we discuss the use of Bayesian networks (BNs) to monitor the health of the on-board software and sensor system, and to perform advanced on-board diagnostic reasoning. We will focus on the approach to develop reliable and robust health models for the combined software and sensor systems.

  19. Career Guidance and Health Promotion with Adolescents: Keys for Intervention Programs

    Science.gov (United States)

    Aguiar, Fernando Henrique Rezende; Conceição, Maria Inês Gandolfo

    2015-01-01

    This qualitative study investigates underprivileged students' perceptions of their future, their health, and the relevance of a career counseling process. Interviews regarding career guidance were conducted during a workshop with nine eleventh-grade students from a public high school in Brazil's capital. The data were analyzed according to…

  20. Lone-Actor Terrorism. Toolkit Paper 1 : Practical Guidance for Mental Health Practitioners and Social Workers

    NARCIS (Netherlands)

    Bakker, E.; Roy, de van Zuijdewijn J.

    2016-01-01

    The aim of this paper is to draw out practical implications for mental health practitioners and social workers in dealing with Lone-Actor Terrorism. It is not intended to provide a profile of lone-actor terrorists, but rather to offer guidance that may be of use to practitioners in Europe (and

  1. Improving health promotion through central rating of interventions: the need for Responsive Guidance.

    Science.gov (United States)

    Kok, Maarten Olivier; Bal, Roland; Roelofs, Caspar David; Schuit, Albertine Jantine

    2017-11-23

    beneficial, the evidence based-inspired ERS approach is too limited to guide both intervention development and the improvement of health promotion in practice. To better contribute to improving health promotion, a more reflexive and responsive guidance approach is required, namely one which stimulates the improvement of different intervention aspects, provides targeted recommendations to practitioners and provides feedback to those who develop and rate interventions.

  2. Improved MPSP Method-based Cooperative Re-entry Guidance for Hypersonic Gliding Vehicles

    Directory of Open Access Journals (Sweden)

    Chu Haiyan

    2017-01-01

    Full Text Available A computationally sufficient technique is used to solve the 3-D cooperative re-entry guidance problem for hypersonic gliding vehicles. Due to the poor surrounding adaptive ability of the traditional cooperative guidance methods, a novel methodology, named as model predictive static programming (MPSP, is used to solve a class of finite-horizon optimal control problems with hard terminal constraints. The main feature of this guidance law is that it is capable of hitting the target with high accuracy for each one of the cooperative vehicles at the same time. In addition, it accurately satisfies variable constraints. Performance of the proposed MPSP-based guidance is demonstrated in 3-D nonlinear dynamics scenario. The numerical simulation results show that the proposed cooperative re-entry guidance methodology has the advantage of computational efficiency and better robustness against the perturbations.

  3. SUPPORTING THE INDUSTRY BY DEVELOPING A DESIGN GUIDANCE FOR COMPUTER-BASED PROCEDURES FOR FIELD WORKERS

    Energy Technology Data Exchange (ETDEWEB)

    Oxstrand, Johanna; LeBlanc, Katya

    2017-06-01

    The paper-based procedures currently used for nearly all activities in the commercial nuclear power industry have a long history of ensuring safe operation of the plants. However, there is potential to greatly increase efficiency and safety by improving how the human interacts with the procedures, which can be achieved through the use of computer-based procedures (CBPs). A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools and dynamic step presentation. As a step toward the goal of improving procedure use performance, the U.S. Department of Energy Light Water Reactor Sustainability Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with CBPs. The main purpose of the CBP research conducted at the Idaho National Laboratory was to provide design guidance to the nuclear industry to be used by both utilities and vendors. After studying existing design guidance for CBP systems, the researchers concluded that the majority of the existing guidance is intended for control room CBP systems, and does not necessarily address the challenges of designing CBP systems for instructions carried out in the field. Further, the guidance is often presented on a high level, which leaves the designer to interpret what is meant by the guidance and how to specifically implement it. The authors developed a design guidance to provide guidance specifically tailored to instructions that are carried out in the field based.

  4. "Health in all policies" in practice: guidance and tools to quantifying the health effects of cycling and walking.

    Science.gov (United States)

    Kahlmeier, Sonja; Racioppi, Francesca; Cavill, Nick; Rutter, Harry; Oja, Pekka

    2010-03-01

    There is growing interest in "Health in All Policies" approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal. A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process. Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A "Health Economic Assessment Tool (HEAT) for cycling" was developed which is being used in several countries. There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting "Health in All Policies" into practice.

  5. Vision-based guidance for an automated roving vehicle

    Science.gov (United States)

    Griffin, M. D.; Cunningham, R. T.; Eskenazi, R.

    1978-01-01

    A controller designed to guide an automated vehicle to a specified target without external intervention is described. The intended application is to the requirements of planetary exploration, where substantial autonomy is required because of the prohibitive time lags associated with closed-loop ground control. The guidance algorithm consists of a set of piecewise-linear control laws for velocity and steering commands, and is executable in real time with fixed-point arithmetic. The use of a previously-reported object tracking algorithm for the vision system to provide position feedback data is described. Test results of the control system on a breadboard rover at the Jet Propulsion Laboratory are included.

  6. A learning based model for career guidance of students with disabilites

    DEFF Research Database (Denmark)

    Dræby, Anders

    must address their resources, challenges, potentialities and barriers regarding their employability from a learning based perspective. The objective of this session is to broaden the awareness of the particular challenges that career guidance for people with disabilities constitute.......The session aims at presenting a 4 stage model for career guidance for students with disabilities. In order to enable and empower the disa bled students regarding their employability and employability competencies at the labour market, the presentation shows how career guidance of these students...

  7. [School choice and vocational guidance for schoolchildren with chronic diseases and other health problems].

    Science.gov (United States)

    Lancić, Franciska; Majski-Cesarec, Slavenka; Musil, Vera

    2010-09-01

    By following a child's growth, development, and health, school medicine specialist can see opportunities for career choice. Special attention is needed for schoolchildren with chronic diseases and developmental difficulties, because of limited occupation choices. Studies report 10 % to 15 % prevalence of chronic diseases among schoolchildren. Parents and children should be informed about child's limitations before career choice. It would be helpful for the students to develop interests for occupations that are not contraindicated for their condition. Physical examination gives an insight into the psycho-physical abilities of an eighth-grade primary school student for further education. During examination, counselling and vocational guidance is provided for all students with chronic diseases and other health problems. All procedures are oriented to personal abilities and preferences. The aim of this study was to analyse the reasons for vocational guidance in the Varazdin County of Croatia. It included eighth-grade students from ten primary schools from 1998/99 to 2007/08. Of 4939 students, 458 (9.3 %) with chronic diseases and health difficulties were referred to vocational guidance. Of these, 41.3 % were referred due to mental and behavioural disorders. These students were assessed and received a recommendation for at least two occupations. Forty-eight students (10.5 %) did not follow the recommendation.In a coordinated effort, school physicians, vocational guidance experts, and school and local authorities should secure enrollment of students with chronic diseases and health difficulties in secondary schools and follow their development and education to provide them the best available career opportunities.

  8. Research-Based Knowledge: Researchers' Contribution to Evidence-Based Practice and Policy Making in Career Guidance

    Science.gov (United States)

    Haug, Erik Hagaseth; Plant, Peter

    2016-01-01

    To present evidence for the outcomes of career guidance is increasingly seen as pivotal for a further professionalization of policy making and service provision. This paper puts an emphasis on researchers' contribution to evidence-based practice and policy making in career guidance. We argue for a broader and more pluralistic research strategy to…

  9. Evaluation of school counseling and guidance services based on views of high school students

    OpenAIRE

    Fulya Yüksel-Şahin

    2008-01-01

    This study evaluated school psychological counseling services based on high school students’ views. Participants were 235 students. “Student Personal Information Form” and “the School Guidance Services Scale” were used for data analysis. MANOVA and multiple regression procedures were used for data analysis. Results showed that students listed the guidance services from the most utilized to the least as follows: consultation, placement, follow-up, public and famil...

  10. Guidance for Researchers Developing and Conducting Clinical Trials in Practice-based Research Networks (PBRNs)

    Science.gov (United States)

    Dolor, Rowena J.; Schmit, Kristine M.; Graham, Deborah G.; Fox, Chester H.; Baldwin, Laura Mae

    2015-01-01

    Background There is increased interest nationally in multicenter clinical trials to answer questions about clinical effectiveness, comparative effectiveness, and safety in real-world community settings. Primary care practice-based research networks (PBRNs), comprising community- and/or academically affiliated practices committed to improving medical care for a range of health problems, offer ideal settings for these trials, especially pragmatic clinical trials. However, many researchers are not familiar with working with PBRNs. Methods Experts in practice-based research identified solutions to challenges that researchers and PBRN personnel experience when collaborating on clinical trials in PBRNs. These were organized as frequently asked questions in a draft document presented at a 2013 Agency for Health care Research and Quality PBRN conference workshop, revised based on participant feedback, then shared with additional experts from the DARTNet Institute, Clinical Translational Science Award PBRN, and North American Primary Care Research Group PBRN workgroups for further input and modification. Results The “Toolkit for Developing and Conducting Multi-site Clinical Trials in Practice-Based Research Networks” offers guidance in the areas of recruiting and engaging practices, budgeting, project management, and communication, as well as templates and examples of tools important in developing and conducting clinical trials. Conclusion Ensuring the successful development and conduct of clinical trials in PBRNs requires a highly collaborative approach between academic research and PBRN teams. PMID:25381071

  11. Dynamic route guidance algorithm based algorithm based on artificial immune system

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To improve the performance of the K-shortest paths search in intelligent traffic guidance systems,this paper proposes an optimal search algorithm based on the intelligent optimization search theory and the memphor mechanism of vertebrate immune systems.This algorithm,applied to the urban traffic network model established by the node-expanding method,can expediently realize K-shortest paths search in the urban traffic guidance systems.Because of the immune memory and global parallel search ability from artificial immune systems,K shortest paths can be found without any repeat,which indicates evidently the superiority of the algorithm to the conventional ones.Not only does it perform a better parallelism,the algorithm also prevents premature phenomenon that often occurs in genetic algorithms.Thus,it is especially suitable for real-time requirement of the traffic guidance system and other engineering optimal applications.A case study verifies the efficiency and the practicability of the algorithm aforementioned.

  12. A conceptual model of physician work intensity: guidance for evaluating policies and practices to improve health care delivery.

    Science.gov (United States)

    Horner, Ronnie D; Matthews, Gerald; Yi, Michael S

    2012-08-01

    Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.

  13. Regional information guidance system based on hypermedia concept

    Science.gov (United States)

    Matoba, Hiroshi; Hara, Yoshinori; Kasahara, Yutako

    1990-08-01

    A regional information guidance system has been developed on an image workstation. Two main features of this system are hypermedia data structure and friendly visual interface realized by the full-color frame memory system. As the hypermedia data structure manages regional information such as maps, pictures and explanations of points of interest, users can retrieve those information one by one, next to next according to their interest change. For example, users can retrieve explanation of a picture through the link between pictures and text explanations. Users can also traverse from one document to another by using keywords as cross reference indices. The second feature is to utilize a full-color, high resolution and wide space frame memory for visual interface design. This frame memory system enables real-time operation of image data and natural scene representation. The system also provides half tone representing function which enables fade-in/out presentations. This fade-in/out functions used in displaying and erasing menu and image data, makes visual interface soft for human eyes. The system we have developed is a typical example of multimedia applications. We expect the image workstation will play an important role as a platform for multimedia applications.

  14. A Smart Infrared Microcontroller-Based Blind Guidance System

    Directory of Open Access Journals (Sweden)

    Amjed S. Al-Fahoum

    2013-01-01

    Full Text Available Blindness is a state of lacking the visual perception due to physiological or neurological factors. The partial blindness represents the lack of integration in the growth of the optic nerve or visual centre of the eye, and total blindness is the full absence of the visual light perception. In this work, a simple, cheap, friendly user, smart blind guidance system is designed and implemented to improve the mobility of both blind and visually impaired people in a specific area. The proposed work includes a wearable equipment consists of head hat and mini hand stick to help the blind person to navigate alone safely and to avoid any obstacles that may be encountered, whether fixed or mobile, to prevent any possible accident. The main component of this system is the infrared sensor which is used to scan a predetermined area around blind by emitting-reflecting waves. The reflected signals received from the barrier objects are used as inputs to PIC microcontroller. The microcontroller is then used to determine the direction and distance of the objects around the blind. It also controls the peripheral components that alert the user about obstacle's shape, material, and direction. The implemented system is cheap, fast, and easy to use and an innovative affordable solution to blind and visually impaired people in third world countries.

  15. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) ; Guidance on the scientific requirements for health claims related to bone, joints, skin and oral health

    DEFF Research Database (Denmark)

    Tetens, Inge

    The Panel on Dietetic Products, Nutrition and Allergies (NDA) has been asked by the European Food Safety Authority (EFSA) to draft guidance on the scientific requirements for health claims related to bone, joints, skin, and oral health. This guidance has been drawn from scientific opinions...

  16. Computer-based written emotional disclosure: the effects of advance or real-time guidance and moderation by Big 5 personality traits.

    Science.gov (United States)

    Beyer, Jonathan A; Lumley, Mark A; Latsch, Deborah V; Oberleitner, Lindsay M S; Carty, Jennifer N; Radcliffe, Alison M

    2014-01-01

    Standard written emotional disclosure (WED) about stress, which is private and unguided, yields small health benefits. The effect of providing individualized guidance to writers may enhance WED, but has not been tested. This trial of computer-based WED compared two novel therapist-guided forms of WED - advance guidance (before sessions) and real-time guidance (during sessions, through instant messaging) - to both standard WED and control writing; it also tested Big 5 personality traits as moderators of guided WED. Young adult participants (n = 163) with unresolved stressful experiences were randomized to conditions, had three, 30-min computer-based writing sessions, and were reassessed six weeks later. Contrary to hypotheses, real-time guidance WED had poorer outcomes than the other conditions on several measures, and advance guidance WED also showed some poorer outcomes. Moderator analyses revealed that participants with low baseline agreeableness, low extraversion, or high conscientiousness had relatively poor responses to guidance. We conclude that providing guidance for WED, especially in real-time, may interfere with emotional processing of unresolved stress, particularly for people whose personalities have poor fit with this interactive form of WED.

  17. Lone-Actor Terrorism. Toolkit Paper 1: Practical Guidance for Mental Health Practitioners and Social Workers

    OpenAIRE

    Bakker, E.; Roy, de, van Zuijdewijn J.

    2016-01-01

    The aim of this paper is to draw out practical implications for mental health practitioners and social workers in dealing with Lone-Actor Terrorism. It is not intended to provide a profile of lone-actor terrorists, but rather to offer guidance that may be of use to practitioners in Europe (and beyond), supporting the development of strategies to detect and deal with potential lone-actor terrorists and to understand the possible risk posed by persons of interest. This paper presents three sets...

  18. Knowledge-based operator guidance system for Japanese PWRs

    International Nuclear Information System (INIS)

    Fujita, Y.; Ito, K.; Kawanago, S.; Tani, M.; Murata, R.

    1986-01-01

    A knowledge-based operator support system for nuclear power plant operation is under development. The main theme of the study is the incorporation of operator's cognitive structure as the framework of the knowledge representation and inference control mechanisms. Based upon information collected from interviews, and experiments using a real-time simulator, an operator's model related to diagnostic tasks was developed. A knowledge-based system incorporating the proposed model demonstrated highly efficient problem solving capabilities and the dynamic fitness to operator's perceptual feeling, thereby suggesting the potential importance and practical benefit of such a study

  19. 75 FR 69449 - Draft Guidance for Industry and Food and Drug Administration Staff on Dear Health Care Provider...

    Science.gov (United States)

    2010-11-12

    ... annually from approximately 25 application holders. FDA professionals familiar with Dear Health Care... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0319] Draft Guidance for Industry and Food and Drug Administration Staff on Dear Health Care Provider Letters...

  20. THE EVALUATION OF COUNSELING AND GUIDANCE SERVICES BASED ON TEACHER VIEWS AND THEIR PREDICTION BASED ON SOME VARIABLES

    Directory of Open Access Journals (Sweden)

    Fulya Yuksel-Sahin

    2009-01-01

    Full Text Available This study evaluated psychological counseling and guidance services based on elementary and secondary education teachers’ views. Participants were 204 teachers. “School Guidance Services Scale” and “Teacher Personal Information Form” were used for gathering the necessary information. Percentage calculations and multiple regression analysis were used for data analysis. The results showed that teachers listed the guidance services from the most utilized to the least as follows: consultation, counseling, information gathering and outreach, appraisal, orientation, placement, research and evaluation public and family relations and follow-up services. Results of this study showed that overall an approximately 46% of all counseling and guidance services were offered. Moreover, according to the results of the study, the grade being taught and holding the view that schools should definitely have a school counselor were significant predictors of teachers’ evaluation of counseling and guidance services. However, taking counseling and guidance lessons during undergraduate studies, the length of service and gender were not significant predictors of teachers’ evaluation of counseling and guidance services.

  1. The UK's Draft Guidance for Health in SEA in light of HIA community priorities and the UNECE SEA Protocol

    International Nuclear Information System (INIS)

    Posas, Paula J.

    2011-01-01

    The Protocol on Strategic Environmental Assessment (SEA) to the United Nations Economic Commission for Europe (UNECE) Espoo Convention came into force on 11 July 2010. This Protocol, to which the European Union is party, gives a legal basis for enhanced attention to human health in the SEA process. In this context, the United Kingdom's (UK's) 2007 Draft Guidance on Health in Strategic Environmental Assessment represents an important early government-led effort to bring health issues and public health considerations more significantly into the SEA process. Since the UK is a worldwide leader in environmental and various other types of impact assessment, and since other countries may eventually consider its example in efforts to meet UNECE SEA Protocol requirements, scrutiny of its outputs is warranted. This paper thus examines the UK's Draft Guidance from both HIA academic and practitioner perspectives. First it assesses the extent to which the Draft Guidance reflects recent issues and lessons learned in the academic literature. In order to make the assessment, a meta-analysis of 70 HIA-related peer-reviewed articles was undertaken to extract authors' priority recommendations. These recommendations were subsequently compared with the contents of the Draft Guidance. Secondly, the Draft Guidance was assessed for its accordance with recommendations of the UNECE SEA Protocol background paper written by two HIA practitioners. Overall, the Draft Guidance's accordance with both sets of recommendations was found to be high, with only a few easily-remedied gaps. This evaluation suggests that the UK's Draft Guidance can be a useful starting point in the creation of future guidance on health in SEA in both the UK and other countries.

  2. Improving Access to Quality Care in Family Planning: WHO's Four Cornerstones of Evidence-based Guidance

    Institute of Scientific and Technical Information of China (English)

    Shang-chun WU; Yan ZOU; K Church; O Meirik

    2007-01-01

    The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainlyface to the policy-makers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines- Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the linicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grassroot providers.

  3. Image registration assessment in radiotherapy image guidance based on control chart monitoring.

    Science.gov (United States)

    Xia, Wenyao; Breen, Stephen L

    2018-04-01

    Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

  4. Career Guidance in India Based on O*NET and Cultural Variables

    Science.gov (United States)

    Bhatnagar, Mohit

    2018-01-01

    The Occupational Information Network (O*NET) is the primary source of occupational information in the United States (US). In this study, I review O*NET's usage for career guidance in India and conceive a career intervention based on it. In an empirical evaluation adopting a posttest-only experimental design with post-graduate management students…

  5. Maintenance and Drainage Guidance for the Scott Base Transition, Antarctica

    Science.gov (United States)

    2014-10-01

    albedo and quickens the melt. Several strategies reduce the amount of dirt tracked on- to the ice shelf: 1. Any vehicles using the ice shelf should...the Ice Transition segment of the SBT is to keep the snow albedo high (keep snow white). This reduces roadway and road-base disin- tegration (i.e...closest to the cliff was 38 ft (11.6 m) deep, and all but the furthest seaward hole encountered sediment (presumably the sea floor or the under- ice

  6. Artificial Intelligence (AI) Based Tactical Guidance for Fighter Aircraft

    Science.gov (United States)

    McManus, John W.; Goodrich, Kenneth H.

    1990-01-01

    A research program investigating the use of Artificial Intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS), a second generation TDG, is presented. The Knowledge-Based Systems used by CLAWS to aid in the tactical decision-making process are outlined in detail, and the results of tests to evaluate the performance of CLAWS versus a baseline TDG developed in FORTRAN to run in real-time in the Langley Differential Maneuvering Simulator (DMS), are presented. To date, these test results have shown significant performance gains with respect to the TDG baseline in one-versus-one air combat engagements, and the AI-based TDG software has proven to be much easier to modify and maintain than the baseline FORTRAN TDG programs. Alternate computing environments and programming approaches, including the use of parallel algorithms and heterogeneous computer networks are discussed, and the design and performance of a prototype concurrent TDG system are presented.

  7. An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

    Science.gov (United States)

    Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

    2017-12-01

    Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

  8. 'Tell us something we don't already know or do!' - The response of planning and transport professionals to public health guidance on the built environment and physical activity.

    Science.gov (United States)

    Allender, Steven; Cavill, Nick; Parker, Mike; Foster, Charles

    2009-04-01

    A large proportion of non-communicable disease can be attributed to modifiable risk factors such as poor nutrition and physical inactivity. We present data on planning and transport practitioners' perceptions and responses to government public health guidance aimed at modifying environmental factors to promote physical activity. This study was informed by questions on the role of evidence-based guidance, the views of professionals towards the guidance, the links between guidance and existing legislation and policy and the practicality of guidelines. A key informant 'snowball' sampling technique was used to recruit participants from the main professional planning organisations across England. Seventy-six people were interviewed in eight focus groups. We found that evidence-based public health guidance is a new voice in urban and town planning, although much of the advice is already reflected by the 'accepted wisdom' of these professions. Evidence-based health guidance could be a powerful driver affecting planning practice, but other legislated planning guidance may take priority for planning and transport professionals.

  9. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues.

    Science.gov (United States)

    Edwards, Rhiannon Tudor; Charles, Joanna Mary; Lloyd-Williams, Huw

    2013-10-24

    If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Electronic databases and organisation websites were searched using a 22 year time horizon (1990-2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader

  10. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues

    Science.gov (United States)

    2013-01-01

    Background If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Methods Electronic databases and organisation websites were searched using a 22 year time horizon (1990–2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. Results We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. Conclusions In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may

  11. Hurricane Season Public Health Preparedness, Response, and Recovery Guidance for Health Care Providers, Response and Recovery Workers, and Affected Communities - CDC, 2017.

    Science.gov (United States)

    2017-09-22

    CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) have guidance and technical materials available in both English and Spanish to help communities prepare for hurricanes and floods (Table 1). To help protect the health and safety of the public, responders, and clean-up workers during response and recovery operations from hurricanes and floods, CDC and ATSDR have developed public health guidance and other resources; many are available in both English and Spanish (Table 2).

  12. 77 FR 6625 - Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care...

    Science.gov (United States)

    2012-02-08

    ... DEPARTMENT OF VETERANS AFFAIRS Meeting the Challenge of Pandemic Influenza: Ethical Guidance for... guidance document entitled ``Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and... should indicate that they are submitted in response to ``Meeting the Challenge of Pandemic Influenza...

  13. Study on the Reduced Traffic Congestion Method Based on Dynamic Guidance Information

    Science.gov (United States)

    Li, Shu-Bin; Wang, Guang-Min; Wang, Tao; Ren, Hua-Ling; Zhang, Lin

    2018-05-01

    This paper studies how to generate the reasonable information of travelers’ decision in real network. This problem is very complex because the travelers’ decision is constrained by different human behavior. The network conditions can be predicted by using the advanced dynamic OD (Origin-Destination, OD) estimation techniques. Based on the improved mesoscopic traffic model, the predictable dynamic traffic guidance information can be obtained accurately. A consistency algorithm is designed to investigate the travelers’ decision by simulating the dynamic response to guidance information. The simulation results show that the proposed method can provide the best guidance information. Further, a case study is conducted to verify the theoretical results and to draw managerial insights into the potential of dynamic guidance strategy in improving traffic performance. Supported by National Natural Science Foundation of China under Grant Nos. 71471104, 71771019, 71571109, and 71471167; The University Science and Technology Program Funding Projects of Shandong Province under Grant No. J17KA211; The Project of Public Security Department of Shandong Province under Grant No. GATHT2015-236; The Major Social and Livelihood Special Project of Jinan under Grant No. 20150905

  14. Robust entry guidance using linear covariance-based model predictive control

    Directory of Open Access Journals (Sweden)

    Jianjun Luo

    2017-02-01

    Full Text Available For atmospheric entry vehicles, guidance design can be accomplished by solving an optimal issue using optimal control theories. However, traditional design methods generally focus on the nominal performance and do not include considerations of the robustness in the design process. This paper proposes a linear covariance-based model predictive control method for robust entry guidance design. Firstly, linear covariance analysis is employed to directly incorporate the robustness into the guidance design. The closed-loop covariance with the feedback updated control command is initially formulated to provide the expected errors of the nominal state variables in the presence of uncertainties. Then, the closed-loop covariance is innovatively used as a component of the cost function to guarantee the robustness to reduce its sensitivity to uncertainties. After that, the models predictive control is used to solve the optimal problem, and the control commands (bank angles are calculated. Finally, a series of simulations for different missions have been completed to demonstrate the high performance in precision and the robustness with respect to initial perturbations as well as uncertainties in the entry process. The 3σ confidence region results in the presence of uncertainties which show that the robustness of the guidance has been improved, and the errors of the state variables are decreased by approximately 35%.

  15. Enhanced Automated Guidance System for Horizontal Auger Boring Based on Image Processing.

    Science.gov (United States)

    Wu, Lingling; Wen, Guojun; Wang, Yudan; Huang, Lei; Zhou, Jiang

    2018-02-15

    Horizontal auger boring (HAB) is a widely used trenchless technology for the high-accuracy installation of gravity or pressure pipelines on line and grade. Differing from other pipeline installations, HAB requires a more precise and automated guidance system for use in a practical project. This paper proposes an economic and enhanced automated optical guidance system, based on optimization research of light-emitting diode (LED) light target and five automated image processing bore-path deviation algorithms. An LED light target was optimized for many qualities, including light color, filter plate color, luminous intensity, and LED layout. The image preprocessing algorithm, direction location algorithm, angle measurement algorithm, deflection detection algorithm, and auto-focus algorithm, compiled in MATLAB, are used to automate image processing for deflection computing and judging. After multiple indoor experiments, this guidance system is applied in a project of hot water pipeline installation, with accuracy controlled within 2 mm in 48-m distance, providing accurate line and grade controls and verifying the feasibility and reliability of the guidance system.

  16. NASA-STD-7009 Guidance Document for Human Health and Performance Models and Simulations

    Science.gov (United States)

    Walton, Marlei; Mulugeta, Lealem; Nelson, Emily S.; Myers, Jerry G.

    2014-01-01

    Rigorous verification, validation, and credibility (VVC) processes are imperative to ensure that models and simulations (MS) are sufficiently reliable to address issues within their intended scope. The NASA standard for MS, NASA-STD-7009 (7009) [1] was a resultant outcome of the Columbia Accident Investigation Board (CAIB) to ensure MS are developed, applied, and interpreted appropriately for making decisions that may impact crew or mission safety. Because the 7009 focus is engineering systems, a NASA-STD-7009 Guidance Document is being developed to augment the 7009 and provide information, tools, and techniques applicable to the probabilistic and deterministic biological MS more prevalent in human health and performance (HHP) and space biomedical research and operations.

  17. Association of family-centered care with improved anticipatory guidance delivery and reduced unmet needs in child health care.

    Science.gov (United States)

    Kuo, Dennis Z; Frick, Kevin D; Minkovitz, Cynthia S

    2011-11-01

    Little is known about the association of family-centered care (FCC) with the quality of pediatric primary care. The objectives were to assess (1) associations between family-centered care (FCC), receipt of anticipatory guidance, and unmet need for health care; and (2) whether these associations vary for children with special health care needs (CSHCN). The study, a secondary data analysis of the 2004 Medical Expenditure Panel Survey, used a nationally representative sample of family members of children 0-17 years. We measured receipt of FCC in the last 12 months with a composite score average>3.5 on a 4 point Likert scale from 4 Consumer Assessment of Healthcare Providers and Systems questions. Outcome measures were six anticipatory guidance and six unmet health care service needs items. FCC was reported by 69.6% of family members. One-fifth (22.1%) were CSHCN. Thirty percent of parents reported≥4 of 6 anticipatory guidance topics discussed and 32.5% reported≥1 unmet need. FCC was positively associated with anticipatory guidance for all children (OR=1.45; 95% CI 1.19, 1.76), but no relation was found for CSHCN in stratified analyses (OR=1.01; 95% CI .75, 1.37). FCC was associated with reduced unmet needs (OR=.38; 95% CI .31, .46), with consistent findings for both non-CSHCN and CSHCN subgroups. Family-centered care is associated with greater receipt of anticipatory guidance and reduced unmet needs. The association between FCC and anticipatory guidance did not persist for CSHCN, suggesting the need for enhanced understanding of appropriate anticipatory guidance for this population.

  18. Vision based guidance and flight control in problems of aerial tracking

    Science.gov (United States)

    Stepanyan, Vahram

    The use of visual sensors in providing the necessary information for the autonomous guidance and navigation of the unmanned-air vehicles (UAV) or micro-air vehicles (MAV) applications is inspired by biological systems and is motivated first of all by the reduction of the navigational sensor cost. Also, visual sensors can be more advantageous in military operations since they are difficult to detect. However, the design of a reliable guidance, navigation and control system for aerial vehicles based only on visual information has many unsolved problems, ranging from hardware/software development to pure control-theoretical issues, which are even more complicated when applied to the tracking of maneuvering unknown targets. This dissertation describes guidance law design and implementation algorithms for autonomous tracking of a flying target, when the information about the target's current position is obtained via a monocular camera mounted on the tracking UAV (follower). The visual information is related to the target's relative position in the follower's body frame via the target's apparent size, which is assumed to be constant, but otherwise unknown to the follower. The formulation of the relative dynamics in the inertial frame requires the knowledge of the follower's orientation angles, which are assumed to be known. No information is assumed to be available about the target's dynamics. The follower's objective is to maintain a desired relative position irrespective of the target's motion. Two types of guidance laws are designed and implemented in the dissertation. The first one is a smooth guidance law that guarantees asymptotic tracking of a target, the velocity of which is viewed as a time-varying disturbance, the change in magnitude of which has a bounded integral. The second one is a smooth approximation of a discontinuous guidance law that guarantees bounded tracking with adjustable bounds when the target's acceleration is viewed as a bounded but otherwise

  19. A novel personal health system with integrated decision support and guidance for the management of chronic liver disease.

    Science.gov (United States)

    Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin

    2014-01-01

    A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.

  20. Cycle water chemistry based on film forming amines at power plants: evaluation of technical guidance documents

    Science.gov (United States)

    Dyachenko, F. V.; Petrova, T. I.

    2017-11-01

    Efficiency and reliability of the equipment in fossil power plants as well as in combined cycle power plants depend on the corrosion processes and deposit formation in steam/water circuit. In order to decrease these processes different water chemistries are used. Today the great attention is being attracted to the application of film forming amines and film forming amine products. The International Association for the Properties of Water and Steam (IAPWS) consolidated the information from all over the World, and based on the research studies and operating experience of researchers and engineers from 21 countries, developed and authorized the Technical Guidance Document: “Application of Film Forming Amines in Fossil, Combined Cycle, and Biomass Power Plants” in 2016. This article describe Russian and International technical guidance documents for the cycle water chemistries based on film forming amines at fossil and combined cycle power plants.

  1. Technical bases and guidance for the use of composite soil sampling for demonstrating compliance with radiological release criteria

    International Nuclear Information System (INIS)

    Vitkus, Timothy J.

    2012-01-01

    This guidance provides information on methodologies and the technical bases that licensees should consider for incorporating composite sampling strategies into final status survey (FSS) plans. In addition, this guidance also includes appropriate uses of composite sampling for generating the data for other decommissioning site investigations such as characterization or other preliminary site investigations

  2. Technical bases and guidance for the use of composite soil sampling for demonstrating compliance with radiological release criteria

    Energy Technology Data Exchange (ETDEWEB)

    Vitkus, Timothy J. [Oak Ridge Institute for Science and Education, Oak Ridge, TN (United States). Independent Environmental Assessment and Verification Program

    2012-04-24

    This guidance provides information on methodologies and the technical bases that licensees should consider for incorporating composite sampling strategies into final status survey (FSS) plans. In addition, this guidance also includes appropriate uses of composite sampling for generating the data for other decommissioning site investigations such as characterization or other preliminary site investigations.

  3. Category-based attentional guidance can operate in parallel for multiple target objects.

    Science.gov (United States)

    Jenkins, Michael; Grubert, Anna; Eimer, Martin

    2018-04-30

    The question whether the control of attention during visual search is always feature-based or can also be based on the category of objects remains unresolved. Here, we employed the N2pc component as an on-line marker for target selection processes to compare the efficiency of feature-based and category-based attentional guidance. Two successive displays containing pairs of real-world objects (line drawings of kitchen or clothing items) were separated by a 10 ms SOA. In Experiment 1, target objects were defined by their category. In Experiment 2, one specific visual object served as target (exemplar-based search). On different trials, targets appeared either in one or in both displays, and participants had to report the number of targets (one or two). Target N2pc components were larger and emerged earlier during exemplar-based search than during category-based search, demonstrating the superior efficiency of feature-based attentional guidance. On trials where target objects appeared in both displays, both targets elicited N2pc components that overlapped in time, suggesting that attention was allocated in parallel to these target objects. Critically, this was the case not only in the exemplar-based task, but also when targets were defined by their category. These results demonstrate that attention can be guided by object categories, and that this type of category-based attentional control can operate concurrently for multiple target objects. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Dynamic Eco-Driving Speed Guidance at Signalized Intersections: Multivehicle Driving Simulator Based Experimental Study

    Directory of Open Access Journals (Sweden)

    Peng Chen

    2018-01-01

    Full Text Available Variations in vehicle fuel consumption and gas emissions are usually associated with changes in cruise speed and the aggressiveness of drivers’ acceleration/deceleration, especially at traffic signals. In an attempt to enhance vehicle fuel efficiency on arterials, this study developed a dynamic eco-driving speed guidance strategy (DESGS using real-time signal timing and vehicle positioning information in a connected vehicle (CV environment. DESGS mainly aims to optimize the fuel/emission speed profiles for vehicles approaching signalized intersections. An optimization-based rolling horizon and a dynamic programming approach were proposed to track the optimal guided velocity for individual vehicles along the travel segment. In addition, a vehicle specific power (VSP based approach was integrated into DESGS to estimate the fuel consumption and CO2 emissions. To evaluate the effectiveness of the overall strategy, 15 experienced drivers were recruited to participate in interactive speed guidance experiments using multivehicle driving simulators. It was found that compared to vehicles without speed guidance, those with DESGS had a significantly reduced number of stops and approximately 25% less fuel consumption and CO2 emissions.

  5. Technical note: real-time web-based wireless visual guidance system for radiotherapy.

    Science.gov (United States)

    Lee, Danny; Kim, Siyong; Palta, Jatinder R; Kim, Taeho

    2017-06-01

    Describe a Web-based wireless visual guidance system that mitigates issues associated with hard-wired audio-visual aided patient interactive motion management systems that are cumbersome to use in routine clinical practice. Web-based wireless visual display duplicates an existing visual display of a respiratory-motion management system for visual guidance. The visual display of the existing system is sent to legacy Web clients over a private wireless network, thereby allowing a wireless setting for real-time visual guidance. In this study, active breathing coordinator (ABC) trace was used as an input for visual display, which captured and transmitted to Web clients. Virtual reality goggles require two (left and right eye view) images for visual display. We investigated the performance of Web-based wireless visual guidance by quantifying (1) the network latency of visual displays between an ABC computer display and Web clients of a laptop, an iPad mini 2 and an iPhone 6, and (2) the frame rate of visual display on the Web clients in frames per second (fps). The network latency of visual display between the ABC computer and Web clients was about 100 ms and the frame rate was 14.0 fps (laptop), 9.2 fps (iPad mini 2) and 11.2 fps (iPhone 6). In addition, visual display for virtual reality goggles was successfully shown on the iPhone 6 with 100 ms and 11.2 fps. A high network security was maintained by utilizing the private network configuration. This study demonstrated that a Web-based wireless visual guidance can be a promising technique for clinical motion management systems, which require real-time visual display of their outputs. Based on the results of this study, our approach has the potential to reduce clutter associated with wired-systems, reduce space requirements, and extend the use of medical devices from static usage to interactive and dynamic usage in a radiotherapy treatment vault.

  6. Guidance on the scientific requirements for health claims related to the immune system, the gastrointestinal tract and defence against pathogenic microorganisms

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2016-01-01

    The European Food Safety Authority (EFSA) has asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to update the guidance on the scientific requirements for health claims related to gut and immune function published in 2011. Since then, the NDA Panel has completed the evaluation...... the shortcomings that prevented the substantiation of these claims. The general document represents the views of the NDA Panel based on the experience gained to date with the evaluation of health claims, and it may be further updated, as appropriate, in the light of experiences gained from the evaluation...

  7. British Association for the Study of Community Dentistry (BASCD) guidance on sampling for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

    Science.gov (United States)

    Pine, C M; Pitts, N B; Nugent, Z J

    1997-03-01

    The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the sampling for these surveys.

  8. A One Health Message about Bats Increases Intentions to Follow Public Health Guidance on Bat Rabies.

    Directory of Open Access Journals (Sweden)

    Hang Lu

    Full Text Available Since 1960, bat rabies variants have become the greatest source of human rabies deaths in the United States. Improving rabies awareness and preventing human exposure to rabid bats remains a national public health priority today. Concurrently, conservation of bats and the ecosystem benefits they provide is of increasing importance due to declining populations of many bat species. This study used a visitor-intercept experiment (N = 521 in two U.S. national parks where human and bat interactions occur on an occasional basis to examine the relative persuasiveness of four messages differing in the provision of benefit and uncertainty information on intentions to adopt a rabies exposure prevention behavior. We found that acknowledging benefits of bats in a risk message led to greater intentions to adopt the recommended rabies exposure prevention behavior without unnecessarily stigmatizing bats. These results signify the importance of communicating benefits of bats in bat rabies prevention messages to benefit both human and wildlife health.

  9. School Based Health Centers

    Science.gov (United States)

    Children's Aid Society, 2012

    2012-01-01

    School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…

  10. Identifying evidence for public health guidance: a comparison of citation searching with Web of Science and Google Scholar.

    Science.gov (United States)

    Levay, Paul; Ainsworth, Nicola; Kettle, Rachel; Morgan, Antony

    2016-03-01

    To examine how effectively forwards citation searching with Web of Science (WOS) or Google Scholar (GS) identified evidence to support public health guidance published by the National Institute for Health and Care Excellence. Forwards citation searching was performed using GS on a base set of 46 publications and replicated using WOS. WOS and GS were compared in terms of recall; precision; number needed to read (NNR); administrative time and costs; and screening time and costs. Outcomes for all publications were compared with those for a subset of highly important publications. The searches identified 43 relevant publications. The WOS process had 86.05% recall and 1.58% precision. The GS process had 90.7% recall and 1.62% precision. The NNR to identify one relevant publication was 63.3 with WOS and 61.72 with GS. There were nine highly important publications. WOS had 100% recall, 0.38% precision and NNR of 260.22. GS had 88.89% recall, 0.33% precision and NNR of 300.88. Administering the WOS results took 4 h and cost £88-£136, compared with 75 h and £1650-£2550 with GS. WOS is recommended over GS, as citation searching was more effective, while the administrative and screening times and costs were lower. Copyright © 2015 John Wiley & Sons, Ltd.

  11. General guidance for stakeholders on the evaluation of Article 13.1, 13.5 and 14 health claims

    DEFF Research Database (Denmark)

    Tetens, Inge

    2011-01-01

    to nutrition and health claims, and establishes rules governing the Community authorisation of health claims made on foods. This general guidance is a combined and updated version of two previous briefing documents (frequently asked question document related to the assessment of Article 14 and 13.5 health...... of available scientific evidence, pertinent studies for substantiation of health claims, wording of claims, the extent to which a food needs to be characterised for the claimed effect, claimed effects which are beneficial physiological effects, definition of a risk factor for the development of a human disease...

  12. [Validity of a standard questionnaire to assess physical activity for specific medical checkups and health guidance].

    Science.gov (United States)

    Kawakami, Ryoko; Miyachi, Motohiko

    2010-10-01

    This study aimed to determine the validity of a standard questionnaire to assess amount of physical activity (PA) and cardiorespiratory fitness (VO2peak). A total of 483 men and women, aged 20 to 69 years, participated. The standard questionnaire included 3 items about exercise, PA, and walking speed. All questions were designed to require an answer of Yes or No. Subjects were classified into one of four groups regarding the number of Yes answers to the three questions, giving activity levels of 0 to 3. The amount of PA was measured objectively with a tn-axial accelerometer which could also calculate daily step counts, and the amounts of PA under 3 metabolic equivalents (METs) and at 3 METs or more. VO2peak. was measured by incremental cycle exercise tests with indirect calorimetry. The daily step counts, the amount of PA at 3 METs or more, and the VO2peak. were significantly higher in subjects who answered Yes to each question than in those who answered No. Sensitivity and specificity of each question were 62-73% and 45-71% for the amount of PA established with the "Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006)". The sum of sensitivity and specificity was the highest when the cutoff value was activity level 2 (sensitivity 73%, specificity 68%). Sensitivity and specificity for VO2max established by EPAR2006 were lower than those for the amount of PA. These results suggest that only answering simple questions with a standard questionnaire is sufficient for estimation of PA levels for specific medical checkups and health guidance, even though the accuracy is somewhat limited.

  13. Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

    Directory of Open Access Journals (Sweden)

    Germaine Hanquet

    2015-01-01

    Full Text Available The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

  14. Career guidance in communities

    DEFF Research Database (Denmark)

    Thomsen, Rie

    for the development of a critically reflexive career guidance practice. The considerations are organised around seven elements. 1. Creating opportunity, structure and access 2. Entering a community and increasing visibility 3. Providing guidance in communities 4. Exploring potentials in guidance situations 5...... in career guidance practices as well as in the lives of the people in the communities. This paper falls into two parts: The first part considers the collective as the starting point for the development of meaningful career guidance activities. Based on previous research on career guidance in communities......The aim of this paper is to inspire practitioners and professionals to leave their offices to bring career guidance into communities that might not identify with career guidance in the first instance. By making the effort to engage with communities, practitioners may bring about a critical change...

  15. Vehicle speed guidance strategy at signalized intersection based on cooperative vehicle infrastructure system

    Directory of Open Access Journals (Sweden)

    Fengyuan JIA

    2017-10-01

    Full Text Available In order to reduce stopping time of vehicle at a signalized intersection, aiming at the difficulty, even the impossibility to obtain real-time queue length of intersection in third and fourth-tier cities in China sometimes, a speed guidance strategy based on cooperative vehicle infrastructure system is put forward and studied. For validating the strategy, the traffic signal timing data of the intersection at Hengshan Road and North Fengming Lake Road in Wuhu is collected by a vehicular traffic signal reminder system which is designed. The simulation experiments using the acquired data are done by software VISSIM. The simulation results demonstrate that the strategy under high and low traffic flow can effectively decrease the link travel-time, reducing average ratio is 9.2 % and 13.0 %, respectively, and the effect under low traffic flow is better than that under high traffic flow. The strategy improves efficiency of traffic at a signalized intersection and provides an idea for the application of vehicle speed guidance based on cooperative vehicle infrastructure system.

  16. WHO guidance grounded in a comprehensive approach to sexual and reproductive health and human rights: topical pre-exposure prophylaxis.

    Science.gov (United States)

    Lusti-Narasimhan, Manjula; Khosla, Rajat; Baggaley, Rachel; Temmerman, Marleen; McGrory, Elizabeth; Farley, Tim

    2014-01-01

    Two new microbicide products based on topical (vaginal) application of antiretroviral drugs - 1% tenofovir gel and the dapivirine ring - are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre-exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used. Given that these new topical PrEP products are designed to be woman initiated and will likely be delivered in reproductive health settings, it is important to ensure that the guidance be framed in the context of comprehensive sexual and reproductive health and human rights. In addition to the safety and effectiveness data resulting from clinical trials, and the regulatory approval required for new products, the WHO normative guidelines on the use of topical PrEP will be essential for rapid roll-out in countries. Human rights standards and principles provide a framework for the provision of woman-initiated HIV prevention products. These include addressing issues related to the gender inequities which are linked to the provision of HIV-prevention, treatment and care for young girls and women. Effective programming for women and girls must therefore be based on understanding the local, social and community contexts of the AIDS epidemic in the country, and adapting HIV strategies and programmes accordingly. Such a framework therefore is needed not only to ensure optimal uptake of these new products by women and girls but also to address sociocultural barriers to women's and girls' access to these products.

  17. Interpreting the International Right to Health in a Human Rights-Based Approach to Health

    OpenAIRE

    Hunt, Paul

    2016-01-01

    Abstract This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing...

  18. Patch-based frame interpolation for old films via the guidance of motion paths

    Science.gov (United States)

    Xia, Tianran; Ding, Youdong; Yu, Bing; Huang, Xi

    2018-04-01

    Due to improper preservation, traditional films will appear frame loss after digital. To deal with this problem, this paper presents a new adaptive patch-based method of frame interpolation via the guidance of motion paths. Our method is divided into three steps. Firstly, we compute motion paths between two reference frames using optical flow estimation. Then, the adaptive bidirectional interpolation with holes filled is applied to generate pre-intermediate frames. Finally, using patch match to interpolate intermediate frames with the most similar patches. Since the patch match is based on the pre-intermediate frames that contain the motion paths constraint, we show a natural and inartificial frame interpolation. We test different types of old film sequences and compare with other methods, the results prove that our method has a desired performance without hole or ghost effects.

  19. A Treatise on the Systematization of School Health Guidance (3) : The Formation of the Comcept of Guidance under the Theory of School Health in the Meiji Era

    OpenAIRE

    瀧澤, 利行

    1990-01-01

    In early Meiji era, the foundations of theories on school health in Japan were formed by translation and interpretation of theories on school health in mordern Europe. Simultaneously, school health practices were consisted of three backgrounds, community prevention of infectious diseases, the maintenance of school facilities, and school child protections. The points of this treatise are summurised as follows. 1) the assesment the dates of realization of each backgrounds above mentioned. 2) th...

  20. GUIDANCE COUNSELOR INSTITUTE FOR HEALTH CAREERS (JULY 7-22, 1966).

    Science.gov (United States)

    MORGAN, PHILIP W.

    THE INSTITUTE, SPONSORED BY A FEDERATED CHARITY REPRESENTING 78 NONPROFIT VOLUNTARY HOSPITALS IN NEW YORK CITY, WAS ATTENDED BY 48 HIGH SCHOOL AND EMPLOYMENT SERVICE COUNSELORS. THE NEED FOR SUCH INSTITUTES WAS DOCUMENTED BY A PRE-INSTITUTE QUESTIONNAIRE TO LICENSED GUIDANCE COUNSELORS. TO EVALUATE THE INSTITUTE, THE PROFESSIONAL EXAMINATION…

  1. Feasibility of a dynamic web guidance approach for personalized physical activity prescription based on daily information from wearable technology.

    Science.gov (United States)

    Coolbaugh, Crystal L; Raymond, Stephen C; Hawkins, David A

    2015-06-04

    Computer tailored, Web-based interventions have emerged as an effective approach to promote physical activity. Existing programs, however, do not adjust activities according to the participant's compliance or physiologic adaptations, which may increase risk of injury and program attrition in sedentary adults. To address this limitation, objective activity monitor (AM) and heart rate data could be used to guide personalization of physical activity, but improved Web-based frameworks are needed to test such interventions. The objective of this study is to (1) develop a personalized physical activity prescription (PPAP) app that combines dynamic Web-based guidance with multi-sensor AM data to promote physical activity and (2) to assess the feasibility of using this system in the field. The PPAP app was constructed using an open-source software platform and a custom, multi-sensor AM capable of accurately measuring heart rate and physical activity. A novel algorithm was written to use a participant's compliance and physiologic response to aerobic training (ie, changes in daily resting heart rate) recorded by the AM to create daily, personalized physical activity prescriptions. In addition, the PPAP app was designed to (1) manage the transfer of files from the AM to data processing software and a relational database, (2) provide interactive visualization features such as calendars and training tables to encourage physical activity, and (3) enable remote administrative monitoring of data quality and participant compliance. A 12-week feasibility study was performed to assess the utility and limitations of the PPAP app used by sedentary adults in the field. Changes in physical activity level and resting heart rate were monitored throughout the intervention. The PPAP app successfully created daily, personalized physical activity prescriptions and an interactive Web environment to guide and promote physical activity by the participants. The varied compliance of the

  2. Optical fiber tip interferometer gas pressure sensor based on anti-resonant reflecting guidance mechanism

    Science.gov (United States)

    Yang, Y. B.; Wang, D. N.; Xu, Ben; Wang, Z. K.

    2018-05-01

    We propose and demonstrate a gas pressure sensor based on an anti-resonant reflecting guidance (ARRG) mechanism in quartz capillary tube with an open cavity. The device is simple in fabrication by only fusion splicing a segment of capillary tube with single mode fiber. It has compact size, robust structure, convenient mode of operation, and high sensitivity of 4.278 nm/MPa. Moreover, as two Faby-Perot cavities exist in the device, which create the interference spectrum with several distinct resonance dips, a simultaneous gas pressure and temperature detection can be readily achieved by tracing two dip wavelengths. The error in the measurement due to the choice of different resonant dips can be effectively reduced by using the Fourier band pass filtering method.

  3. Guidance for Decision Making based on Extended PSA. Volume 1 - Summary report

    International Nuclear Information System (INIS)

    Loeffler, H.; Kumar, M.; Raimond, E.

    2016-01-01

    This report of ASAMPSA-E project is a summary report of the WP30 activities which were intended to develop guidance on decision-making process based on extended PSA results, when the PSA scope has been extended to all sources of radioactivity, all internal and relevant external events. It summarizes the ASAMPSA-E recommendations on: - the lessons of Fukushima Dai-ichi accident for PSA, - the risk metrics, - the method for identifying Initiating Events and Hazards for an Extended PSA (screening), - the link between extended PSA and the defense-in-depth concept. The report then provides some general considerations on application of extended PSA results, criteria that can be applied and also some difficulties inherent to the status of extended PSAs. (authors)

  4. Manipulation robot system based on visual guidance for sealing blocking plate of steam generator

    International Nuclear Information System (INIS)

    Duan Xingguang; Wang Yonggui; Li Meng; Kong Xiangzhan; Liu Qingsong

    2016-01-01

    To reduce labor intensity and irradiation exposure time inside the steam generator during the maintenance period of the nuclear power plant, a blocking plate manipulation robot system, including manipulation robot and pneumatic control console, is developed as an automatic remote-control tool to help staff to complete sealing steam generator primary pipes. The manipulation robot for fastening/loosening bolts utilizes visual guidance for target position, and the recognition algorithm is exerted to extract the bolt center coordinate values from image captured by camera in the procedure. The control strategy based on the position and current feedback is proposed for single bolt operation and whole bolts automatic operation. Meanwhile, the virtual interactive interface and remote monitoring are designed to improve the operability and safety. Finally, the relative experiments have verified the work effectiveness and the future work would be discussed. (author)

  5. A Critical Analysis of UNESCO's International Technical Guidance on School-Based Education for Puberty and Sexuality

    Science.gov (United States)

    Goldman, Juliette D. G.

    2012-01-01

    Preparing children and adolescents for sexual safety and reproductive responsibility lies at the heart and purpose of puberty/sexuality education. The document of International Technical Guidance released by UNESCO in December 2009 aims to provide an evidence-based and rights-based platform offering children and adolescents vital knowledge about…

  6. Design of Second-Order Sliding Mode Guidance Law Based on the Nonhomogeneous Disturbance Observer

    Directory of Open Access Journals (Sweden)

    Huibo Zhou

    2014-01-01

    Full Text Available Considering the guidance problem of relative motion of missile target without the dynamic characteristics of missile autopilot in the interception planar, non-homogeneous disturbance observer is applied for finite-time estimation with respect to the target maneuvering affecting the guidance performance. Two guidance laws with finite-time convergence are designed by using a fast power rate reaching law and the prescribed sliding variable dynamics. The nonsingular terminal sliding mode surface is selected to improve dynamic characteristics of missile autopilot. Furthermore, the finite-time guidance law with dynamic delay characteristics is designed for the target maneuvering through adopting variable structure dynamic compensation. The simulation results demonstrate that, for different target maneuvering, the proposed guidance laws can restrain the sliding mode chattering problem effectively and make the missile hit the maneuvering target quickly and accurately with condition of corresponding assumptions.

  7. Guidance on health effects of toxic chemicals. Safety Analysis Report Update Program

    Energy Technology Data Exchange (ETDEWEB)

    Foust, C.B.; Griffin, G.D.; Munro, N.B.; Socolof, M.L.

    1994-02-01

    Martin Marietta Energy Systems, Inc. (MMES), and Martin Marietta Utility Services, Inc. (MMUS), are engaged in phased programs to update the safety documentation for the existing US Department of Energy (DOE)-owned facilities. The safety analysis of potential toxic hazards requires a methodology for evaluating human health effects of predicted toxic exposures. This report provides a consistent set of health effects and documents toxicity estimates corresponding to these health effects for some of the more important chemicals found within MMES and MMUS. The estimates are based on published toxicity information and apply to acute exposures for an ``average`` individual. The health effects (toxicological endpoints) used in this report are (1) the detection threshold; (2) the no-observed adverse effect level; (3) the onset of irritation/reversible effects; (4) the onset of irreversible effects; and (5) a lethal exposure, defined to be the 50% lethal level. An irreversible effect is defined as a significant effect on a person`s quality of life, e.g., serious injury. Predicted consequences are evaluated on the basis of concentration and exposure time.

  8. Religious leaders' opinions and guidance towards oral health maintenance and promotion: a qualitative study.

    Science.gov (United States)

    Zini, Avraham; Sgan-Cohen, Harold D; Feder-Bubis, Paula

    2015-04-01

    Religions emphasize the supreme value of life. However, potential or concrete conflicts of perception between dictates of faith and science often present an inescapable dilemma. The aim of this qualitative research was to examine the views of spiritual and religious leaders towards general and oral health issues. A total of 11 eminent Jewish spiritual and religious community leaders were purposively chosen. They were interviewed using a semi-structured questionnaire. The verbatim transcriptions of the interviews were analysed in the spirit of grounded theory, using qualitative data analysis software. Open, axial, and thematic coding served to build categories and themes. Analysis of participants' perspectives reflected that they, based upon Jewish theology, attributed high importance to primary prevention at both personal and community levels. Religious and orthodox people were depicted as being motivated towards maintaining oral health behaviours due to a sense of obligation to follow religious edicts, strong social support, and elevated perceived spiritual levels. We offer a theoretical model that can explain the potential high motivation among these communities towards implementing positive general and oral health behaviours. Religiosity may be regarded as an example of a psycho-social health determinant, encompassing spiritual belief ("psycho") and social support ("social") components.

  9. Photoacoustic-based approach to surgical guidance performed with and without a da Vinci robot

    Science.gov (United States)

    Gandhi, Neeraj; Allard, Margaret; Kim, Sungmin; Kazanzides, Peter; Lediju Bell, Muyinatu A.

    2017-12-01

    Death and paralysis are significant risks of modern surgeries, caused by injury to blood vessels and nerves hidden by bone and other tissue. We propose an approach to surgical guidance that relies on photoacoustic (PA) imaging to determine the separation between these critical anatomical features and to assess the extent of safety zones during surgical procedures. Images were acquired as an optical fiber was swept across vessel-mimicking targets, in the absence and presence of teleoperation with a research da Vinci Surgical System. Vessel separation distances were measured directly from PA images. Vessel positions were additionally recorded based on the fiber position (calculated from the da Vinci robot kinematics) that corresponded to an observed PA signal, and these recordings were used to indirectly measure vessel separation distances. Amplitude- and coherence-based beamforming were used to estimate vessel separations, resulting in 0.52- to 0.56-mm mean absolute errors, 0.66- to 0.71-mm root-mean-square errors, and 65% to 68% more accuracy compared to fiber position measurements obtained through the da Vinci robot kinematics. Similar accuracy was achieved in the presence of up to 4.5-mm-thick ex vivo tissue. Results indicate that PA image-based measurements of the separation among anatomical landmarks could be a viable method for real-time path planning in multiple interventional PA applications.

  10. Structure-based thresholds of toxicological concern-guidance for application to substances present at low levels in the diet

    International Nuclear Information System (INIS)

    Renwick, A.G.

    2005-01-01

    Health-based guidance values, such as the ADI, use chemical-specific data to determine the highest intake that would be without significant adverse health effects. A threshold of toxicological concern (TTC) is a level of intake predicted to be without adverse effects based on the toxicity of structurally related compounds. The main advantage of the use of TTCs is that the risk of low exposures can be evaluated without the need for chemical-specific animal toxicity data. TTCs have been used for many years for screening the safety of packaging migrants by the FDA in the USA, and of flavoring substances, by the JECFA. A recent reassessment of the use of TTCs, organized by ILSI Europe, has developed a decision tree which allows a systematic approach to the evaluation of low levels of diverse chemicals in food. The decision tree incorporates a series of increasing TTC values into a step-wise approach. Potentially genotoxic carcinogens are considered first, based on the presence of known structural alerts. Aflatoxin-like, azoxy- and nitroso-compounds are removed from consideration because they are the most potent, and a practical TTC could not be established. Other compounds with structural alerts for genotoxicity are allocated a TTC of 0.15 μg/person per day. Compounds without structural alerts for genotoxicity are evaluated based on chemical structure and intake using a series of TTC values derived by the application of a 100-fold uncertainty factor to the 5th percentile of the distribution of NOAELs from chronic studies on compounds sharing similar structural characteristics

  11. The relationship between playing computer or video games with mental health and social relationships among students in guidance schools, Kermanshah.

    Science.gov (United States)

    Reshadat, S; Ghasemi, S R; Ahmadian, M; RajabiGilan, N

    2014-01-09

    Computer or video games are a popular recreational activity and playing them may constitute a large part of leisure time. This cross-sectional study aimed to evaluate the relationship between playing computer or video games with mental health and social relationships among students in guidance schools in Kermanshah, Islamic Republic of Iran, in 2012. Our total sample was 573 students and our tool was the General Health Questionnaire (GHQ-28) and social relationships questionnaires. Survey respondents reported spending an average of 71.07 (SD 72.1) min/day on computer or video games. There was a significant relationship between time spent playing games and general mental health (P computer or video games with social relationships and their subscales, including trans-local relationships (P games (P < 0.02) and its dimensions, except for family relationships.

  12. Localized intraoperative virtual endoscopy (LIVE) for surgical guidance in 16 skull base patients.

    Science.gov (United States)

    Haerle, Stephan K; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian; Gentili, Fred; Zadeh, Gelareh; Kucharczyk, Walter; Irish, Jonathan C

    2015-01-01

    Previous preclinical studies of localized intraoperative virtual endoscopy-image-guided surgery (LIVE-IGS) for skull base surgery suggest a potential clinical benefit. The first aim was to evaluate the registration accuracy of virtual endoscopy based on high-resolution magnetic resonance imaging under clinical conditions. The second aim was to implement and assess real-time proximity alerts for critical structures during skull base drilling. Patients consecutively referred for sinus and skull base surgery were enrolled in this prospective case series. Five patients were used to check registration accuracy and feasibility with the subsequent 11 patients being treated under LIVE-IGS conditions with presentation to the operating surgeon (phase 2). Sixteen skull base patients were endoscopically operated on by using image-based navigation while LIVE-IGS was tested in a clinical setting. Workload was quantitatively assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Real-time localization of the surgical drill was accurate to ~1 to 2 mm in all cases. The use of 3-mm proximity alert zones around the carotid arteries and optic nerve found regular clinical use, as the median minimum distance between the tracked drill and these structures was 1 mm (0.2-3.1 mm) and 0.6 mm (0.2-2.5 mm), respectively. No statistical differences were found in the NASA-TLX indicators for this experienced surgical cohort. Real-time proximity alerts with virtual endoscopic guidance was sufficiently accurate under clinical conditions. Further clinical evaluation is required to evaluate the potential surgical benefits, particularly for less experienced surgeons or for teaching purposes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  13. Piloted Simulator Evaluation Results of Flight Physics Based Stall Recovery Guidance

    Science.gov (United States)

    Lombaerts, Thomas; Schuet, Stefan; Stepanyan, Vahram; Kaneshige, John; Hardy, Gordon; Shish, Kimberlee; Robinson, Peter

    2018-01-01

    In recent studies, it has been observed that loss of control in flight is the most frequent primary cause of accidents. A significant share of accidents in this category can be remedied by upset prevention if possible, and by upset recovery if necessary, in this order of priorities. One of the most important upsets to be recovered from is stall. Recent accidents have shown that a correct stall recovery maneuver remains a big challenge in civil aviation, partly due to a lack of pilot training. A possible strategy to support the flight crew in this demanding context is calculating a recovery guidance signal, and showing this signal in an intuitive way on one of the cockpit displays, for example by means of the flight director. Different methods for calculating the recovery signal, one based on fast model predictive control and another using an energy based approach, have been evaluated in four relevant operational scenarios by experienced commercial as well as test pilots in the Vertical Motion Simulator at NASA Ames Research Center. Evaluation results show that this approach could be able to assist the pilots in executing a correct stall recovery maneuver.

  14. The role of guidance in computer-based problem solving for the development of concepts of logic

    NARCIS (Netherlands)

    Eysink, Tessa H.S.; Dijkstra, S.; Kuper, Jan

    The effect of two instructional variables, manipulation of objects and guidance, in learning to use the logical connective, conditional, was investigated. Instructions for 72 first- and second year social science students were varied in the computer-based learning environment Tarski’s World,

  15. 76 FR 53683 - Draft Guidance for Industry on Oversight of Clinical Investigations: A Risk-Based Approach to...

    Science.gov (United States)

    2011-08-29

    ... 200N, Rockville, MD 20852-1448; or the Office of Communication, Education and Radiation Programs... describes a modern, risk-based approach to monitoring that focuses on critical study parameters and relies... appropriate, and other forms of information technology. Title: Draft Guidance for Industry: Oversight of...

  16. Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

    Science.gov (United States)

    Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

    2014-01-01

    Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

  17. EFSA Panel on Dietetic Products, Nutrition and Allerg ies (NDA) ; Guidance on the scientific requirements for health claims related to appetite ratings, weight management, and blood glucose concentrations

    DEFF Research Database (Denmark)

    Tetens, Inge

    The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to draft guidance on scientific requirements for health claims related to appetite ratings, weight management, and blood glucose concentrations. This guidance has been drawn from scientific...... and studies/outcome measures which are acceptable. Rather, it presents examples drawn from evaluations already carried out in order to illustrate the approach of the Panel, as well as some examples which are currently under consideration within ongoing evaluations. A draft of this guidance document, endorsed...

  18. Altitude control in honeybees: joint vision-based learning and guidance.

    Science.gov (United States)

    Portelli, Geoffrey; Serres, Julien R; Ruffier, Franck

    2017-08-23

    Studies on insects' visual guidance systems have shed little light on how learning contributes to insects' altitude control system. In this study, honeybees were trained to fly along a double-roofed tunnel after entering it near either the ceiling or the floor of the tunnel. The honeybees trained to hug the ceiling therefore encountered a sudden change in the tunnel configuration midways: i.e. a "dorsal ditch". Thus, the trained honeybees met a sudden increase in the distance to the ceiling, corresponding to a sudden strong change in the visual cues available in their dorsal field of view. Honeybees reacted by rising quickly and hugging the new, higher ceiling, keeping a similar forward speed, distance to the ceiling and dorsal optic flow to those observed during the training step; whereas bees trained to follow the floor kept on following the floor regardless of the change in the ceiling height. When trained honeybees entered the tunnel via the other entry (the lower or upper entry) to that used during the training step, they quickly changed their altitude and hugged the surface they had previously learned to follow. These findings clearly show that trained honeybees control their altitude based on visual cues memorized during training. The memorized visual cues generated by the surfaces followed form a complex optic flow pattern: trained honeybees may attempt to match the visual cues they perceive with this memorized optic flow pattern by controlling their altitude.

  19. Combined measurement system for double shield tunnel boring machine guidance based on optical and visual methods.

    Science.gov (United States)

    Lin, Jiarui; Gao, Kai; Gao, Yang; Wang, Zheng

    2017-10-01

    In order to detect the position of the cutting shield at the head of a double shield tunnel boring machine (TBM) during the excavation, this paper develops a combined measurement system which is mainly composed of several optical feature points, a monocular vision sensor, a laser target sensor, and a total station. The different elements of the combined system are mounted on the TBM in suitable sequence, and the position of the cutting shield in the reference total station frame is determined by coordinate transformations. Subsequently, the structure of the feature points and matching technique for them are expounded, the position measurement method based on monocular vision is presented, and the calibration methods for the unknown relationships among different parts of the system are proposed. Finally, a set of experimental platforms to simulate the double shield TBM is established, and accuracy verification experiments are conducted. Experimental results show that the mean deviation of the system is 6.8 mm, which satisfies the requirements of double shield TBM guidance.

  20. THE GHOST IN THE MACHINE? THE VALUE OF EXPERT ADVICE IN THE PRODUCTION OF EVIDENCE-BASED GUIDANCE: A MIXED METHODS STUDY OF THE NICE INTERVENTIONAL PROCEDURES PROGRAMME.

    Science.gov (United States)

    Oyebode, Oyinlola; Patrick, Hannah; Walker, Alexander; Campbell, Bruce; Powell, John

    2016-01-01

    The aim of this study was to determine the aspects of expert advice that decision makers find most useful in the development of evidence-based guidance and to identify the characteristics of experts providing the most useful advice. First, semi-structured interviews were conducted with seventeen members of the Interventional Procedures Advisory Committee of the UK's National Institute of Health and Care Excellence. Interviews examined the usefulness of expert advice during guidance development. Transcripts were analyzed inductively to identify themes. Second, data were extracted from 211 experts' questionnaires for forty-one consecutive procedures. Usefulness of advice was scored using an index developed through the qualitative work. Associations between usefulness score and characteristics of the expert advisor were investigated using univariate and multivariate analyses. Expert opinion was seen as a valued complement to empirical evidence, providing context and tacit knowledge unavailable in published literature, but helpful for interpreting it. Interviewees also valued advice on the training and experience required to perform a procedure, on patient selection criteria and the place of a procedure within a clinical management pathway. Limitations of bias in expert opinion were widely acknowledged and skepticism expressed regarding the anecdotal nature of advice on safety or efficacy outcomes. Quantitative analysis demonstrated that the most useful advice was given by clinical experts with direct personal experience of the procedure, particularly research experience. Evidence-based guidance production is often characterized as a rational, pipeline process. This ignores the valuable role that expert opinion plays in guidance development, complementing and supporting the interpretation of empirical data.

  1. SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T; Yue, N; Jabbour, S; Zhang, M [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components that were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy

  2. SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

    International Nuclear Information System (INIS)

    Chen, T; Yue, N; Jabbour, S; Zhang, M

    2016-01-01

    Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components that were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy

  3. Guidance on the implementation of a risk based safety performance monitoring system for nuclear power plants

    International Nuclear Information System (INIS)

    Sewell, R.T.; Kuritzky, A.S.; Khatib-Rahbar, M.

    1997-05-01

    The principal objective of the present study is to review and evaluate existing Performance Indicator (PI) monitoring programs, and to develop and demonstrate an overall PSA-based methodology and framework for the monitoring and use of risk-based PIs and SIs (Safety Indicator), that would enable: Identification of trends and patterns in safety performance at a specific plant and a population of plants; Assessment of the significance of the trends and patterns; Identification of precursors of accident sequences and safety reductions; Identification of the most critical functional areas of concern, especially as they relate to a defense-in-depth safety philosophy; Comparison of safety performance trends at a plant with those at comparable plants; Incorporation of the PIs and SIs into a risk- and performance-based decision process. To support the overall project objective, it is important that information needs and data collection procedures are clearly outlined. Of key significance in this regard is the premise that a performance monitoring system should not be burdened by an excessive number of low-level PIs that may have only a peripheral relationship to safety. Other supporting objectives of the study include: To identify and discuss other issues pertaining to the practical implementation of a safety performance monitoring system (outlining the databases and algorithms needed); and to demonstrate implementation of the preliminary guidance for monitoring and use of the selected set of PIs and SIs, within the proposed framework, via application to the operating history of a NPP having a PSA and readily available event data

  4. Guidance for implementing an environmental, safety, and health assurance program. Volume 10. Model guidlines for line organization environmental, safety and health audits and appraisals

    International Nuclear Information System (INIS)

    Ellingson, A.C.

    1981-10-01

    This is 1 of 15 documents designed to illustrate how an Environmental, Safety and Health (ES and H) Assurance Program may be implemented. The generic definition of ES and H Assurance Programs is given in a companion document entitled An Environmental, Safety and Health Assurance Program Standard. The Standard specifies that the operational level of an institution must have an internal assurance function, and this document provides guidance for the audit/appraisal portion of the operational level's ES and H program. The appendixes include an ES and H audit checklist, a sample element rating guide, and a sample audit plan for working level line organization internal audits

  5. Guidance for implementing an environmental, safety, and health-assurance program. Volume 15. A model plan for line organization environmental, safety, and health-assurance programs

    Energy Technology Data Exchange (ETDEWEB)

    Ellingson, A.C.; Trauth, C.A. Jr.

    1982-01-01

    This is 1 of 15 documents designed to illustrate how an Environmental, Safety and Health (ES and H) Assurance Program may be implemented. The generic definition of ES and H Assurance Programs is given in a companion document entitled An Environmental, Safety and Health Assurance Program Standard. This particular document presents a model operational-level ES and H Assurance Program that may be used as a guide by an operational-level organization in developing its own plan. The model presented here reflects the guidance given in the total series of 15 documents.

  6. Improving health promotion through central rating of interventions: the need for Responsive Guidance.

    NARCIS (Netherlands)

    Kok, Maarten Olivier; Bal, Roland; Roelofs, Caspar David; Schuit, Albertine Jantine

    2017-01-01

    In several countries, attempts are made to improve health promotion by centrally rating the effectiveness of health promotion interventions. The Dutch Effectiveness Rating System (ERS) for health promotion interventions is an improvement-oriented approach in which multi-disciplinary expert

  7. Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

    Science.gov (United States)

    Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

    2016-01-01

    UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…

  8. A speed guidance strategy for multiple signalized intersections based on car-following model

    Science.gov (United States)

    Tang, Tie-Qiao; Yi, Zhi-Yan; Zhang, Jian; Wang, Tao; Leng, Jun-Qiang

    2018-04-01

    Signalized intersection has great roles in urban traffic system. The signal infrastructure and the driving behavior near the intersection are paramount factors that have significant impacts on traffic flow and energy consumption. In this paper, a speed guidance strategy is introduced into a car-following model to study the driving behavior and the fuel consumption in a single-lane road with multiple signalized intersections. The numerical results indicate that the proposed model can reduce the fuel consumption and the average stop times. The findings provide insightful guidance for the eco-driving strategies near the signalized intersections.

  9. Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

    Directory of Open Access Journals (Sweden)

    Christopher E. McCoy

    2014-11-01

    Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

  10. A guidance law for UAV autonomous aerial refueling based on the iterative computation method

    Directory of Open Access Journals (Sweden)

    Luo Delin

    2014-08-01

    Full Text Available The rendezvous and formation problem is a significant part for the unmanned aerial vehicle (UAV autonomous aerial refueling (AAR technique. It can be divided into two major phases: the long-range guidance phase and the formation phase. In this paper, an iterative computation guidance law (ICGL is proposed to compute a series of state variables to get the solution of a control variable for a UAV conducting rendezvous with a tanker in AAR. The proposed method can make the control variable converge to zero when the tanker and the UAV receiver come to a formation flight eventually. For the long-range guidance phase, the ICGL divides it into two sub-phases: the correction sub-phase and the guidance sub-phase. The two sub-phases share the same iterative process. As for the formation phase, a velocity coordinate system is created by which control accelerations are designed to make the speed of the UAV consistent with that of the tanker. The simulation results demonstrate that the proposed ICGL is effective and robust against wind disturbance.

  11. VA Mental Health: Clearer Guidance on Access Policies and Wait-Time Data Needed

    Science.gov (United States)

    2015-10-01

    Abuse and Mental Health Services Administration, the nation faces a current shortage in the mental health and addiction services workforce, and that...order. Call for additional information. Connect with GAO on Facebook , Flickr, Twitter, and YouTube. Subscribe to our RSS Feeds or E-mail Updates

  12. 78 FR 25758 - Migratory Birds; Eagle Conservation Plan Guidance: Module 1-Land-Based Wind Energy, Version 2

    Science.gov (United States)

    2013-05-02

    ...-FXMB123209EAGL0L2] RIN 1018-AX53 Migratory Birds; Eagle Conservation Plan Guidance: Module 1-- Land-Based Wind... Migratory Bird Management, U.S. Fish and Wildlife Service, 4401 North Fairfax Drive, Arlington, Virginia... Act (BGEPA) (16 U.S.C. 668-668c), the Migratory Bird Treaty Act (MBTA) (16 U.S.C. 703-12), and the...

  13. Organizational coherence in health care organizations: conceptual guidance to facilitate quality improvement and organizational change.

    Science.gov (United States)

    McAlearney, Ann Scheck; Terris, Darcey; Hardacre, Jeanne; Spurgeon, Peter; Brown, Claire; Baumgart, Andre; Nyström, Monica E

    2014-01-01

    We sought to improve our understanding of how health care quality improvement (QI) methods and innovations could be efficiently and effectively translated between settings to reduce persistent gaps in health care quality both within and across countries. We aimed to examine whether we could identify a core set of organizational cultural attributes, independent of context and setting, which might be associated with success in implementing and sustaining QI systems in health care organizations. We convened an international group of investigators to explore the issues of organizational culture and QI in different health care contexts and settings. This group met in person 3 times and held a series of conference calls to discuss emerging ideas over 2 years. Investigators also conducted pilot studies in their home countries to examine the applicability of our conceptual model. We suggest that organizational coherence may be a critical element of QI efforts in health care organizations and propose that there are 3 key components of organizational coherence: (1) people, (2) processes, and (3) perspectives. Our work suggests that the concept of organizational coherence embraces both culture and context and can thus help guide both researchers and practitioners in efforts to enhance health care QI efforts, regardless of organizational type, location, or context.

  14. Image Guidance

    Science.gov (United States)

    Guidance that explains the process for getting images approved in One EPA Web microsites and resource directories. includes an appendix that shows examples of what makes some images better than others, how some images convey meaning more than others

  15. Effect of Addiction to Computer Games on Physical and Mental Health of Female and Male Students of Guidance School in City of Isfahan

    OpenAIRE

    Zamani, Eshrat; Chashmi, Maliheh; Hedayati, Nasim

    2009-01-01

    Background: This study aimed to investigate the effects of addiction to computer games on physical and mental health of students. Methods: The study population includes all students in the second year of public guidance schools in the city of Isfahan in the educational year of 2009-2010. The sample size includes 564 students selected by multiple steps stratified sampling. Dependent variables include general health in dimensions of physical health, anxiety and sleeplessness and impaired social...

  16. Automated guidance algorithms for a space station-based crew escape vehicle.

    Science.gov (United States)

    Flanary, R; Hammen, D G; Ito, D; Rabalais, B W; Rishikof, B H; Siebold, K H

    2003-04-01

    An escape vehicle was designed to provide an emergency evacuation for crew members living on a space station. For maximum escape capability, the escape vehicle needs to have the ability to safely evacuate a station in a contingency scenario such as an uncontrolled (e.g., tumbling) station. This emergency escape sequence will typically be divided into three events: The first separation event (SEP1), the navigation reconstruction event, and the second separation event (SEP2). SEP1 is responsible for taking the spacecraft from its docking port to a distance greater than the maximum radius of the rotating station. The navigation reconstruction event takes place prior to the SEP2 event and establishes the orbital state to within the tolerance limits necessary for SEP2. The SEP2 event calculates and performs an avoidance burn to prevent station recontact during the next several orbits. This paper presents the tools and results for the whole separation sequence with an emphasis on the two separation events. The first challenge includes collision avoidance during the escape sequence while the station is in an uncontrolled rotational state, with rotation rates of up to 2 degrees per second. The task of avoiding a collision may require the use of the Vehicle's de-orbit propulsion system for maximum thrust and minimum dwell time within the vicinity of the station vicinity. The thrust of the propulsion system is in a single direction, and can be controlled only by the attitude of the spacecraft. Escape algorithms based on a look-up table or analytical guidance can be implemented since the rotation rate and the angular momentum vector can be sensed onboard and a-priori knowledge of the position and relative orientation are available. In addition, crew intervention has been provided for in the event of unforeseen obstacles in the escape path. The purpose of the SEP2 burn is to avoid re-contact with the station over an extended period of time. Performing this maneuver requires

  17. Health surveillance of persons occupationally exposed to ionizing radiation: Guidance for occupational physicians

    International Nuclear Information System (INIS)

    1998-01-01

    This Safety Report is intended mainly for occupational physicians, as well as for occupational health service personnel, to assist them in routine practice by specifying the features of work under radiation conditions, the general rules of radiological protection for occupational exposure and the organization of the medical surveillance of workers occupationally exposed to radiation. The Report is consistent with the recommendations of the International Commission on Radiological Protection presented in its Publication 60 (1990) and with the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources published by the IAEA in 1966. It supersedes Safety Series No.83 (Radiation Protection in Occupational Health: Manual for Occupational Physicians) published by the IAEA in 1987

  18. A Qualitative Assessment of Current CCF Guidance Based on a Review of Safety System Digital Implementation Changes with Evolving Technology

    Energy Technology Data Exchange (ETDEWEB)

    Korsah, Kofi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wood, Richard [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-04-01

    The US Nuclear Regulatory Commission (NRC) is initiating a new rulemaking project to develop a digital system common-cause failure (CCF) rule. This rulemaking will review and modify or affirm the NRC's current digital system CCF policy as discussed in the Staff Requirements Memorandum to the Secretary of the Commission, Office of the NRC (SECY) 93-087, Policy, Technical, and Licensing Issues Pertaining to Evolutionary and Advanced Light Water Reactor (ALWR) Designs, and Branch Technical Position (BTP) 7-19, Guidance on Evaluation of Defense-in-Depth and Diversity in Digital Computer-Based Instrumentation and Control Systems, as well as Chapter 7, Instrumentation and Controls, in NRC Regulatory Guide (NUREG)-0800, Standard Review Plan for Review of Safety Analysis Reports for Nuclear Power Plants (ML033580677). The Oak Ridge National Laboratory (ORNL) is providing technical support to the NRC staff on the CCF rulemaking, and this report is one of several providing the technical basis to inform NRC staff members. For the task described in this report, ORNL examined instrumentation and controls (I&C) technology implementations in nuclear power plants in the light of current CCF guidance. The intent was to assess whether the current position on CCF is adequate given the evolutions in digital safety system implementations and, if gaps in the guidance were found, to provide recommendations as to how these gaps could be closed.

  19. Science-based response planning guidance for the first 100 minutes of the response to a radiological dispersal device

    International Nuclear Information System (INIS)

    Musolino, S.V.; Harper, F.T.

    2016-01-01

    The first 100 minutes of a response to a radiological dispersal device are critical as this period will set the stage for how the overall response will be executed. First responders will be tasked with multiple activities such as confirming a radiological release, conducting lifesaving rescue operations, issuing protective actions, and beginning characterization of the scene. These activities need to take place as soon as the responders arrive on the scene (the first few minutes). The effectiveness of these early activities will define how well or how poorly the response will be in the emergency phase. The document which is under development provides guidance that can be used for planning an effective response to an RDD that will result in protection of the responders and the members of the public. The information is based on research and results of extensive experiments conducted by the Department of Energy National Laboratories. This guidance provides a realistic estimate of the possible consequences of an RDD detonation and delineates five missions and ten tactics that should be executed by the first responders and local response agencies in the first 100 minutes of a response. The guidance includes recommendations on how to execute the strategy, equipment requirements including personal protective equipment and public messaging

  20. [Health care economic guidance in Germany from the example Morbi-RSA].

    Science.gov (United States)

    Litmathe, Jens

    2016-04-01

    Increasing costs in health care represent still a major challenge in most industrial contries. A lot of attempts especially in Germany have been made to manage such problems and for a fair allocation oft he underlying resources. One of this ist the Morbi-RSA. The current review reflects all historical, medical and economical aspects of the Morbi-RSA and gives a perspective to possible future developments.

  1. European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders.

    Science.gov (United States)

    Völlm, Birgit A; Clarke, Martin; Herrando, Vicenç Tort; Seppänen, Allan O; Gosek, Paweł; Heitzman, Janusz; Bulten, Erik

    2018-03-20

    Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders (MDOs) are often cared for in secure psychiatric environments or prisons. In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective. We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings: The forensic psychiatrist as expert witness, risk, treatment settings for mentally disordered offenders, and what works for MDOs. We undertook a rapid review of the literature with search terms related to: forensic psychiatry, review articles, randomised controlled trials and best practice. We searched the Medline, Embase, PsycINFO, and Cochrane library databases from 2000 onwards for adult groups only. We scrutinised publications for additional relevant literature, and searched the websites of relevant professional organisations for policies, statements or guidance of interest. We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified. We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only. Practitioners need to follow general psychiatric guidance as well as that for offenders, adapted for the complex needs of this patient group, paying particular attention to long-term detention and ethical issues. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Guidance on methodology for evaluation of the effectiveness of options for reducing the risk of introduction and spread of organisms harmful to plant health in the EU territory

    DEFF Research Database (Denmark)

    Baker, R.; Candresse, T.; Dormannsné Simon, E.

    2012-01-01

    The European Food Safety Authority (EFSA) requested the Panel on Plant Health (PLH Panel) to provide guidance for the evaluation of the effectiveness of the options for plants and plant products for reducing the risk of introduction and spread of harmful organisms in the European Union territory...... and guidance documents for assessing a proposed RRO. In addition, the current document provides recommendations for assessing RROs, specifically: on experimental design; on the use of statistical methods including approaches for studying uncertainty; on the use of quantitative pathway analysis and spread...

  3. Guidance for health and social care providers, principles of good practice in medication reconciliation

    LENUS (Irish Health Repository)

    Ward, Marie

    2017-07-17

    Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning.

  4. Efficacy of a web-based intervention with and without guidance for employees with risky drinking: results of a three-arm randomized controlled trial.

    Science.gov (United States)

    Boß, Leif; Lehr, Dirk; Schaub, Michael Patrick; Paz Castro, Raquel; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

    2018-04-01

    To test the efficacy of a web-based alcohol intervention with and without guidance. Three parallel groups with primary end-point after 6 weeks. Open recruitment in the German working population. Adults (178 males/256 females, mean age 47 years) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥ 8/6 on the Alcohol Use Disorders Identification Test. Five web-based modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation during 5 weeks. One intervention group received an unguided self-help version (n=146) and the second received additional adherence-focused guidance by eCoaches (n=144). Controls were on a waiting list with full access to usual care (n=144). Primary outcome was weekly consumed SUA after 6 weeks. SUA after 6 months was examined as secondary outcome, next to numbers of participants drinking within the low-risk range, and general and work-specific mental health measures. All groups showed reductions of mean weekly SUA after 6 weeks (unguided: -8.0; guided: -8.5; control: -3.2). There was no significant difference between the unguided and guided intervention (P=0.324). Participants in the combined intervention group reported significantly fewer SUA than controls [B=-4.85, 95% confidence interval (CI)=-7.02 to -2.68, P < 0.001]. The intervention groups also showed significant reductions in SUA consumption after 6 months (B=-5.72, 95% CI=-7.71 to -3.73, P < 0.001) and improvements regarding general and work-related mental health outcomes after 6 weeks and 6 months. A web-based alcohol intervention, administered with or without personal guidance, significantly reduced mean weekly alcohol consumption and improved mental health and work-related outcomes in the German working population. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  5. 76 FR 24494 - Draft Guidance for Industry and FDA Staff: Processing/Reprocessing Medical Devices in Health Care...

    Science.gov (United States)

    2011-05-02

    ..., you may submit written requests for single copies of the draft guidance to the Office of Communication... critical to ensuring a reusable device is appropriately prepared for its next use. II. Significance of.... 10.115). The draft guidance, when finalized, will represent the Agency's current thinking on...

  6. Review of UCN 3,4 PSA model based on NEI PRA peer review process guidance, rev.0

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Kang, D. I.; Kim, K. Y.; Lee, Y. H.; Jang, S. C.; Ha, J. J.; Han, S. H.; Han, S. J.; Hwang, M. J.

    2003-05-01

    Recently, under the de-regulation environment, nuclear industry has attempted various approaches to improve the economics of Nuclear Power Plants (NPP). One of these efforts is the Risk Informed/Performance-Based Operation (RIPBO). This approach uses the risk and performance information to manage the resources effectively and efficiently that are used in the operation of NPP. In RIPBO, PSA quality is one of the most important things. The nuclear industry and regulatory body of U.S.A have developed a measure to evaluate the quality of PSA. NEI (Nuclear Energy Institute) has developed a guidance called 'NEI PRA Peer Review Guidance,' and NRC (Nuclear Regulatory Committee) and ASME have developed the 'PRA Standard.' In Korea, several projects are on going now, such as the extension of AOT/STI of RPS/ESFAS, Risk-Informed In-Service Inspection (RI-ISI). However, in Korea, there have been no attempts to evaluate the quality of PSA model itself. Therefore, we cannot be sure about the quality of PSA whether or not the present PSA model can be used for the risk-informed applications such as mentioned above. We can say that the evaluation of PSA model quality is the basis for the RIPBO. In this report, we have evaluated the quality of PSA model for Ulchin 3 and 4 units based on the NEI guidance. We, also, have derived what items are to be improved to upgrade the quality of PSA model and how it can be improved. This report can be used as the base of RIPBO work in Korea. The review result based on ASME Standard is published as the separated technical report of KAERI

  7. British Association for the Study of Community Dentistry (BASCD) guidance on the statistical aspects of training and calibration of examiners for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

    Science.gov (United States)

    Pine, C M; Pitts, N B; Nugent, Z J

    1997-03-01

    The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the statistical aspects of training and calibration of examiners for these surveys.

  8. ls with Chronic Conditions Want More Guidance from Health Professionals in Finding Quality Online Health SourcesIndividua

    Directory of Open Access Journals (Sweden)

    Cari Merkley

    2016-04-01

    Full Text Available Objective – To explore how and when individuals with chronic health conditions seek out health information online, and the challenges they encounter when doing so. Design – Qualitative study employing thematic analysis. Setting – Urban Western Australia. Subjects – 17 men and women between 19 and 85 years of age with at least 1 chronic health condition. Methods – Participants were recruited in late 2013 at nine local pharmacies, through local radio, media channels, and a university's social media channels. Participants were adult English speakers who had looked for information on their chronic health condition(s using the Internet. Semi-structured face-to-face interviews were conducted with each participant, audio recorded, and transcribed. The transcripts were coded in QSR Nvivo using two different processes – an initial data-driven inductive approach to coding, followed by a theory driven analysis of the data. Main Results – Three major themes emerged: trust, patient activation, and relevance. Many of the participants expressed trust both in health professionals and in the efficacy of search engines like Google. However, there was uncertainty about the quality of some of the health information sources found. Searching for information online was seen by some participants as a way to feel more empowered about their condition(s and treatment, but they reported frustration in finding information that was relevant to their specific condition(s given the volume of information available. Low health literacy emerged in participant interviews as an intrinsic barrier to effective online searches for health information, along with low patient motivation and lack of time. The many extrinsic barriers identified included difficulty determining the quality of information found, the accessibility of the information (e.g., journal paywalls, and poor relationships with health care providers. Conclusion – Individuals look for online health

  9. Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

    Science.gov (United States)

    Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

    2017-10-01

    In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

  10. Improving health visitor emollient prescribing using a CQUIN-based approach.

    Science.gov (United States)

    Brooks, Christina; Khatau, Tejas

    2015-12-01

    Prescribing is an essential element of health visiting practice. This initiative used the payment framework of Commissioning for Quality and Innovation (CQUIN) to develop health visiting practice across a large health visiting workforce in the East Midlands. A focus on emollient prescribing practice was agreed and a guidance booklet regarding preferred emollient products was produced, based on the local formulary Each health visitor benefitted from receiving additional training and was given a guidance booklet to inform their practice. Targets were set for each quarter to demonstrate an improved prescribing adherence to the preferred product list.The targets were achieved for each quarter. Prescribing rates and confidence improved across the service. Therefore, it was demonstrated that specific guidance and ongoing support can improve prescribing practice within the health visiting service.

  11. Nutrition for Health and Performance: Nutritional Guidance for Military Operations in Temperate and Extreme Environments

    Science.gov (United States)

    1993-02-01

    oatmeal, Cream of Wheat, Cheerios, Chex, etc.) juices (liquid or powders) instant mashed potatoes or rice Cup of Noodles Ramen Fruit Newtons (fig, apple...juices and sugar-sweetened beverage base fruits (dried, canned, or fresh), instant mashed potatoes, rice, couscous, noodles , MRE and T ration cakes...easy-to-tolerate foods that might appeal to soldiers suffering from AMS include Cream of Wheat or oatmeal, instant mashed potatoes, instant rice

  12. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  13. Health Physics Positions Data Base

    International Nuclear Information System (INIS)

    Kerr, G.D.; Borges, T.; Stafford, R.S.; Lu, P.Y.; Carter, D.

    1992-05-01

    The Health Physics Positions (HPPOS) Data Base of the Nuclear Regulatory Commission (NRC) is a collection of summaries of NRC staff positions on a wide range of topics in radiation protection (health physics). The bases for the data base are 247 original documents in the form of letters, memoranda, and excerpts from technical reports. The HPPOS Data Base was developed by the NRC Headquarters and Regional Offices to help ensure uniformity in inspections, enforcement, and licensing actions

  14. The Connection Between Forms of Guidance for Inquiry-Based Learning and the Communicative Approaches Applied—a Case Study in the Context of Pre-service Teachers

    Science.gov (United States)

    Lehtinen, Antti; Lehesvuori, Sami; Viiri, Jouni

    2017-09-01

    Recent research has argued that inquiry-based science learning should be guided by providing the learners with support. The research on guidance for inquiry-based learning has concentrated on how providing guidance affects learning through inquiry. How guidance for inquiry-based learning could promote learning about inquiry (e.g. epistemic practices) is in need of exploration. A dialogic approach to classroom communication and pedagogical link-making offers possibilities for learners to acquire these practices. The focus of this paper is to analyse the role of different forms of guidance for inquiry-based learning on building the communicative approach applied in classrooms. The data for the study comes from an inquiry-based physics lesson implemented by a group of five pre-service primary science teachers to a class of sixth graders. The lesson was video recorded and the discussions were transcribed. The data was analysed by applying two existing frameworks—one for the forms of guidance provided and another for the communicative approaches applied. The findings illustrate that providing non-specific forms of guidance, such as prompts, caused the communicative approach to be dialogic. On the other hand, providing the learners with specific forms of guidance, such as explanations, shifted the communication to be more authoritative. These results imply that different forms of guidance provided by pre-service teachers can affect the communicative approach applied in inquiry-based science lessons, which affects the possibilities learners are given to connect their existing ideas to the scientific view. Future research should focus on validating these results by also analysing inservice teachers' lessons.

  15. Integrated Guidance and Control Based Air-to-Air Autonomous Attack Occupation of UCAV

    Directory of Open Access Journals (Sweden)

    Chang Luo

    2016-01-01

    Full Text Available An approach of air-to-air autonomous attack occupation for Unmanned Combat Aerial Vehicles (UCAVs is proposed to improve attack precision and combat effectiveness. According to the shortage of UCAV in the task of attack occupation, kinematic and dynamic models of UCAV and missile loaded on it are formed. Then, attack zone and no-escape zone are calculated by pattern search algorithm, and the optimum attack position is indicated. To arrive at the optimum attack position accurately with restriction of gesture, a novel adaptive sliding mode control method is suggested to design the integrated guidance and control system of UCAV in the process of autonomous attack occupation. Key parameters of the control system are adaptively regulated, which further economize control energy at the same time. The simulation results show that compared with traditional methods our approach can guide the UCAV to the optimum attack position with stable gesture and economize nearly 25% control energy.

  16. Knowledge Based Health

    OpenAIRE

    Sasson, Amir

    2011-01-01

    In this study, we assess the underlying properties of a global knowledge hub to examine the extent to which the Norwegian health industry constitutes such a hub. We begin with a general discussion of the industry before we examine the underlying properties of global knowledge hubs: cluster attractiveness, educational attractiveness, talent attractiveness, R&D and innovation attractiveness, ownership attractiveness, environmental attractiveness and cluster dynamics. We conclude by providin...

  17. Strategic guidance based on the concept of cleaner production to improve the ship recycling industry

    NARCIS (Netherlands)

    Jain, K.P.; Pruijn, J.F.J.; Hopman, J.J.

    2017-01-01

    The implementation of international ship recycling regulations and international standards of health, safety and environment on a ship recycling yard improves environmental protection, occupational health and safety of the workers. However, it results in increased costs of the ship recycling

  18. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  19. UNESCO's Guidance on Puberty and Sexual Health Education for Students Aged 9-12 Years Compared to an Upper Primary School Curriculum

    Science.gov (United States)

    Goldman, Juliette D. G.

    2015-01-01

    Background: Children and young adolescents are reaching puberty earlier. Providing information about such changes before puberty can help them develop in a more competent and informed manner. Context and Objective: UNESCO's "International Technical Guidance on Sexuality Education" forms a comprehensive, evidence-based, authoritative…

  20. Regulatory guidance document

    International Nuclear Information System (INIS)

    1994-05-01

    The Office of Civilian Radioactive Waste Management (OCRWM) Program Management System Manual requires preparation of the OCRWM Regulatory Guidance Document (RGD) that addresses licensing, environmental compliance, and safety and health compliance. The document provides: regulatory compliance policy; guidance to OCRWM organizational elements to ensure a consistent approach when complying with regulatory requirements; strategies to achieve policy objectives; organizational responsibilities for regulatory compliance; guidance with regard to Program compliance oversight; and guidance on the contents of a project-level Regulatory Compliance Plan. The scope of the RGD includes site suitability evaluation, licensing, environmental compliance, and safety and health compliance, in accordance with the direction provided by Section 4.6.3 of the PMS Manual. Site suitability evaluation and regulatory compliance during site characterization are significant activities, particularly with regard to the YW MSA. OCRWM's evaluation of whether the Yucca Mountain site is suitable for repository development must precede its submittal of a license application to the Nuclear Regulatory Commission (NRC). Accordingly, site suitability evaluation is discussed in Chapter 4, and the general statements of policy regarding site suitability evaluation are discussed in Section 2.1. Although much of the data and analyses may initially be similar, the licensing process is discussed separately in Chapter 5. Environmental compliance is discussed in Chapter 6. Safety and Health compliance is discussed in Chapter 7

  1. Feasibility of missile guidance using MEMS-based active flow control

    International Nuclear Information System (INIS)

    DeChamplain, A.; Hamel, N.; Rainville, P.-A.; Gosselin, P.; Wong, F.

    2002-01-01

    The aim of this study was to evaluate the feasibility to control a missile or rocket by mean of an active flow control device such as MEMS (Micro Electro Mechanical Systems) in the form of a microbubble. For this simple aerodynamic form coupled to the geometry of a generic missile, different microbubble arrangements can have a very significant impact in steady operation. Using CFD, combinations of different microbubble configurations (ratio between the apparent diameter and apparent height) and positions on the surface of the missile were evaluated for their impact on overall system performance for a missile flying at Mach 2.5 at an altitude of 6 km at a zero angle of attack. From a validation study with the generic missile geometry tested experimentally, the Fluent commercial code gave an excellent accuracy of 2% for the drag coefficient. With the appropriate numerical parameters from the validation, different configurations of microbubble(s) were simulated to give only marginal changes to the coefficient of moment as compared to experimental values at an angle of attack of 14 degrees. Considering the major advantages in weight and space savings, this would certainly be a technology to implement for small changes in guidance parameters. (author)

  2. FSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Guidance on the scientific requirements for health claims related to functions of the ne rvous system, including psycholog ical functions

    DEFF Research Database (Denmark)

    Tetens, Inge

    The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products, Nutrition and Allergies to draft guidance on scientific requirements for health claims related to functions of the nervous system, including psychological functions. This guidance has been drawn from scientific opinions......, and was released for public consultation from 17 October 2011 to 16 December 2011....

  3. Image Guidance Based on Prostate Position for Prostate Cancer Proton Therapy

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Indelicato, Daniel; Fryer, Amber; Horne, David; Chellini, Angela; McKenzie, Craig; Lawlor, Paula; Mahajan, Chaitali; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the target coverage for proton therapy with and without image guidance and daily prebeam reorientation. Methods and Materials: A total of 207 prostate positions were analyzed for 9 prostate cancer patients treated using our low-risk prostate proton therapy protocol (University of Florida Proton Therapy Institute 001). The planning target volume was defined as the prostate plus a 5-mm axial and 8-mm superoinferior extension. The prostate was repositioned using 5- and 10-mm shifts (anteriorly, inferiorly, posteriorly, and superiorly) and for Points A-D using a combination of 10-mm multidimensional movements (anteriorly or inferiorly; posteriorly or superiorly; and left or right). The beams were then realigned using the new prostate position. The prescription dose was 78 Gray equivalent (GE) to 95% of the planning target volume. Results: For small movements in the anterior, inferior, and posterior directions within the planning target volume (≤5 mm), treatment realignment demonstrated small, but significant, improvements in the clinical target volume (CTV) coverage to the prescribed dose (78 GE). The anterior and posterior shifts also significantly increased the minimal CTV dose (Δ +1.59 GE). For prostate 10-mm movements in the inferior, posterior, and superior directions, the beam realignment produced larger and significant improvements for both the CTV V 78 (Δ +6.4%) and the CTV minimal dose (Δ +8.22 GE). For the compounded 10-mm multidimensional shifts, realignment significantly improved the CTV V 78 (Δ +11.8%) and CTV minimal dose (Δ +23.6 GE). After realignment, the CTV minimal dose was >76.6 GE (>98%) for all points (A-D). Conclusion: Proton beam realignment after target shift will enhance CTV coverage for different prostate positions

  4. Developing a workbook to support the contextualisation of global health systems guidance: a case study identifying steps and critical factors for success in this process at WHO.

    Science.gov (United States)

    Alvarez, Elizabeth; Lavis, John N; Brouwers, Melissa; Schwartz, Lisa

    2018-03-02

    Global guidance can help countries strengthen their health systems to deliver effective interventions to their populations. However, to have an impact, guidance needs to be contextualised or adapted to local settings; this process includes consideration of health system arrangements and political system factors. To date, methods to support contextualisation do not exist. In response, a workbook was designed to provide specific methods and strategies to enable the contextualisation of WHO's 'Optimizing health worker roles to improve maternal and newborn health' (OptimizeMNH) guidance at the national or subnational level. The objective of this study was to describe the process of developing the workbook and identify key steps of the development process, barriers that arose and facilitators that helped overcome some of these barriers. A qualitative single case study design was carried out. Interviews, documents and a reflexive journal were used. Constant comparison and an edit-style of organisation were used during data analysis to develop concepts, themes, subthemes and relationships among them. Thirteen interviews were conducted and 52 documents were reviewed. Three main steps were identified in the process of developing the workbook for health systems guidance contextualisation, namely (1) determining the need for and gaining approval to develop the workbook, (2) developing the workbook (taking on the task, creating the structure of the workbook, operationalising its components, undergoing approval processes and editing it), and (3) implementing the workbook both at the WHO level and at the national/subnational level. Five barriers and/or facilitators emerged relevant to each step, namely (1) having well-placed and credible champions, (2) creating and capitalising on opportunities, (3) finding the right language to engage various actors and obtain buy-in, (4) obtaining and maintaining meaningful buy-in, and (5) ensuring access to resources. Understanding the key

  5. BLENDED LEARNING METHOD BASED ON LOCAL WISDOM AS A SPIRITUAL GUIDANCE HOLY TRINITY COMMUNITY IN DISTRICT BENGKAYANG

    Directory of Open Access Journals (Sweden)

    Priska Vasantan

    2016-03-01

    Full Text Available Bengkayang is one of the districts the outermost in Indonesia. The district has limitations and underdevelopment in various fields, one of which is in the field of education. Writing this article aims to show that blended learning based on local wisdom is very helpful coaching Holy Trinity Community (HTC in the district Bengkayang. It has been proven from previous studies, suggesting that coaching HTC with blended learning to be more flexible, effective and efficient . Blended learning has been applied HTC with a combination of conventional learning and e-learning in most areas in Indonesia. With the blended learning, the process of spiritual guidance becomes more flexible, effective and efficient so as to improve student in district Bengkayang.

  6. Is the faculty of family planning and reproductive health care guidance on emergency contraception being followed in general practice? An audit in the West Midlands, UK.

    Science.gov (United States)

    Bannister, Lisa; Macve, Joanna; Pinkey, Benjamin; Webberley, Helen

    2007-07-01

    In 2003, the Faculty of Family Planning and Reproductive Health Care (FFPRHC) of the Royal College of Obstetricians and Gynaecologists published guidance on emergency contraception (EC). A literature search revealed no published work describing doctors' actions when prescribing EC. In order to assess the extent to which the FFPRHC Guidance is being followed in general practice, an audit of the medical notes of women requesting EC between January 2003 and December 2004 in six general practice surgeries located in the West Midlands, UK was conducted. From the medical notes, discussions between health care professionals and patients requesting EC regarding ongoing contraceptive needs, the risk of sexually transmitted infections (STIs) and the availability of the emergency intrauterine device (IUD) were recorded. A total of 718 emergency contraceptive pill consultations were analysed. The median age for presentation was 24 years. The 20-24 years age group accounted for the most consultations (30.9%). In 40% of consultations there was no evidence of future contraceptive needs having been discussed. Only 20 (2.8%) consultation notes contained evidence that STIs had been discussed. Chlamydia tests were undertaken in only 15/718 (1.7%) consultations. In only 10 (1.4%) of the consultations was the IUD discussed with the patient as an alternative form of EC. This audit suggests that the FFPRHC Guidance on EC is not being followed in general practice, and therefore patients requesting EC may not be receiving the highest standard of care.

  7. The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.

    Science.gov (United States)

    Lee, Mi Kyung; Amorin-Woods, Lyndon; Cascioli, Vincenzo; Adams, Jon

    2018-01-01

    Food consumption and nutritional status affect an individual's health throughout their life-course and an unhealthy diet is a major risk factor for the current global burden of chronic disease. The promotion of health and good nutrition through healthy eating requires the active involvement of all health professionals including chiropractors. This paper reports findings from the first nationally representative examination of the use of nutritional guidance within chiropractic patient management in Australia. A sample of 1000 practising chiropractors was randomly selected from the Australian Chiropractic Research Network (ACORN) practice-based research network database for a cross-sectional study and 33% participated in the online survey in November 2016. The questionnaire, based on previous designs used in similar surveys and nutrition resources developed by the National Health and Medical Research Council, was pretested prior to the survey. Pearson's Chi square and bivariate logistic regression were undertaken to explore relationships with variables of interest. The demographic details of the respondents are similar to those of the chiropractic workforce registered in Australia. Most chiropractors provided nutritional advice as part of their patient care and around a quarter provided specific dietary advice to their patients, including the use of nutrition supplements. Nutrition-related conditions most commonly encountered by the chiropractors were musculoskeletal, usually inflammatory in origin. Common nutritional assessment methods used included questioning patients to assess their nutritional and health status and physical appearance. Most of the participants provided nutritional resources to their patients in their clinics. However, the Australian Dietary Guidelines and the accompanying Australian Guide to Healthy Eating were not well utilised by the respondents. Australian chiropractors often referred patients with nutrition issues to qualified dietitians and

  8. Health effects of fine particulate matter in life cycle impact assessment: findings from the Basel Guidance Workshop

    DEFF Research Database (Denmark)

    Fantke, Peter; Jolliet, Olivier; Evans, John S.

    2015-01-01

    Purpose Fine particulate matter (PM2.5) is considered to be one of the most important environmental factors contributing to the global human disease burden. However, due to the lack of broad consensus and harmonization in the life cycle assessment (LCA) community, there is no clear guidance on ho...

  9. Do We Provide Meaningful Guidance for Healthful Eating? An Investigation into Consumers' Interpretation of Frequency Consumption Terms

    Science.gov (United States)

    King, Lesley; Watson, Wendy L.; Chapman, Kathy; Kelly, Bridget; Louie, Jimmy C. Y.; Hughes, Clare; Crawford, Jennifer; Gill, Timothy P.

    2012-01-01

    Objective: To investigate consumers' understanding of terms commonly used to provide guidance about frequency and quantity of food consumption. Methods: A survey of 405 shoppers explored how frequently consumers thought food labeled with the terms "eat often," "eat moderately," "eat occasionally," "a sometimes food," and "an extra food" should be…

  10. Alcoholism and its Effects: an Approach Based on Health Psychology

    Directory of Open Access Journals (Sweden)

    Maria de las Mercedes Pretel Olite

    2014-11-01

    Full Text Available Alcoholism is a complex biopsychosocial disorder that requires a specialised and multidisciplinary approach focusing on both the patient and the family. Alcohol consumption is the most important addiction worldwide due to its prevalence and impact. Therefore, the main objective of a primary care physician should be to facilitate the referral of patients and their families to a structured treatment, support and guidance program during the whole detoxification process. In every health area in Cienfuegos, there are community mental health centers with a staff trained to deal with these disorders in addicts and their family. A literature review was conducted to establish the relationship between alcohol consumption and its harmful effects on health, family and society, using an approach based on Health Psychology.

  11. Intelligent Web-Based Learning System with Personalized Learning Path Guidance

    Science.gov (United States)

    Chen, C. M.

    2008-01-01

    Personalized curriculum sequencing is an important research issue for web-based learning systems because no fixed learning paths will be appropriate for all learners. Therefore, many researchers focused on developing e-learning systems with personalized learning mechanisms to assist on-line web-based learning and adaptively provide learning paths…

  12. Accuracy of a novel photoacoustic-based approach to surgical guidance performed with and without a da Vinci robot

    Science.gov (United States)

    Gandhi, Neeraj; Kim, Sungmin; Kazanzides, Peter; Lediju Bell, Muyinatu A.

    2017-03-01

    Minimally invasive surgery carries the deadly risk of rupturing major blood vessels, such as the internal carotid arteries hidden by bone in endonasal transsphenoidal surgery. We propose a novel approach to surgical guidance that relies on photoacoustic-based vessel separation measurements to assess the extent of safety zones during these type of surgical procedures. This approach can be implemented with or without a robot or navigation system. To determine the accuracy of this approach, a custom phantom was designed and manufactured for modular placement of two 3.18-mm diameter vessel-mimicking targets separated by 10-20 mm. Photoacoustic images were acquired as the optical fiber was swept across the vessels in the absence and presence of teleoperation with a research da Vinci Surgical System. When the da Vinci was used, vessel positions were recorded based on the fiber position (calculated from the robot kinematics) that corresponded to an observed photoacoustic signal. In all cases, compounded photoacoustic data from a single sweep displayed the four vessel boundaries in one image. Amplitude- and coherence-based photoacoustic images were used to estimate vessel separations, resulting in 0.52-0.56 mm mean absolute errors, 0.66-0.71 mm root mean square errors, and 65-68% more accuracy compared to fiber position measurements obtained through the da Vinci robot kinematics. Results indicate that with further development, photoacoustic image-based measurements of anatomical landmarks could be a viable method for real-time path planning in multiple interventional photoacoustic applications.

  13. Spike Neuromorphic VLSI-Based Bat Echolocation for Micro-Aerial Vehicle Guidance

    National Research Council Canada - National Science Library

    Horiuchi, Timothy K; Krishnaprasad, P. S

    2007-01-01

    .... This includes multiple efforts related to a VLSI-based echolocation system being developed in one of our laboratories from algorithm development, bat flight data analysis, to VLSI circuit design...

  14. Guidance Trades for Interceptors Not Constrained by Ground-Based Radar

    National Research Council Canada - National Science Library

    Deutsch, Owen

    2000-01-01

    .... New space-based sensor systems such as SBIRS-low are seen as an adjunct that can be used to achieve range extension by cueing of radars and in some concepts, kinematic range extension of interceptors...

  15. Base Stabilization Guidance and Additive Selection for Pavement Design and Rehabilitation

    Science.gov (United States)

    2017-12-01

    Significant improvements have been made in base stabilization practice that include design specifications and methodology, experience with the selection of stabilizing additives, and equipment for distribution and uniform blending of additives. For t...

  16. Spike Neuromorphic VLSI-Based Bat Echolocation for Micro-Aerial Vehicle Guidance

    Science.gov (United States)

    2007-03-31

    IFinal 03/01/04 - 02/28/07 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Neuromorphic VLSI-based Bat Echolocation for Micro-aerial 5b.GRANTNUMBER Vehicle...uncovered interesting new issues in our choice for representing the intensity of signals. We have just finished testing the first chip version of an echo...timing-based algorithm (’openspace’) for sonar-guided navigation amidst multiple obstacles. 15. SUBJECT TERMS Neuromorphic VLSI, bat echolocation

  17. Object-based attention: strength of object representation and attentional guidance.

    Science.gov (United States)

    Shomstein, Sarah; Behrmann, Marlene

    2008-01-01

    Two or more features belonging to a single object are identified more quickly and more accurately than are features belonging to different objects--a finding attributed to sensory enhancement of all features belonging to an attended or selected object. However, several recent studies have suggested that this "single-object advantage" may be a product of probabilistic and configural strategic prioritizations rather than of object-based perceptual enhancement per se, challenging the underlying mechanism that is thought to give rise to object-based attention. In the present article, we further explore constraints on the mechanisms of object-based selection by examining the contribution of the strength of object representations to the single-object advantage. We manipulated factors such as exposure duration (i.e., preview time) and salience of configuration (i.e., objects). Varying preview time changes the magnitude of the object-based effect, so that if there is ample time to establish an object representation (i.e., preview time of 1,000 msec), then both probability and configuration (i.e., objects) guide attentional selection. If, however, insufficient time is provided to establish a robust object-based representation, then only probabilities guide attentional selection. Interestingly, at a short preview time of 200 msec, when the two objects were sufficiently different from each other (i.e., different colors), both configuration and probability guided attention selection. These results suggest that object-based effects can be explained both in terms of strength of object representations (established at longer exposure durations and by pictorial cues) and probabilistic contingencies in the visual environment.

  18. Responding to Hostility: Evidence-Based Guidance for Communication during Planned Organizational Change

    Science.gov (United States)

    Campbell, Kim Sydow; Carmichael, Pierson; Naidoo, Jefrey S.

    2015-01-01

    Hostile challenges to planned organization change are common and challenging to deal with effectively. Little research has explained successful responses to such stakeholder hostility. To address this gap, we use the concept of readiness to characterize the content of hostile challenges. We also use rhetorical strategies based on speech act theory…

  19. Design and construction control guidance for chemically stabilized pavement base layers.

    Science.gov (United States)

    2013-12-01

    A laboratory and field study was conducted related to chemically stabilized pavement layers, which is also : referred to as soil-cement. Soil-cement practices within MDOT related to Class 9C soils used for base layers : were evaluated in this report....

  20. Appropriateness to set a group health‐based guidance value for fumonisins and their modified forms

    DEFF Research Database (Denmark)

    Petersen, Annette

    2018-01-01

    The EFSA Panel on Contaminants in the Food Chain (CONTAM) established a tolerable daily intake (TDI) for fumonisin B1 (FB1) of 1.0 μg/kg body weight (bw) per day based on increased incidence of megalocytic hepatocytes found in a chronic study with mice. The CONTAM Panel considered the limited data...

  1. Identifying Themes for Research-Based Development of Pedagogy and Guidance in Higher Education

    Science.gov (United States)

    Jääskelä, Päivikki; Nissilä, Pia

    2015-01-01

    The high value accorded to the research-based development of education in higher education communities means that researchers in the field have an important role in determining the foci of such efforts. However, it is important to ask whether higher education research is providing answers that satisfy practical educational needs. In this study,…

  2. A Neural Networks Based Operation Guidance System for Procedure Presentation and Validation

    International Nuclear Information System (INIS)

    Seung, Kun Mo; Lee, Seung Jun; Seong, Poong Hyun

    2006-01-01

    In this paper, a neural network based operator support system is proposed to reduce operator's errors in abnormal situations in nuclear power plants (NPPs). There are many complicated situations, in which regular and suitable operations should be done by operators accordingly. In order to regulate and validate operators' operations, it is necessary to develop an operator support system which includes computer based procedures with the functions for operation validation. Many computerized procedures systems (CPS) have been recently developed. Focusing on the human machine interface (HMI) design and procedures' computerization, most of CPSs used various methodologies to enhance system's convenience, reliability and accessibility. Other than only showing procedures, the proposed system integrates a simple CPS and an operation validation system (OVS) by using artificial neural network (ANN) for operational permission and quantitative evaluation

  3. Learning-based 3T brain MRI segmentation with guidance from 7T MRI labeling.

    Science.gov (United States)

    Deng, Minghui; Yu, Renping; Wang, Li; Shi, Feng; Yap, Pew-Thian; Shen, Dinggang

    2016-12-01

    Segmentation of brain magnetic resonance (MR) images into white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) is crucial for brain structural measurement and disease diagnosis. Learning-based segmentation methods depend largely on the availability of good training ground truth. However, the commonly used 3T MR images are of insufficient image quality and often exhibit poor intensity contrast between WM, GM, and CSF. Therefore, they are not ideal for providing good ground truth label data for training learning-based methods. Recent advances in ultrahigh field 7T imaging make it possible to acquire images with excellent intensity contrast and signal-to-noise ratio. In this paper, the authors propose an algorithm based on random forest for segmenting 3T MR images by training a series of classifiers based on reliable labels obtained semiautomatically from 7T MR images. The proposed algorithm iteratively refines the probability maps of WM, GM, and CSF via a cascade of random forest classifiers for improved tissue segmentation. The proposed method was validated on two datasets, i.e., 10 subjects collected at their institution and 797 3T MR images from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Specifically, for the mean Dice ratio of all 10 subjects, the proposed method achieved 94.52% ± 0.9%, 89.49% ± 1.83%, and 79.97% ± 4.32% for WM, GM, and CSF, respectively, which are significantly better than the state-of-the-art methods (p-values brain MR image segmentation. © 2016 American Association of Physicists in Medicine.

  4. Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study.

    Science.gov (United States)

    Seleskog, B; Lindqvist, L; Wårdh, I; Engström, A; von Bültzingslöwen, I

    2018-04-12

    Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands-on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands-on guidance by dental hygienists on a regular basis in everyday care may be a new approach. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Tailoring four-dimensional cone-beam CT acquisition settings for fiducial marker-based image guidance in radiation therapy.

    Science.gov (United States)

    Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C C M; Bel, Arjan; Alderliesten, Tanja

    2018-04-01

    Use of four-dimensional cone-beam CT (4D-CBCT) and fiducial markers for image guidance during radiation therapy (RT) of mobile tumors is challenging due to the trade-off among image quality, imaging dose, and scanning time. This study aimed to investigate different 4D-CBCT acquisition settings for good visibility of fiducial markers in 4D-CBCT. Using these 4D-CBCTs, the feasibility of marker-based 4D registration for RT setup verification and manual respiration-induced motion quantification was investigated. For this, we applied a dynamic phantom with three different breathing motion amplitudes and included two patients with implanted markers. Irrespective of the motion amplitude, for a medium field of view (FOV), marker visibility was improved by reducing the imaging dose per projection and increasing the number of projection images; however, the scanning time was 4 to 8 min. For a small FOV, the total imaging dose and the scanning time were reduced (62.5% of the dose using a medium FOV, 2.5 min) without losing marker visibility. However, the body contour could be missing for a small FOV, which is not preferred in RT. The marker-based 4D setup verification was feasible for both the phantom and patient data. Moreover, manual marker motion quantification can achieve a high accuracy with a mean error of [Formula: see text].

  6. Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth : A randomized controlled trial

    NARCIS (Netherlands)

    Hoffenkamp, H.N.; Tooten, A.; Hall, R.A.S.; Braeken, J.; Eliens, M.; Vingerhoets, A.J.J.M.; van Bakel, H.J.A.

    2015-01-01

    OBJECTIVE: This study examined the effectiveness of hospital-based Video Interaction Guidance (VIG; Eliëns, 2010; Kennedy, Landor, & Todd, 2011) for mothers and fathers of infants born preterm (25-37 weeks of gestation). METHOD: VIG is a preventive video-feedback intervention to support the

  7. The acceptability of an Internet-based exposure treatment for flying phobia with and without therapist guidance: patients’ expectations, satisfaction, treatment preferences, and usability

    Science.gov (United States)

    Campos, Daniel; Mira, Adriana; Bretón-López, Juana; Castilla, Diana; Botella, Cristina; Baños, Rosa Maria; Quero, Soledad

    2018-01-01

    Purpose Internet-based treatments have been tested for several psychological disorders. However, few studies have directly assessed the acceptability of these self-applied interventions in terms of expectations, satisfaction, treatment preferences, and usability. Moreover, no studies provide this type of data on Internet-based treatment for flying phobia (FP), with or without therapist guidance. The aim of this study was to analyze the acceptability of an Internet-based treatment for FP (NO-FEAR Airlines) that includes exposure scenarios composed of images and real sounds. A secondary aim was to compare patients’ acceptance of two ways of delivering this treatment (with or without therapist guidance). Patients and methods The sample included 46 participants from a randomized controlled trial who had received the self-applied intervention with (n = 23) or without (n = 23) therapist guidance. All participants completed an assessment protocol conducted online and by telephone at both pre- and posttreatment. Results Results showed good expectations, satisfaction, opinion, and usability, regardless of the presence of therapist guidance, including low aversiveness levels from before to after the intervention. However, participants generally preferred the therapist-supported condition. Conclusion NO-FEAR Airlines is a well-accepted Internet-based treatment that can help enhance the application of the exposure technique, improving patient acceptance and access to FP treatment. PMID:29636613

  8. Threshold guidance update

    International Nuclear Information System (INIS)

    Wickham, L.E.

    1986-01-01

    The Department of Energy (DOE) is developing the concept of threshold quantities for use in determining which waste materials must be handled as radioactive waste and which may be disposed of as nonradioactive waste at its sites. Waste above this concentration level would be managed as radioactive or mixed waste (if hazardous chemicals are present); waste below this level would be handled as sanitary waste. Last years' activities (1984) included the development of a threshold guidance dose, the development of threshold concentrations corresponding to the guidance dose, the development of supporting documentation, review by a technical peer review committee, and review by the DOE community. As a result of the comments, areas have been identified for more extensive analysis, including an alternative basis for selection of the guidance dose and the development of quality assurance guidelines. Development of quality assurance guidelines will provide a reasonable basis for determining that a given waste stream qualifies as a threshold waste stream and can then be the basis for a more extensive cost-benefit analysis. The threshold guidance and supporting documentation will be revised, based on the comments received. The revised documents will be provided to DOE by early November. DOE-HQ has indicated that the revised documents will be available for review by DOE field offices and their contractors

  9. Cell phone–based health education messaging improves health ...

    African Journals Online (AJOL)

    SMS), provides new and innovative opportunities for disease prevention and health education. Objective: To explore the use of cell phone–based health education SMS to improve the health literacy of community residents in China. Methods: ...

  10. Midcourse Guidance Law Based on High Target Acquisition Probability Considering Angular Constraint and Line-of-Sight Angle Rate Control

    Directory of Open Access Journals (Sweden)

    Xiao Liu

    2016-01-01

    Full Text Available Random disturbance factors would lead to the variation of target acquisition point during the long distance flight. To acquire a high target acquisition probability and improve the impact precision, missiles should be guided to an appropriate target acquisition position with certain attitude angles and line-of-sight (LOS angle rate. This paper has presented a new midcourse guidance law considering the influences of random disturbances, detection distance restraint, and target acquisition probability with Monte Carlo simulation. Detailed analyses of the impact points on the ground and the random distribution of the target acquisition position in the 3D space are given to get the appropriate attitude angles and the end position for the midcourse guidance. Then, a new formulation biased proportional navigation (BPN guidance law with angular constraint and LOS angle rate control has been derived to ensure the tracking ability when attacking the maneuvering target. Numerical simulations demonstrates that, compared with the proportional navigation guidance (PNG law and the near-optimal spatial midcourse guidance (NSMG law, BPN guidance law demonstrates satisfactory performances and can meet both the midcourse terminal angular constraint and the LOS angle rate requirement.

  11. Category-based guidance of spatial attention during visual search for feature conjunctions.

    Science.gov (United States)

    Nako, Rebecca; Grubert, Anna; Eimer, Martin

    2016-10-01

    The question whether alphanumerical category is involved in the control of attentional target selection during visual search remains a contentious issue. We tested whether category-based attentional mechanisms would guide the allocation of attention under conditions where targets were defined by a combination of alphanumerical category and a basic visual feature, and search displays could contain both targets and partially matching distractor objects. The N2pc component was used as an electrophysiological marker of attentional object selection in tasks where target objects were defined by a conjunction of color and category (Experiment 1) or shape and category (Experiment 2). Some search displays contained the target or a nontarget object that matched either the target color/shape or its category among 3 nonmatching distractors. In other displays, the target and a partially matching nontarget object appeared together. N2pc components were elicited not only by targets and by color- or shape-matching nontargets, but also by category-matching nontarget objects, even on trials where a target was present in the same display. On these trials, the summed N2pc components to the 2 types of partially matching nontargets were initially equal in size to the target N2pc, suggesting that attention was allocated simultaneously and independently to all objects with target-matching features during the early phase of attentional processing. Results demonstrate that alphanumerical category is a genuine guiding feature that can operate in parallel with color or shape information to control the deployment of attention during visual search. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. The effect of directive tutor guidance on students' conceptual understanding of statistics in problem-based learning.

    Science.gov (United States)

    Budé, Luc; van de Wiel, Margaretha W J; Imbos, Tjaart; Berger, Martijn P F

    2011-06-01

    Education is aimed at students reaching conceptual understanding of the subject matter, because this leads to better performance and application of knowledge. Conceptual understanding depends on coherent and error-free knowledge structures. The construction of such knowledge structures can only be accomplished through active learning and when new knowledge can be integrated into prior knowledge. The intervention in this study was directed at both the activation of students as well as the integration of knowledge. Undergraduate university students from an introductory statistics course, in an authentic problem-based learning (PBL) environment, were randomly assigned to conditions and measurement time points. In the PBL tutorial meetings, half of the tutors guided the discussions of the students in a traditional way. The other half guided the discussions more actively by asking directive and activating questions. To gauge conceptual understanding, the students answered open-ended questions asking them to explain and relate important statistical concepts. Results of the quantitative analysis show that providing directive tutor guidance improved understanding. Qualitative data of students' misconceptions seem to support this finding. Long-term retention of the subject matter seemed to be inadequate. ©2010 The British Psychological Society.

  13. Solving the interoperability challenge of a distributed complex patient guidance system: a data integrator based on HL7's Virtual Medical Record standard.

    Science.gov (United States)

    Marcos, Carlos; González-Ferrer, Arturo; Peleg, Mor; Cavero, Carlos

    2015-05-01

    We show how the HL7 Virtual Medical Record (vMR) standard can be used to design and implement a data integrator (DI) component that collects patient information from heterogeneous sources and stores it into a personal health record, from which it can then retrieve data. Our working hypothesis is that the HL7 vMR standard in its release 1 version can properly capture the semantics needed to drive evidence-based clinical decision support systems. To achieve seamless communication between the personal health record and heterogeneous data consumers, we used a three-pronged approach. First, the choice of the HL7 vMR as a message model for all components accompanied by the use of medical vocabularies eases their semantic interoperability. Second, the DI follows a service-oriented approach to provide access to system components. Third, an XML database provides the data layer.Results The DI supports requirements of a guideline-based clinical decision support system implemented in two clinical domains and settings, ensuring reliable and secure access, high performance, and simplicity of integration, while complying with standards for the storage and processing of patient information needed for decision support and analytics. This was tested within the framework of a multinational project (www.mobiguide-project.eu) aimed at developing a ubiquitous patient guidance system (PGS). The vMR model with its extension mechanism is demonstrated to be effective for data integration and communication within a distributed PGS implemented for two clinical domains across different healthcare settings in two nations. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Effect of addiction to computer games on physical and mental health of female and male students of guidance school in city of isfahan.

    Science.gov (United States)

    Zamani, Eshrat; Chashmi, Maliheh; Hedayati, Nasim

    2009-01-01

    This study aimed to investigate the effects of addiction to computer games on physical and mental health of students. The study population includes all students in the second year of public guidance schools in the city of Isfahan in the educational year of 2009-2010. The sample size includes 564 students selected by multiple steps stratified sampling. Dependent variables include general health in dimensions of physical health, anxiety and sleeplessness and impaired social functioning. Data were collected using General Health Questionnaire (GHQ-28) scale and a questionnaire on addiction to computer games. Pearson's correlation coefficient and structural model were used for data analysis. There was a significant positive correlation between students' computer games addiction and their physical and mental health in dimensions of physical health, anxiety and sleeplessness There was a significant negative relationship between addictions to computer games and impaired social functioning. The results of this study are in agreement with the findings of other studies around the world. As the results show, addiction to computer games affects various dimensions of health and increases physical problems, anxiety and depression, while decreases social functioning disorder.

  15. 78 FR 60283 - Guidance for Temporary Reassignment of State and Local Personnel During a Public Health Emergency

    Science.gov (United States)

    2013-10-01

    ... Personnel During a Public Health Emergency AGENCY: Department of Health and Human Services, Office of the... and Local Personnel during a Public Health Emergency.'' Section 201 of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), Public Law 113-5, amends section 319 of the Public Health...

  16. Privatizing community animal health worker based veterinary ...

    African Journals Online (AJOL)

    Privatizing community animal health worker based veterinary services delivery system in West Kordofan, Southern Sudan; The needed roles of community animal health assistant (CAHA) and Pastoral unions.

  17. Development of a real time imaging-based guidance system of magnetic nanoparticles for targeted drug delivery

    International Nuclear Information System (INIS)

    Zhang, Xingming; Le, Tuan-Anh; Yoon, Jungwon

    2017-01-01

    Targeted drug delivery using magnetic nanoparticles is an efficient technique as molecules can be directed toward specific tissues inside a human body. For the first time, we implemented a real-time imaging-based guidance system of nanoparticles using untethered electro-magnetic devices for simultaneous guiding and tracking. In this paper a low-amplitude-excitation-field magnetic particle imaging (MPI) is introduced. Based on this imaging technology, a hybrid system comprised of an electromagnetic actuator and MPI was used to navigate nanoparticles in a non-invasive way. The real-time low-amplitude-excitation-field MPI and electromagnetic actuator of this navigation system are achieved by applying a time-division multiplexing scheme to the coil topology. A one dimensional nanoparticle navigation system was built to demonstrate the feasibility of the proposed approach and it could achieve a 2 Hz navigation update rate with the field gradient of 3.5 T/m during the imaging mode and 8.75 T/m during the actuation mode. Particles with both 90 nm and 5 nm diameters could be successfully manipulated and monitored in a tube through the proposed system, which can significantly enhance targeting efficiency and allow precise analysis in a real drug delivery. - Highlights: • A real-time system comprised of an electromagnetic actuator and a low-amplitude-excitation-field MPI can navigate magnetic nanoparticles. • The imaging scheme is feasible to enlarge field of view size. • The proposed navigation system can be cost efficient, compact, and optimized for targeting of the nanoparticles.

  18. Development of a real time imaging-based guidance system of magnetic nanoparticles for targeted drug delivery

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xingming [School of Naval Architecture and Ocean Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong (China); School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of); Le, Tuan-Anh [School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of); Yoon, Jungwon, E-mail: jwyoon@gnu.ac.kr [School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of)

    2017-04-01

    Targeted drug delivery using magnetic nanoparticles is an efficient technique as molecules can be directed toward specific tissues inside a human body. For the first time, we implemented a real-time imaging-based guidance system of nanoparticles using untethered electro-magnetic devices for simultaneous guiding and tracking. In this paper a low-amplitude-excitation-field magnetic particle imaging (MPI) is introduced. Based on this imaging technology, a hybrid system comprised of an electromagnetic actuator and MPI was used to navigate nanoparticles in a non-invasive way. The real-time low-amplitude-excitation-field MPI and electromagnetic actuator of this navigation system are achieved by applying a time-division multiplexing scheme to the coil topology. A one dimensional nanoparticle navigation system was built to demonstrate the feasibility of the proposed approach and it could achieve a 2 Hz navigation update rate with the field gradient of 3.5 T/m during the imaging mode and 8.75 T/m during the actuation mode. Particles with both 90 nm and 5 nm diameters could be successfully manipulated and monitored in a tube through the proposed system, which can significantly enhance targeting efficiency and allow precise analysis in a real drug delivery. - Highlights: • A real-time system comprised of an electromagnetic actuator and a low-amplitude-excitation-field MPI can navigate magnetic nanoparticles. • The imaging scheme is feasible to enlarge field of view size. • The proposed navigation system can be cost efficient, compact, and optimized for targeting of the nanoparticles.

  19. 75 FR 69089 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2010-11-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0514] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document... Administration (FDA) is announcing the availability of the guidance entitled ``Class II Special Controls Guidance...

  20. 76 FR 29251 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance...

    Science.gov (United States)

    2011-05-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2006-D-0094] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance Document... of the guidance entitled ``Guidance for Industry and Food and Drug Administration Staff; Class II...

  1. Three-dimensional nonlinear H-infinity guidance design and H-infinity-based pursuit-evasion game

    Science.gov (United States)

    Chen, Hsin-Yuan; Yang, Chi-Ching

    2001-08-01

    There are five features in this approach: (1) The complete nonlinear dynamics of the pursuit-evasion motion is considered in 3D spherical coordinate system. Neither linearization nor small signal assumptions are made. (2) The nonlinear H-infinity guidance design is derived analytically and expressed in a very simple form. (3) Unlike adaptive control concept, implementation of the proposed H(infinity ) guidance design does not need the information on target acceleration while ensuring acceptable intercept performance for arbitrary targets with the finite acceleration. (4) The derived guidance design exhibits strong robustness against variations in target acceleration. (5) Finally the issues related to the validation of the control law using Hardware In The Loop simulation are presented. The effects of the Flight Motion Simulator static and dynamic accuracies (time delay etc...) are discussed.

  2. Evidence-Based Background Material Underlying Guidance for Federal Agencies in Implementing Strategic Sustainability Performance Plans - Implementing Sustainability: The Institutional-Behavioral Dimension

    Energy Technology Data Exchange (ETDEWEB)

    Malone, Elizabeth L. [Pacific Northwest National Laboratory (PNNL); Sanquist, Tom [Pacific Northwest National Laboratory (PNNL); Wolfe, Amy K. [ORNL; Diamond, Rick [Lawrence Berkeley National Laboratory (LBNL); Payne, Christopher [Lawrence Berkeley National Laboratory (LBNL); Dion, Jerry [ORNL

    2013-06-01

    This document is part of a larger, programmatic effort to assist federal agencies in taking action and changing their institutions to achieve and maintain federal sustainability goals, while meeting their mission goals. FEMP is developing guidance for federal agency efforts to enable institutional behavior change for sustainability, and for making sustainability “business as usual.” The driving requirement for this change is Executive Order (EO) 13514, Federal Leadership in Environmental, Energy, and Economic Performance. FEMP emphasizes strategies for increasing energy efficiency and renewable energy utilization as critical components of attaining sustainability, and promotes additional non-energy action pathways contained in EO 13514. This report contributes to the larger goal by laying out the conceptual and evidentiary underpinnings of guidance to federal agencies. Conceptual frameworks focus and organize the development of guidance. We outline a series of progressively refined conceptual frameworks, including a multi-layer approach, key steps in sustainability implementation, a process view of specific approaches to institutional change, the agency Strategic Sustainability Performance Plans (SSPPs), and concepts related to context-specific rules, roles and tools for sustainability. Additionally, we tap pertinent bodies of literature in drawing eight evidence-based principles for behavior change. These principles are important foundations upon which to build in selecting strategies to effect change in organizations. Taken together, this report presents a suite of components that inform the training materials, presentations, web site, and other products that provide guidance to federal agencies.

  3. Guidance for implementing an environmental, safety and health assurance program. Volume 2. A model plan for environmental, safety and health staff audits and appraisals

    International Nuclear Information System (INIS)

    Ellingson, A.C.

    1980-09-01

    This is 1 of 15 documents designed to illustrate how an Environmental, Safety and Health (ES and H) Assurance Program may be implemented. The generic definition of ES and H Assurance Programs is given in a companion document entitled An Environmental, Safety and Health Assurance Program Standard. This document is concerned with ES and H audit and appraisal activities of an ES and H Staff Organization as they might be performed in an institution whose ES and H program is based upon the ES and H Assurance Program Standard. An annotated model plan for ES and H Staff audits and appraisals is presented and discussed

  4. Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy.

    Science.gov (United States)

    Abe, James; Lobo, Jennifer M; Trifiletti, Daniel M; Showalter, Timothy N

    2017-08-24

    aid program, based upon Markov modeling with individualized model inputs, to provide a patient-centered framework to support for genomic-based treatment decisions for cancer patients. The guidance provided by our stakeholders may be broadly applicable to the communication of genomic test results to patients in a patient-centered fashion that supports effective shared decision-making that represents a spectrum of personal factors such as age, medical comorbidities, and individual priorities and values.

  5. STRATEGIC MANAGEMENT GUIDANCE IN HEALTH INSTITUTIONS MANAGEMENT: DETERMINATION OF MISSIONVISION- STRATEGY SELCUK UNIVERSITY MEDICAL FACULTY HOSPITAL SAMPLE

    OpenAIRE

    GÖKBEL, Hakkı; GÜLEŞ, Hasan Kürşat; ERGEN IŞIKLAR, Zeynep; ŞENER, Tuğba

    2016-01-01

    As the nature of the services they offer and areas in which they operate health care institutions are always in the process of change. Especially with the impact of technological advances, new techniques are constantly emerging in health care presentation, in parallel to innovation in health care change is also becoming necessary in the way of health care management. On the other hand today, research conducted in hospitals has reached a holisticand administrative size with the understanding t...

  6. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.

    Science.gov (United States)

    Jünger, Saskia; Payne, Sheila A; Brine, Jenny; Radbruch, Lukas; Brearley, Sarah G

    2017-09-01

    The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE. Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting. A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'. Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.

  7. Marijuana in the Workplace: Guidance for Occupational Health Professionals and Employers: Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine.

    Science.gov (United States)

    Phillips, Jennan A; Holland, Michael G; Baldwin, Debra D; Gifford-Meuleveld, Linda; Mueller, Kathryn L; Perkison, Brett; Upfal, Mark; Dreger, Marianne

    2015-04-01

    Employers are often put in a difficult position trying to accommodate state laws that allow the use of marijuana for medical purposes while enforcing federal rules or company drug-use policies based on federal law. To ensure workplace safety as well as compliance with state and federal legislation, employers should review state laws on discrimination against marijuana users and ensure that policies enacted are consistent with the state’s antidiscrimination statutes. Although it appears that in most states that allow medical marijuana use, employers can continue enforcing policies banning or restricting the use of marijuana, this approach may change on the basis of future court decisions. The Joint Task Force recommends that marijuana use be closely monitored for all employees in safety-sensitive positions, whether or not covered by federal drug-testing regulations. Best practice would support employers prohibiting marijuana use at work. Employers, in compliance with applicable state laws, may choose to simply prohibit their employees from working while using or impaired by marijuana. In some states, employers may choose to prohibit marijuana use by all members of their workforce whether on or off duty. Nevertheless, in all cases, a clear policy to guide decisions on when marijuana use is allowed and how to evaluate for impairment must be widely distributed and carefully explained to all workers. Legal consultation during policy development and continual review is imperative to ensure compliance with federal, state, and case law. Drug-use and drug-testing policies should clearly delineate expectations regarding on-the-job impairment and marijuana use outside of work hours. Specific criteria for use by supervisors and HR personnel when referring employees suspected of impairment for an evaluation by a qualified occupational health professional are critical. Detailed actions based on the medical evaluation results must also be clearly delineated for HRs, supervisors

  8. A guidance manual for estimating greenhouse gas emissions from fuel combustion and process-related sources for primary base metals smelting and refining

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-03-01

    This technical guidance manual is a useful resource for helping the metals industry compile inventories of its greenhouse gas (GHG) emissions. The guidance is consistent with Canada's national GHG accounting methodologies. It provides information to smelters and refiners of base metals on how to estimate their GHG emissions from fuel combustion and specific process-related activities. The base metals group in this manual included copper, nickel, lead, zinc, and cobalt. Fuel combustion includes all stationary combustion activities for generating heat or work, and includes waste incineration if the waste heat is used for energy. It also includes mobile fuel combustion activities such as on-site transportation of raw materials from one process to another. Guidance is provided for carbon dioxide (CO{sub 2}), methane (CH{sub 4}) and nitrous oxide (N{sub 2}O). Process-related activities include specific industrial processes that contribute to GHG emissions. For base metal smelting, this includes CO{sub 2} emissions from use of carbonate reagents, use of reducing agents, electrode consumption, and hydrofluorocarbons (HFC) emissions from use in refrigeration systems. This document also included sections on quality assurance; aspects of uncertainty assessment; verification; and, reporting of emissions information. refs., tabs., figs.

  9. Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

    Science.gov (United States)

    de Barros, F.; Rubin, Y.; Maxwell, R. M.

    2013-12-01

    In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

  10. Strategic Environmental Assessment as catalyst of healthier spatial planning: The Danish guidance and practice

    DEFF Research Database (Denmark)

    Kørnøv, Lone

    2009-01-01

    and guidance. This paper examines the inclusion of health as a formal component in impact assessment of spatial plans. Based upon a documentary study of 100 environmental reports, the paper analyses and discusses how health impact considerations are incorporated in SEA practice. It is found that health impacts...

  11. Health Equity Impacts of Medical Tourism in the Caribbean: The Need to Provide Actionable Guidance Regarding Balancing Local and Foreign Interests

    Directory of Open Access Journals (Sweden)

    L Hoffman

    2015-09-01

    Full Text Available Medical tourism is a practice where individuals cross international borders with the intention of privately purchasing healthcare. Caribbean countries are increasingly entering into the medical tourism market, which presents both opportunities and dangers. Our previous fieldwork shows that medical tourism requires host countries to balance the interests of private developers and domestic actors, including those accessing healthcare locally. Discussions with stakeholders in Jamaica, Cayman Islands, Barbados and St Lucia demonstrate concrete instances of this problem. Firstly, medical tourism can enhance training and employment opportunities for domestic health-workers. In doing so, it may exacerbate the inequitable distribution of these workers between the public and private sectors. Secondly, the expansion of private medical services can provide locals with more care options. These facilities may also crowd out existing local operators and price out local consumers. Thirdly, medical tourism is hailed as potentially cross-subsidizing and strengthening the local public health system. It may also heighten health inequities and distract local attention from the needs of the public health sector. Caribbean stakeholders are aware of the promise and dangers of medical tourism. However, they lack clear advice from medical tourism researchers about how to navigate these issues, and specifically balancing local and foreign interests. We call on researchers to shift focus from highlighting the theoretical problems associated with medical tourism to providing concrete guidance to stakeholders in a position to decide whether or not to pursue medical tourism development and to shape this development when it takes place.

  12. The Influence of the Japanese Nationwide Cardiovascular Prevention System Health Guidance on Smoking Cessation Among Smokers: A Propensity Score Matching Analysis.

    Science.gov (United States)

    Nakamura, Koshi; Watanabe, Makoto; Okuda, Nagako; Yoshita, Katsushi; Kabayama, Mai; Torii, Sayuki; Kuribayashi, Toru; Itai, Kazuyoshi; Kamide, Kei; Miura, Katsuyuki; Okayama, Akira

    2018-04-01

    We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was +2.64% (95% confidence interval: +1.51% to +3.77%) for males and +3.11% (-1.85% to +8.07%) for females. The ATE of single counseling was +0.61% (-1.17% to +2.38%) for males and -1.06% (-5.96% to +3.85%) for females. In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.

  13. GBS: Guidance by Semantics-Using High-Level Visual Inference to Improve Vision-Based Mobile Robot Localization

    Science.gov (United States)

    2015-08-28

    Major Findings Each major finding is demarcated by a horizontal rule , and a large, boldface heading. Guidance by Semantics Early Work with ARL on Data...Transactions on Medical Imaging, 27(5):629–640, 2008. [CSF+12] M. Cognetti, P. Stegagno, A. Franchi , G. Oriolo, and H.H. Bulthoff. 3-D mutual localiza...Segmentation. International Journal of Computer Vision, 59(2):167–181, 2004. [FOS09] A. Franchi , G. Oriolo, and P. Stegagno. Mutual localization in a

  14. Health technology assessment, value-based decision making, and innovation.

    Science.gov (United States)

    Henshall, Chris; Schuller, Tara

    2013-10-01

    Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

  15. School-Based Health Centers

    Science.gov (United States)

    ... care group, such as a community health center, hospital, or health department. A few are run by the school district itself. Centers often get money from charities and the government so they can give care ...

  16. Consensus Among International Ethical Guidelines for the Provision of Videoconferencing-Based Mental Health Treatments

    Science.gov (United States)

    Wakefield, Claire E; McGill, Brittany C; Wilson, Helen L; Patterson, Pandora

    2016-01-01

    Background Online technologies may reduce barriers to evidence-based mental health care, yet they also create numerous ethical challenges. Recently, numerous professional organizations and expert groups have produced best-practice guidelines to assist mental health professionals in delivering online interventions in an ethically and clinically sound manner. However, there has been little critical examination of these international best-practice guidelines regarding appropriate electronic mental health (e-mental health) service delivery via technologies such as videoconferencing (including Skype), particularly for specific, vulnerable populations. Further, the extent to which concordance exists between these guidelines remains unclear. Synthesizing this literature to provide clear guidance to both mental health professionals and researchers is critical to ensure continued progress in the field of e-mental health. Objective This study aims to review all currently available ethical and best-practice guidelines relating to videoconferencing-delivered mental health treatments in order to ascertain the recommendations for which international consensus could be found. Additionally, this review examines the extent to which each set of guidance addresses several key special populations, including children and young people, and populations living with illness. Methods This systematic review examined guidelines using a two-armed search strategy, examining (1) professional organizations’ published guidance; and (2) MEDLINE, PsycINFO, and EMBASE for the past ten years. In order to determine consensus for best-practice, a recommendation was considered "firm" if 50% or more of the reviewed guidelines endorsed it and "tentative" if recommended by fewer guidelines than these. The professional guidelines were also scored by two raters using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) criteria. Results In the study, 19 guidelines were included, yielding 11

  17. Graphic Turbulence Guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

  18. Graphical Turbulence Guidance - Composite

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

  19. Analysis of the Effects of Thermal Environment on Optical Systems for Navigation Guidance and Control in Supersonic Aircraft Based on Empirical Equations.

    Science.gov (United States)

    Cheng, Xuemin; Yang, Yikang; Hao, Qun

    2016-10-17

    The thermal environment is an important factor in the design of optical systems. This study investigated the thermal analysis technology of optical systems for navigation guidance and control in supersonic aircraft by developing empirical equations for the front temperature gradient and rear thermal diffusion distance, and for basic factors such as flying parameters and the structure of the optical system. Finite element analysis (FEA) was used to study the relationship between flying and front dome parameters and the system temperature field. Systematic deduction was then conducted based on the effects of the temperature field on the physical geometry and ray tracing performance of the front dome and rear optical lenses, by deriving the relational expressions between the system temperature field and the spot size and positioning precision of the rear optical lens. The optical systems used for navigation guidance and control in supersonic aircraft when the flight speed is in the range of 1-5 Ma were analysed using the derived equations. Using this new method it was possible to control the precision within 10% when considering the light spot received by the four-quadrant detector, and computation time was reduced compared with the traditional method of separately analysing the temperature field of the front dome and rear optical lens using FEA. Thus, the method can effectively increase the efficiency of parameter analysis and computation in an airborne optical system, facilitating the systematic, effective and integrated thermal analysis of airborne optical systems for navigation guidance and control.

  20. Analysis of the Effects of Thermal Environment on Optical Systems for Navigation Guidance and Control in Supersonic Aircraft Based on Empirical Equations

    Directory of Open Access Journals (Sweden)

    Xuemin Cheng

    2016-10-01

    Full Text Available The thermal environment is an important factor in the design of optical systems. This study investigated the thermal analysis technology of optical systems for navigation guidance and control in supersonic aircraft by developing empirical equations for the front temperature gradient and rear thermal diffusion distance, and for basic factors such as flying parameters and the structure of the optical system. Finite element analysis (FEA was used to study the relationship between flying and front dome parameters and the system temperature field. Systematic deduction was then conducted based on the effects of the temperature field on the physical geometry and ray tracing performance of the front dome and rear optical lenses, by deriving the relational expressions between the system temperature field and the spot size and positioning precision of the rear optical lens. The optical systems used for navigation guidance and control in supersonic aircraft when the flight speed is in the range of 1–5 Ma were analysed using the derived equations. Using this new method it was possible to control the precision within 10% when considering the light spot received by the four-quadrant detector, and computation time was reduced compared with the traditional method of separately analysing the temperature field of the front dome and rear optical lens using FEA. Thus, the method can effectively increase the efficiency of parameter analysis and computation in an airborne optical system, facilitating the systematic, effective and integrated thermal analysis of airborne optical systems for navigation guidance and control.

  1. Effect of differentiating exercise guidance based on a patient's level of low back pain in primary care

    DEFF Research Database (Denmark)

    Jorgensen, Jens Erik; Afzali, Tamana; Riis, Allan

    2018-01-01

    in patients in primary care. METHODS AND ANALYSIS: A systematic search will be performed on PubMed, EMBASE, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Physiotherapy Evidence Database (PEDRO), Cochrane and PROSPERO from their inception until September 2017. Published peer......-reviewed human experimental and observational studies with quantitative or qualitative designs will be included. Two independent reviewers will identify papers by reviewing titles and abstracts. Papers passing the initial selection will be appraised by two reviewers, based on their full texts. Furthermore...

  2. Health Benefits of Water-based Exercise

    Science.gov (United States)

    ... Pools Operating Public Hot Tubs/Spas Recommendations for Hydrotherapy Tanks Preventing Pool Chemical-Associated Health Events Chloramines & ... arthritis have more health improvements after participating in hydrotherapy than with other activities 8 . Water-based exercise ...

  3. THE ADDED VALUE OF INTEGRATE-HTA GUIDANCE IN THE WORK PROCESSES OF HEALTH TECHNOLOGY ASSESSMENT AGENCIES.

    Science.gov (United States)

    van der Wilt, Gert Jan; Kievit, Wietske; Oortwijn, Wija

    2017-01-01

    A central idea underlying the INTEGRATE-HTA project is that many of the interventions that are being used in health care are quite complex. By this, we mean that the relation between the delivery of the intervention on the one hand, and the onset of (desired and undesired) changes may be less straightforward than hoped for. There may be all sorts of reasons for this, varying from a lack of resources, lack of skills, perverse incentives, organizational problems, etc. Not identifying such factors and their potential impact may seriously compromise the policy relevance of a health technology assessment (HTA) (1). However, current approaches and methods in HTA do not seem to be adequately geared to deal with this complexity.

  4. Amending the Characterization of Guidance in Visual Analytics

    OpenAIRE

    Ceneda, Davide; Gschwandtner, Theresia; May, Thorsten; Miksch, Silvia; Schulz, Hans-Jörg; Streit, Marc; Tominski, Christian

    2017-01-01

    At VAST 2016, a characterization of guidance has been presented. It includes a definition of guidance and a model of guidance based on van Wijk's model of visualization. This note amends the original characterization of guidance in two aspects. First, we provide a clarification of what guidance actually is (and is not). Second, we insert into the model a conceptually relevant link that was missing in the original version.

  5. Health physics society position on draft environmental protection agency recommendations for federal radiation protection guidance for occupational exposure

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    Specific recommendations of the Health Physics Society are presented. There should not be any occupational exposure to ionizing radiation without the expectation of an overall benefit from the activity causing the exposure. Such activities should be permitted only when exposure to workers is controlled under a comprehensive radiation protection program that includes several elements: adequate, practical standards; adequately trained and qualified staff; adequately designed, operated and maintained facilities and equipment; appropriate monitoring programs, dose assessment programs and occupational exposure records; appropriate methods and procedures for controlling exposures in conformance with both the applicable limits and the ALARA philosophy; and appropriate quality assurance and audit programs

  6. WHO guidance grounded in a comprehensive approach to sexual and reproductive health and human rights: topical pre-exposure prophylaxis

    OpenAIRE

    Geary, Cynthia W; Bukusi, Elizabeth A; Geary, Cynthia W; Bukusi, Elizabeth A; van der Straten, Ariane; Stadler, Jonathan; Luecke, Ellen; Laborde, Nicole; Hartmann, Miriam; Montgomery, Elizabeth T; Corneli, Amy L; McKenna, Kevin; Headley, Jennifer; Ahmed, Khatija; Odhiambo, Jacob

    2014-01-01

    Introduction Risk perception is a core construct in many behaviour change theories in public health. Individuals who believe they are at risk of acquiring an illness may be more likely to engage in behaviours to reduce that risk; those who do not feel at risk may be unlikely to engage in risk reduction behaviours. Among participants who seroconverted in two FEM-PrEP sites – Bondo, Kenya, and Pretoria, South Africa – we explored perceived HIV risk and worry about acquiring HIV prior to HIV inf...

  7. CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

    Science.gov (United States)

    2011-01-01

    Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

  8. Guidance for the national healthcare disparities report

    National Research Council Canada - National Science Library

    Swift, Elaine K

    2002-01-01

    The Agency for Healthcare Research Quality commissioned the Institute of Medicine establish a committee to provide guidance on the National Healthcare Disparities Report is of access to health care...

  9. Community-based health insurance knowledge, concern ...

    African Journals Online (AJOL)

    Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. ... This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity ...

  10. FDA-EPA Public Health Guidance on Fish Consumption: A Case Study on Informal Interagency Cooperation in "Shared Regulatory Space".

    Science.gov (United States)

    Holden, Mark

    2015-01-01

    This article is a case study on how administrative agencies interact with each other in cases of shared regulatory jurisdiction. The theoretical literature on the topic of overlapping jurisdiction both (1) makes predictions about how agencies are expected to behave when they share jurisdiction, and (2) in recent iterations argues that overlapping jurisdiction can confer unique policymaking benefits. Through the lens of that theoretical literature, this article examines the relations between the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) regarding the public health risks posed by mercury in fish. It concludes that the FDA-EPA case study (1) corroborates the extant theoretical accounts of how agencies behave in cases of overlapping jurisdiction, (2) supports the conclusion of the recent scholarship that overlapping jurisdiction can confer unique policy benefits, and (3) reveals a few wrinkles not given adequate treatment in the extant literature.

  11. Late-in-life surgery associated with Creutzfeldt-Jakob disease: a methodological outline for evidence-based guidance

    Science.gov (United States)

    2013-01-01

    Background There is increasing epidemiological evidence of etiological links between general surgery and sporadic Creutzfeldt-Jakob disease (sCJD) with long incubation periods. The purpose of this study was to identify specific surgical procedures potentially associated with sCJD to be targeted for preventive presurgical-intervention guidance. Results We propose a three-step clinical guidance outline where surgical procedures associated with sCJD clinical onset – potentially more contaminant - are taken into account. Data on hospital discharges and surgical procedures were obtained from Danish and Swedish national in-patient hospital registries for 167 sCJD cases, onset 1987–2003, and for 835 matched and 2,224 unmatched population controls. Surgery was allocated to different life-time periods as previously reported, and frequencies were compared using logistic regression analysis. In the year preceding clinical onset, persons with sCJD underwent a statistically significant higher number of minor surgical interventions (OR (95% CI): 17.50 (3.64-84.24)), transluminal endoscopies (OR: 2.73 (1.01–7.37)) and gastrointestinal operations (OR: 3.51 (1.21–10.19)) compared to matched controls. Surgical discharges clustered towards clinical onset. These differences increased during the clinical period, with statistically significant higher frequencies for both endoscopies and minor surgery (OR: 13.91 (5.87-32.95), and for main surgical procedures (OR: 2.10 (1.00-4.39)), particularly gastrointestinal surgery (OR: 6.00 (1.83-19.66)), and surgery contacting skeletal muscle. Comparisons with unmatched controls yielded similar results for neurosurgery in the clinical period (OR: 19.40 (2.22-168.34)). Conclusions These results suggest that some types of surgical procedures are associated with sCJD, after clinical onset or particularly just before onset. Selective planning of such surgery to minimize instrument/device contamination or quarantining might be feasible

  12. WHO guidance grounded in a comprehensive approach to sexual and reproductive health and human rights: topical pre-exposure prophylaxis

    OpenAIRE

    Lusti-Narasimhan, Manjula; Khosla, Rajat; Baggaley, Rachel; Temmerman, Marleen; McGrory, Elizabeth; Farley, Tim

    2014-01-01

    Introduction: Two new microbicide products based on topical (vaginal) application of antiretroviral drugs – 1% tenofovir gel and the dapivirine ring – are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre-exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used. Discussion: Given that these new topical ...

  13. Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

    Directory of Open Access Journals (Sweden)

    Ihana Thaís Guerra de Oliveira Gondim

    Full Text Available Abstract Introduction: Home therapeutic exercises have been a target of interest in the treatment of the Parkinson's disease (PD. The way that the physical therapist guides and monitors these exercises can impact the success of therapy. Objective: To evaluate the effects of individualized orientation and monitoring by telephone in a self-supervised home therapeutic exercise program on signs and symptoms of PD and quality of life (QoL. Methods: Single-blind randomized clinical trials with 28 people with PD (Hoehn and Yahr 1 to 3. Patients were randomized into two groups: experimental and control. The experimental group had a meeting with individualized guidance about physiotherapy exercises present in a manual, received the manual to guide their activities at home and obtained subsequent weekly monitoring by telephone. The control group received the usual cares by the service. Both were orientated to carry out exercises three times a week during 12 weeks. Was evaluated: (1 activities of daily living (ADL and motor examination sections of the Unified Parkinson's Disease Rating Scale (UPDRS and QoL by the Parkinson Disease Questionnaire 39 (PDQ-39. The analysis between groups was performed by the Mann-Whitney test and intragroup through the Wilcoxon (p < 0.05. Results: Significant improvement in ADL (p= 0.001 and motor examination (p= 0.0008 of the UPDRS, PDQ-39 total (p = 0.027 and dimensions mobility (p = 0.027, emotional well-being (p= 0.021 and bodily discomfort (p = 0.027 in the experimental group compared to the control group. Conclusion: The individualized guidance and weekly monitoring by telephone in a self-supervised home therapeutic exercises program promoted positive effects on ADL, motor examination and QoL of people in early stages of PD.

  14. Information architecture. Volume 3: Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    The purpose of this document, as presented in Volume 1, The Foundations, is to assist the Department of Energy (DOE) in developing and promulgating information architecture guidance. This guidance is aimed at increasing the development of information architecture as a Departmentwide management best practice. This document describes departmental information architecture principles and minimum design characteristics for systems and infrastructures within the DOE Information Architecture Conceptual Model, and establishes a Departmentwide standards-based architecture program. The publication of this document fulfills the commitment to address guiding principles, promote standard architectural practices, and provide technical guidance. This document guides the transition from the baseline or defacto Departmental architecture through approved information management program plans and budgets to the future vision architecture. This document also represents another major step toward establishing a well-organized, logical foundation for the DOE information architecture.

  15. Achieving good oral health in children: the importance of a current, relevant and unbiased evidence base in paediatric dentistry.

    Science.gov (United States)

    Clarkson, J E; Bonetti, D; Worthington, H

    2013-06-01

    The Cochrane Collaboration was founded in 1993 as an international, non-profit and independent organisation dedicated to making up-to-date, accurate and reliable information about healthcare readily available. This paper discusses how the Cochrane Oral Health Group reviews have contributed to the oral health evidence base used in the development of many international and U.K. dental guidance documents, particularly in the field of paediatric dentistry.

  16. Environmental chemicals in human milk: a review of levels, infant exposures and health, and guidance for future research

    International Nuclear Information System (INIS)

    LaKind, Judy S.; Amina Wilkins, A.; Berlin, Cheston M.

    2004-01-01

    The aim of this review is to introduce the reader to various science and policy aspects of the topic of environmental chemicals in human milk. Although information on environmental chemicals in human milk has been available since the 1950s, it is only relatively recently that public awareness of the issue has grown. This review on environmental chemicals in human milk provides a resource summarizing what is currently known about levels and trends of environmental chemicals in human milk, potential infant exposures, and benefits of breast-feeding relative to the risks of exposures to environmental chemicals. The term 'environmental chemicals', as it pertains to human milk, refers to many classes of exogenous chemicals that may be detected in human milk. For example, pharmaceutical agents and alcohol are environmental chemicals that have been found in human milk. Other chemicals, such as heavy metals and volatile organic compounds, have also been detected in human milk. Most research on environmental chemicals in human milk has concentrated on persistent, bioaccumulative, and toxic (PBT) chemicals. In this review, a description of human milk is provided, including a brief review of endogenous substances in human milk. Determinants of levels of PBTs are discussed, as are models that have been developed to predict levels of PBTs in human milk and associated body burdens in breast-feeding infants. Methodologies for human milk sampling and analysis, and concepts for consideration in interpretation and communication of study results, as developed by the Technical Workshop on Human Milk Surveillance and Research for Environmental Chemicals in the United States are described. Studies which have compared the health risks and benefits associated with breast-feeding and formula-feeding are discussed

  17. Cell phone-based health education messaging improves health literacy.

    Science.gov (United States)

    Zhuang, Runsen; Xiang, Yueying; Han, Tieguang; Yang, Guo-An; Zhang, Yuan

    2016-03-01

    The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education. To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China. A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups. Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54. SMS may be a useful tool for improving health literacy.

  18. Extending FDA guidance to include consumer medication information (CMI) delivery on mobile devices.

    Science.gov (United States)

    Sage, Adam; Blalock, Susan J; Carpenter, Delesha

    This paper describes the current state of consumer-focused mobile health application use and the current U.S. Food and Drug Administration (FDA) guidance on the distribution of consumer medication information (CMI), and discusses recommendations and considerations for the FDA to expand CMI guidance to include CMI in mobile applications. Smartphone-based health interventions have been linked to increased medication adherence and improved health outcomes. Trends in smartphone ownership present opportunities to more effectively communicate and disseminate medication information; however, current FDA guidance for CMI does not outline how to effectively communicate CMI on a mobile platform, particularly in regards to user-centered design and information sourcing. As evidence supporting the potential effectiveness of mobile communication in health care continues to increase, CMI developers, regulating entities, and researchers should take note. Although mobile-based CMI offers an innovative mechanism to deliver medication information, caution should be exercised. Specifically, considerations for developing mobile CMI include consumers' digital literacy, user experience (e.g., usability), and the quality and accuracy of new widely used sources of information (e.g., crowd-sourced reviews and ratings). Recommended changes to FDA guidance for CMI include altering the language about scientific accuracy to address more novel methods of information gathering (e.g., anecdotal experiences and Google Consumer Surveys) and including guidance for usability testing of mobile health applications. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Plant-based diets and cardiovascular health.

    Science.gov (United States)

    Satija, Ambika; Hu, Frank B

    2018-02-13

    Plant-based diets, defined in terms of low frequency of animal food consumption, have been increasingly recommended for their health benefits. Numerous studies have found plant-based diets, especially when rich in high quality plant foods such as whole grains, fruits, vegetables, and nuts, to be associated with lower risk of cardiovascular outcomes and intermediate risk factors. This review summarizes the current evidence base examining the associations of plant-based diets with cardiovascular endpoints, and discusses the potential biological mechanisms underlying their health effects, practical recommendations and applications of this research, and directions for future research. Healthful plant-based diets should be recommended as an environmentally sustainable dietary option for improved cardiovascular health. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. A flight management algorithm and guidance for fuel-conservative descents in a time-based metered air traffic environment: Development and flight test results

    Science.gov (United States)

    Knox, C. E.

    1984-01-01

    A simple airborne flight management descent algorithm designed to define a flight profile subject to the constraints of using idle thrust, a clean airplane configuration (landing gear up, flaps zero, and speed brakes retracted), and fixed-time end conditions was developed and flight tested in the NASA TSRV B-737 research airplane. The research test flights, conducted in the Denver ARTCC automated time-based metering LFM/PD ATC environment, demonstrated that time guidance and control in the cockpit was acceptable to the pilots and ATC controllers and resulted in arrival of the airplane over the metering fix with standard deviations in airspeed error of 6.5 knots, in altitude error of 23.7 m (77.8 ft), and in arrival time accuracy of 12 sec. These accuracies indicated a good representation of airplane performance and wind modeling. Fuel savings will be obtained on a fleet-wide basis through a reduction of the time error dispersions at the metering fix and on a single-airplane basis by presenting the pilot with guidance for a fuel-efficient descent.

  1. Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures

    Directory of Open Access Journals (Sweden)

    Katharine E. Alter

    2017-12-01

    Full Text Available Injections of botulinum neurotoxins (BoNTs are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

  2. D ampersand D screening risk evaluation guidance

    International Nuclear Information System (INIS)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D ampersand D) facilities. Although this method has been developed for D ampersand D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D ampersand D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis

  3. D & D screening risk evaluation guidance

    Energy Technology Data Exchange (ETDEWEB)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D&D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis.

  4. Plowshare radiation protection guidance

    International Nuclear Information System (INIS)

    Parker, H.M.

    1969-01-01

    The recommendations of the ICRP and the NCRP were developed primarily for occupational radiation exposures. They were later modified and applied to non-occupational exposures of populations. These, with appropriate interpretations, can be used to provide Plowshare radiation protection guidance. Exposures from Plowshare operations will tend to be acute, arising from radionuclides of relatively short half-life, but will have some chronic aspects due to small amounts of long-lived radionuclides generated. In addition, the neutron activation process of Plowshare technology will produce radionuclides not commonly encountered in routine nuclear energy programs. How these radionuclides contribute to personnel exposure is known for only a few situations that may not be representative of Plowshare exposure. Further complications arise from differences in radionuclide deposition and physiological sensitivity among individuals of different ages and states of health in the exposed population. All parameters necessary to evaluate such exposures are not available, even for good quantitative approximations, resulting in the need for interpretive experience. (author)

  5. Plowshare radiation protection guidance

    Energy Technology Data Exchange (ETDEWEB)

    Parker, H M [Environmental and Life Sciences Division, Battelle Memorial Institute, Pacific Northwest Laboratory, Richland, WA (United States)

    1969-07-01

    The recommendations of the ICRP and the NCRP were developed primarily for occupational radiation exposures. They were later modified and applied to non-occupational exposures of populations. These, with appropriate interpretations, can be used to provide Plowshare radiation protection guidance. Exposures from Plowshare operations will tend to be acute, arising from radionuclides of relatively short half-life, but will have some chronic aspects due to small amounts of long-lived radionuclides generated. In addition, the neutron activation process of Plowshare technology will produce radionuclides not commonly encountered in routine nuclear energy programs. How these radionuclides contribute to personnel exposure is known for only a few situations that may not be representative of Plowshare exposure. Further complications arise from differences in radionuclide deposition and physiological sensitivity among individuals of different ages and states of health in the exposed population. All parameters necessary to evaluate such exposures are not available, even for good quantitative approximations, resulting in the need for interpretive experience. (author)

  6. DOE Waste Treatability Group Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, T.D.

    1995-01-01

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level.

  7. DOE Waste Treatability Group Guidance

    International Nuclear Information System (INIS)

    Kirkpatrick, T.D.

    1995-01-01

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level

  8. Accuracy of Ultrasound-Based Image Guidance for Daily Positioning of the Upper Abdomen: An Online Comparison With Cone Beam CT

    International Nuclear Information System (INIS)

    Boda-Heggemann, Judit; Mennemeyer, Philipp; Wertz, Hansjoerg; Riesenacker, Nadja; Kuepper, Beate; Lohr, Frank; Wenz, Frederik

    2009-01-01

    Purpose: Image-guided intensity-modulated radiotherapy can improve protection of organs at risk when large abdominal target volumes are irradiated. We estimated the daily positioning accuracy of ultrasound-based image guidance for abdominal target volumes by a direct comparison of daily imaging obtained with cone beam computed tomography (CBCT). Methods and Materials: Daily positioning (n = 83 positionings) of 15 patients was completed by using ultrasound guidance after an initial CBCT was obtained. Residual error after ultrasound was estimated by comparison with a second CBCT. Ultrasound image quality was visually rated using a scale of 1 to 4. Results: Of 15 patients, 7 patients had good sonographic imaging quality, 5 patients had satisfactory sonographic quality, and 3 patients were excluded because of unsatisfactory sonographic quality. When image quality was good, residual errors after ultrasound were -0.1 ± 3.11 mm in the x direction (left-right; group systematic error M = -0.09 mm; standard deviation [SD] of systematic error, Σ = 1.37 mm; SD of the random error, σ = 2.99 mm), 0.93 ± 4.31 mm in the y direction (superior-inferior, M = 1.12 mm; Σ = 2.96 mm; σ = 3.39 mm), and 0.71 ± 3.15 mm in the z direction (anteroposterior; M = 1.01 mm; Σ = 2.46 mm; σ = 2.24 mm). For patients with satisfactory image quality, residual error after ultrasound was -0.6 ± 5.26 mm in the x (M = 0.07 mm; Σ = 5.67 mm; σ = 4.86 mm), 1.76 ± 4.92 mm in the y (M = 3.54 mm; Σ = 4.1 mm; σ = 5.29 mm), and 1.19 ± 4.75 mm in the z (M = 0.82 mm; Σ = 2.86 mm; σ = 3.05 mm) directions. Conclusions: In patients from whom good sonographic image quality could be obtained, ultrasound improved daily positioning accuracy. In the case of satisfactory image quality, ultrasound guidance improved accuracy compared to that of skin marks only minimally. If sonographic image quality was unsatisfactory, daily CBCT scanning improved treatment accuracy distinctly over that of ultrasound. Use of

  9. A Conceptual Flash Flood Early Warning System for Africa, Based on Terrestrial Microwave Links and Flash Flood Guidance

    Directory of Open Access Journals (Sweden)

    Joost C. B. Hoedjes

    2014-04-01

    Full Text Available A conceptual flash flood early warning system for developing countries is described. The system uses rainfall intensity data from terrestrial microwave communication links and the geostationary Meteosat Second Generation satellite, i.e., two systems that are already in place and operational. Flash flood early warnings are based on a combination of the Flash Flood Guidance method and a hydrological model. The system will be maintained and operated through a public-private partnership, which includes a mobile telephone operator, a national meteorological service and an emergency relief service. The mobile telephone operator acts as both the supplier of raw input data and the disseminator of early warnings. The early warning system could significantly reduce the number of fatalities due to flash floods, improve the efficiency of disaster risk reduction efforts and play an important role in strengthening the resilience to climate change of developing countries in Africa. This paper describes the system that is currently being developed for Kenya.

  10. TH-CD-207A-06: Optimizing Four-Dimensional Digital Tomosynthesis Acquisition Based On Respiratory Guidance

    International Nuclear Information System (INIS)

    Kim, D; Kang, S; Kim, T; Kim, K; Cho, M; Shin, D; Noh, Y; Suh, T; Lee, S; Kim, S

    2016-01-01

    Purpose: Patient breathing-related sorting method of projections in 4D digital tomosythesis (DTS) can be suffered from severe artifacts due to non-uniform angle distribution of projections and noncoplanar reconstructed images for each phase. In this study, we propose a method for optimally acquiring projection images in 4D DTS. Methods: In this method every pair of projections at x-ray tube’s gantry angles symmetrical with respect to the center of the range of gantry rotation is obtained at the same respiration amplitude. This process is challenging but becomes feasible with visual-biofeedback using a patient specific respiration guide wave which is in sinusoidal shape (i.e., smooth and symmetrical enough). Depending on scan parameters such as the number of acquisition points per cycle, total scan angle and projections per acquisition amplitude, acquisition sequence is pre-determined. A simulation study for feasibility test was performed. To mimic actual situation closely, a group of volunteers were recruited and breathing data were acquired both with/without biofeedback. Then, x-ray projections for a humanoid phantom were virtually performed following (1) the breathing data from volunteers without guide, (2) the breathing data with guide and (3) the planned breathing data (i.e., ideal situation). Images from all of 3 scenarios were compared. Results: Scenario #2 showed significant artifact reduction compared to #1 while did minimal increase from the ideal situation (i.e., scenario #3). We verified the performance of the method with regard to the degree of inaccuracy during respiratory guiding. Also, the scan angle dependence-related differences in the DTS images could reduce between using the proposed method and the established patient breathing-related sorting method. Conclusion: Through the proposed 4D DTS method, it is possible to improve the accuracy of image guidance between intra/inter fractions with relatively low imaging dose. This research was supported

  11. TH-CD-207A-06: Optimizing Four-Dimensional Digital Tomosynthesis Acquisition Based On Respiratory Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D; Kang, S; Kim, T; Kim, K; Cho, M; Shin, D; Noh, Y; Suh, T [Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Lee, S [Department of Radiological Science, College of Medical Science, Konyang University, Daejeon (Korea, Republic of); Kim, S [Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, VA (United States)

    2016-06-15

    Purpose: Patient breathing-related sorting method of projections in 4D digital tomosythesis (DTS) can be suffered from severe artifacts due to non-uniform angle distribution of projections and noncoplanar reconstructed images for each phase. In this study, we propose a method for optimally acquiring projection images in 4D DTS. Methods: In this method every pair of projections at x-ray tube’s gantry angles symmetrical with respect to the center of the range of gantry rotation is obtained at the same respiration amplitude. This process is challenging but becomes feasible with visual-biofeedback using a patient specific respiration guide wave which is in sinusoidal shape (i.e., smooth and symmetrical enough). Depending on scan parameters such as the number of acquisition points per cycle, total scan angle and projections per acquisition amplitude, acquisition sequence is pre-determined. A simulation study for feasibility test was performed. To mimic actual situation closely, a group of volunteers were recruited and breathing data were acquired both with/without biofeedback. Then, x-ray projections for a humanoid phantom were virtually performed following (1) the breathing data from volunteers without guide, (2) the breathing data with guide and (3) the planned breathing data (i.e., ideal situation). Images from all of 3 scenarios were compared. Results: Scenario #2 showed significant artifact reduction compared to #1 while did minimal increase from the ideal situation (i.e., scenario #3). We verified the performance of the method with regard to the degree of inaccuracy during respiratory guiding. Also, the scan angle dependence-related differences in the DTS images could reduce between using the proposed method and the established patient breathing-related sorting method. Conclusion: Through the proposed 4D DTS method, it is possible to improve the accuracy of image guidance between intra/inter fractions with relatively low imaging dose. This research was supported

  12. Online thesis guidance management information system

    Science.gov (United States)

    Nasution, T. H.; Pratama, F.; Tanjung, K.; Siregar, I.; Amalia, A.

    2018-03-01

    The development of internet technology in education is still not maximized, especially in the process of thesis guidance between students and lecturers. Difficulties met the lecturers to help students during thesis guidance is the limited communication time and the compatibility of schedule between students and lecturer. To solve this problem, we designed an online thesis guidance management information system that helps students and lecturers to do thesis tutoring process anytime, anywhere. The system consists of a web-based admin app for usage management and an android-based app for students and lecturers.

  13. NGST fine guidance sensor

    Science.gov (United States)

    Rowlands, Neil; Hutchings, John; Murowinski, Richard G.; Alexander, Russ

    2003-03-01

    Instrumentation for the Next Generation Space Telescope (NGST) is currently in the Phase A definition stage. We have developed a concept for the NGST Fine Guidance Sensor or FGS. The FGS is a detector array based imager which resides in the NGST focal plane. We report here on tradeoff studies aimed at defining an overall configuration of the FGS which will meet the performance and interface requirements. A key performance requirement is a noise equivalent angle of 3 milli-arcseconds to be achieved with 95% probability for any pointing of the observatory in the celestial sphere. A key interface requirement is compatibility with the architecture of the Integrated Science Instrument Module (ISIM). The concept developed consists of two independent and redundant FGS modules, each with a 4' x 2' field of view covered by two 2048 x 2048 infrared detector arrays, providing 60 milli-arcsecond sampling. Performance modeling supporting the choice of this architecture and the trade space considered is presented. Each module has a set of readout electronics which perform star detection, pixel-by-pixel correction, and in fine guiding mode, centroid calculation. These readout electronics communicate with the ISIM Command &Data Handling Units where the FGS control software is based. Rationale for this choice of architecture is also presented.

  14. Towards Evidence Based Usability in Health Informatics?

    NARCIS (Netherlands)

    Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.

    2015-01-01

    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still

  15. Accuracy and inter-observer variability of 3D versus 4D cone-beam CT based image-guidance in SBRT for lung tumors

    International Nuclear Information System (INIS)

    Sweeney, Reinhart A; Seubert, Benedikt; Stark, Silke; Homann, Vanessa; Müller, Gerd; Flentje, Michael; Guckenberger, Matthias

    2012-01-01

    To analyze the accuracy and inter-observer variability of image-guidance (IG) using 3D or 4D cone-beam CT (CBCT) technology in stereotactic body radiotherapy (SBRT) for lung tumors. Twenty-one consecutive patients treated with image-guided SBRT for primary and secondary lung tumors were basis for this study. A respiration correlated 4D-CT and planning contours served as reference for all IG techniques. Three IG techniques were performed independently by three radiation oncologists (ROs) and three radiotherapy technicians (RTTs). Image-guidance using respiration correlated 4D-CBCT (IG-4D) with automatic registration of the planning 4D-CT and the verification 4D-CBCT was considered gold-standard. Results were compared with two IG techniques using 3D-CBCT: 1) manual registration of the planning internal target volume (ITV) contour and the motion blurred tumor in the 3D-CBCT (IG-ITV); 2) automatic registration of the planning reference CT image and the verification 3D-CBCT (IG-3D). Image quality of 3D-CBCT and 4D-CBCT images was scored on a scale of 1–3, with 1 being best and 3 being worst quality for visual verification of the IGRT results. Image quality was scored significantly worse for 3D-CBCT compared to 4D-CBCT: the worst score of 3 was given in 19 % and 7.1 % observations, respectively. Significant differences in target localization were observed between 4D-CBCT and 3D-CBCT based IG: compared to the reference of IG-4D, tumor positions differed by 1.9 mm ± 0.9 mm (3D vector) on average using IG-ITV and by 3.6 mm ± 3.2 mm using IG-3D; results of IG-ITV were significantly closer to the reference IG-4D compared to IG-3D. Differences between the 4D-CBCT and 3D-CBCT techniques increased significantly with larger motion amplitude of the tumor; analogously, differences increased with worse 3D-CBCT image quality scores. Inter-observer variability was largest in SI direction and was significantly larger in IG using 3D-CBCT compared to 4D-CBCT: 0.6 mm versus 1.5 mm

  16. Strategies for Structural Youth Unemployment: a Capability Approach for Guidance

    OpenAIRE

    Massimiliano Costa; Daniele Morselli; John Polesel; Suzanne Rice

    2015-01-01

    The aim of this article is to present an innovative approach for guidance. The article starts by introducing the structural reason of unemployment in Italy. It presents the Australian model of guidance and the new reforms on guidance which are being introduced in Italy. It then describes a Change Laboratory intervention carried in a vocational setting in Australia in 2012, which is proposed as model of guidance based on the capability approach.The different stakeholders actively participate i...

  17. Optimal Aerocapture Guidance

    Data.gov (United States)

    National Aeronautics and Space Administration — The main goal of my research is to develop, implement, verify, and validate an optimal numerical predictor-corrector aerocapture guidance algorithm that is...

  18. Coral Reef Guidance

    Science.gov (United States)

    Guidance prepared by EPA and Army Corps of Engineers concerning coral reef protection under the Clean Water Act, Marine Protection, Research, and Sanctuaries Act, Rivers and Harbors Act, and Federal Project Authorities.

  19. Laser Guidance Analysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility, which provides for real time, closed loop evaluation of semi-active laser guidance hardware, has and continues to be instrumental in the development...

  20. Guidance on future art commissioning.

    Science.gov (United States)

    2009-05-01

    Delegates at Building Better Healthcare's recent "National Patient Environment and the Arts Conference 2009" in London heard how national public arts think tank ixia has appointed Bristol-based arts and wellbeing development agency Willis Newson to write "concise and convincing guidance" on commissioning art for new healthcare facilities. A key message, during a joint presentation, was that integrating artwork into hospitals and other healthcare premises requires the earliest possible consideration to reap the maximum rewards.

  1. Visual guidance of mobile platforms

    Science.gov (United States)

    Blissett, Rodney J.

    1993-12-01

    Two systems are described and results presented demonstrating aspects of real-time visual guidance of autonomous mobile platforms. The first approach incorporates prior knowledge in the form of rigid geometrical models linking visual references within the environment. The second approach is based on a continuous synthesis of information extracted from image tokens to generate a coarse-grained world model, from which potential obstacles are inferred. The use of these techniques in workplace applications is discussed.

  2. Individual plant examination: Submittal guidance

    International Nuclear Information System (INIS)

    1989-08-01

    Based on a Policy Statement on Severe Accidents Regarding Future Designs and Existing Plants, the performance of a plant examination is requested from the licensee of each nuclear power plant. The plant examination looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document delineates guidance for reporting the results of that plant examination. 38 refs., 2 tabs

  3. Evaluation of the endocrine activity of 2,4,6-tribromophenol, benzanthrone and benzophenone-2 based on Appendix 7.8-5 of REACH guidance document

    DEFF Research Database (Denmark)

    Duis, Karen; Holbech, Henrik; Velasco-Santamaría, Yohana M.

    Within a project funded by the German Federal Environment Agency, the practicability of Appendix 7.8-5 of REACH guidance document R.7b was evaluated using three case study substances. Shortcomings in the guidance were identified. An assessment of potential endocrine activity in aquatic vertebrates...

  4. Construction of health monitoring system for traveler based on the mobile Internet

    Directory of Open Access Journals (Sweden)

    Wei Haoqian

    2017-04-01

    Full Text Available With the development of communication technology and computer technology,intelligent terminals represented by smartphone and mobile Internet have become indispensable tools in people's life and work.As the intelligent terminal platform is widely used and the wearable medical equipment is gradually mature,this paper based on the Internet designs and develops a health monitoring system for travelers who suffered from chronic diseases or worried about their physical conditions,to provide a whole process of health monitoring and assistant service.The system,combing smartphone and wearable medical devices,uploads the health and physical signs data to the health monitoring platform through the mobile Internet.Then the professionals statistically analyze the data and provide appropriate advice and guidance,so as to achieve the remote medical treatment for travelers.

  5. The graphics-based human interface to the DISYS diagnostic/control guidance system at EBR-2

    International Nuclear Information System (INIS)

    Edwards, R.M.; Chavez, C.; Kamarthi, S.; Dharap, S.; Lindsay, R.W.; Staffon, J.

    1990-01-01

    An initial graphics based interface to the real-time DISYS diagnostic system has been developed using the multi-tasking capabilities of the UNIX operating system and X-Windows 11 Xlib graphics library. This system is interfaced to live plant data at the Experimental Breeder Reactor (EBR-2) for the Argon Cooling System of fuel handling operations and the steam plant. The interface includes an intelligent process schematic which highlights problematic components and sensors based on the results of the diagnostic computations. If further explanation of a faulted component is required, the user can call up a display of the diagnostic computations presented in a tree-like diagram. Numerical data on the process schematic and optional diagnostic tree are updated as new real-time data becomes available. The initial X-Windows 11 based interface will be further enhanced using VI Corporation DATAVIEWS graphical data base software. 5 refs., 6 figs

  6. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    Science.gov (United States)

    Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

    2017-01-01

    Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

  7. Organizing the public health-clinical health interface: theoretical bases.

    Science.gov (United States)

    St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard

    2006-01-01

    This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

  8. Review of soil contamination guidance

    International Nuclear Information System (INIS)

    Mueller, M.A.; Kennedy, W.E. Jr.; Soldat, J.K.

    1981-08-01

    A review of existing and proposed radioactive soil contamination standards and guidance was conducted for United Nuclear Corporation (UNC), Office of Surplus Facilities Management. Information was obtained from both government agencies and other sources during a literature survey. The more applicable standards were reviewed, evaluated, and summarized. Information pertaining to soil contamination for both facility operation and facility decommissioning was obtained from a variety of sources. These sources included: the Code of Federal Regulations, regulatory guides, the Federal Register, topical reports written by various government agencies, topical reports written by national laboratories, and publications from the American National Standards Institute (ANSI). It was difficult to directly compare the standards and guidance obtained from these sources since each was intended for a specific situation and different units or bases were used. However, most of the information reviewed was consistent with the philosophy of maintaining exposures at levels as low as reasonably achievable

  9. Radionuclide Data Quality Evaluation Guidance

    International Nuclear Information System (INIS)

    Tucker, B.J.; Winters, M.S.; Evans, D.

    2009-01-01

    A considerable amount of radioanalytical data is generated during various phases of the characterization and remediation of radiologically-contaminated sites and properties. It is critical that data generated from the analysis of collected samples be to a level of quality usable by the project and acceptable to stakeholders. In July 2004, the final version of a multi-agency guidance manual entitled Multi-Agency Radiological Analytical Protocols Manual (MARLAP) was issued by the Environmental Protection Agency, Department of Energy, Department of Homeland Security, Nuclear Regulatory Commission, Department of Defense, National Institute of Standards and Technology, U. S. Geological Survey, Food and Drug Administration, and the States of Kentucky and California. The authors' purpose is to introduce readers to some key elements of MARLAP as it relates to radioanalytical lab quality control, and to demonstrate how these guidance elements can be effectively incorporated into mature radioanalytical lab operations and data validation regimes. Based upon the logic and statistical methodologies presented in MARLAP, the authors have revised existing project-specific Radioanalytical Data Evaluation Guidance (RadDEG) used at the FUSRAP Maywood Site in Maywood, NJ. The RadDEG allows users to qualify data in a meaningful way by tying the usability of the data to its activity and uncertainty relative to project action levels and QC results. This exercise may be useful to other projects looking to implement a MARLAP-based approach into their project/site-specific data evaluation methodologies. (authors)

  10. Acupuncture for treating polycystic ovary syndrome: guidance for future randomized controlled trials

    OpenAIRE

    Wu, Y; Robinson, N; Hardiman, PJ; Taw, MB; Zhou, J; Wang, FF; Qu, F

    2016-01-01

    Objective: To provide guidance for future randomized controlled trials (RCTs) based on a review concerning acupuncture for treating polycystic ovary syndrome (PCOS). Methods: A comprehensive literature search was conducted in October 2015 using MEDLINE, EMBASE, SCISEARCH, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Menstrual Disorders and Subfertility Group trials register, Allied and Complementary Medicine (AMED), China National Knowledge Infrastructure (CNKI), and...

  11. Guidance on accidents involving radioactivity

    International Nuclear Information System (INIS)

    1989-01-01

    This annex contains advice to Health Authorities on their response to accidents involving radioactivity. The guidance is in six parts:-(1) planning the response required to nuclear accidents overseas, (2) planning the response required to UK nuclear accidents a) emergency plans for nuclear installations b) nuclear powered satellites, (3) the handling of casualties contaminated with radioactive substances, (4) background information for dealing with queries from the public in the event of an accident, (5) the national arrangements for incident involving radioactivity (NAIR), (6) administrative arrangements. (author)

  12. Values-based recruitment in health care.

    Science.gov (United States)

    Miller, Sam Louise

    2015-01-27

    Values-based recruitment is a process being introduced to student selection for nursing courses and appointment to registered nurse posts. This article discusses the process of values-based recruitment and demonstrates why it is important in health care today. It examines the implications of values-based recruitment for candidates applying to nursing courses and to newly qualified nurses applying for their first posts in England. To ensure the best chance of success, candidates should understand the principles and process of values-based recruitment and how to prepare for this type of interview.

  13. Problem Based Learning: Does It Provide Appropriate Levels of Guidance and Flexibility for Use in Police Recruit Education?

    Science.gov (United States)

    Shipton, Brett

    2009-01-01

    Education programs for police recruits have often been criticised for their over-reliance on teacher-centred approaches that are less than ideal for promoting functional knowledge and critical thinking skills. Problem-Based Learning (PBL), which is suggested as an alternative, has been criticised for not providing novice learners with appropriate…

  14. Promoting Socially Shared Metacognitive Regulation in Collaborative Project-Based Learning: A Framework for the Design of Structured Guidance

    Science.gov (United States)

    Kim, Dongho; Lim, Cheolil

    2018-01-01

    Despite the emergence of collaborative project-based learning in higher education settings, how it can be supported has received little attention. We noted the positive impact of socially shared metacognitive regulation on students' collaboration processes. The purpose of this study was to present a framework for the design and implementation of…

  15. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    OpenAIRE

    Larson, S; Chapman, S; Spetz, J; Brindis, CD

    2017-01-01

    Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

  16. Bearing Health Assessment Based on Chaotic Characteristics

    Directory of Open Access Journals (Sweden)

    Chen Lu

    2013-01-01

    Full Text Available Vibration signals extracted from rotating parts of machinery carry a lot of useful information about the condition of operating machine. Due to the strong non-linear, complex and non-stationary characteristics of vibration signals from working bearings, an accurate and reliable health assessment method for bearing is necessary. This paper proposes to utilize the selected chaotic characteristics of vibration signal for health assessment of a bearing by using self-organizing map (SOM. Both Grassberger-Procaccia algorithm and Takens' theory are employed to calculate the characteristic vector which includes three chaotic characteristics, such as correlation dimension, largest Lyapunov exponent and Kolmogorov entropy. After that, SOM is used to map the three corresponding characteristics into a confidence value (CV which represents the health state of the bearing. Finally, a case study based on vibration datasets of a group of testing bearings was conducted to demonstrate that the proposed method can reliably assess the health state of bearing.

  17. Health Literacy Based Communication by Illinois Pharmacists

    Directory of Open Access Journals (Sweden)

    Radhika Devraj

    2015-01-01

    Full Text Available Objectives: Health literacy has received attention as an important issue for pharmacists to consider when interacting with patients. Yet, there is little information about methods pharmacists use to communicate with patients and their extent of use of health literacy based interventions during patient interactions. The purpose of this study was to examine methods of communication and types of health literacy based interventions that practicing pharmacists use in Illinois. Methods: A survey instrument addressing the study purpose was designed along with other items that were part of a larger study. Eleven items in the survey referred to pharmacist-patient communication. The instrument was pilot tested before administering to a random sample of 1457 pharmacists from the Illinois Pharmacists Association. Data were primarily collected via a mailed survey using Dillman’s five step total design method (TDM. Two reminder letters were mailed at two week intervals to non-respondents. Results: Usable responses were obtained from 701 respondents (48.1% response rate. Using simple words (96% and asking patients open-ended questions to determine comprehension (85% were the most frequent methods that pharmacists used to communicate with patients. Only 18% of respondents always asked patients to repeat medication instructions to confirm understanding. The various recommended types of health literacy interventions were “always” performed by only 8 to 33% of the respondents. More than 50% of respondents indicated that they rarely or never had access to an interpreter (51%, or employed bilingual pharmacists (59%. Only 11% of pharmacists said that they rarely/never pay attention to nonverbal cues that may suggest low health literacy. Conclusions: Pharmacists infrequently use action oriented health literacy interventions such as using visual aids, having interpreter access, medication calendars, etc. Additional training on health literacy, its scope, and

  18. BLENDED LEARNING METHOD BASED ON LOCAL WISDOM AS A SPIRITUAL GUIDANCE HOLY TRINITY COMMUNITY IN DISTRICT BENGKAYANG

    OpenAIRE

    Priska Vasantan

    2016-01-01

    Bengkayang is one of the districts the outermost in Indonesia. The district has limitations and underdevelopment in various fields, one of which is in the field of education. Writing this article aims to show that blended learning based on local wisdom is very helpful coaching Holy Trinity Community (HTC) in the district Bengkayang. It has been proven from previous studies, suggesting that coaching HTC with blended learning to be more flexible, effective and efficient . Blended learning has b...

  19. Overcoming consumer inertia to dietary guidance.

    Science.gov (United States)

    Webb, Densie; Byrd-Bredbenner, Carol

    2015-07-01

    Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. © 2015 American Society for Nutrition.

  20. Overcoming Consumer Inertia to Dietary Guidance12

    Science.gov (United States)

    Webb, Densie; Byrd-Bredbenner, Carol

    2015-01-01

    Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. PMID:26178023

  1. Does the insertion of a gel-based marker at stereotactic breast biopsy allow subsequent wire localizations to be carried out under ultrasound guidance?

    International Nuclear Information System (INIS)

    McMahon, M.A.; James, J.J.; Cornford, E.J.; Hamilton, L.J.; Burrell, H.C.

    2011-01-01

    Aim: To investigate whether the insertion of a gel-based marker at the time of stereotactic breast biopsy allows subsequent preoperative localization to be performed under ultrasound guidance. Materials and methods: One hundred consecutive women who underwent either a 10 G stereotactic vacuum-assisted breast biopsy or 14 G stereotactic core biopsy with marker placement, followed by wire localization and surgical excision were identified. All had mammographic abnormalities not initially visible with ultrasound. The method of preoperative localization was recorded and its success judged with reference to the wire position on the post-procedure films relative to the mammographic abnormality and the marker. Histopathology data were reviewed to ensure the lesion had been adequately excised. Results: Eighty-three women (83%) had a successful ultrasound-guided wire localization. Successful ultrasound-guided localization was more likely after stereotactic vacuum biopsy (86%) compared to stereotactic core biopsy (68%), although this did not quite reach statistical significance (p = 0.06). Conclusion: The routine placement of a gel-based marker after stereotactic breast biopsy facilitates preoperative ultrasound-guided localization.

  2. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    Washington TRU Solutions, LLC

    2003-01-01

    The purpose of this program guidance document is to provide technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the SARP and/or C of C shall govern. The C of C states: ''...each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, ''Operating Procedures,'' of the application.'' It further states: ''...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, ''Acceptance Tests and Maintenance Program of the Application.'' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC approved, users need to be familiar with 10 CFR (section) 71.11, ''Deliberate Misconduct.'' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. This document details the instructions to be followed to operate, maintain, and test the RH-TRU 72-B packaging. This Program Guidance standardizes instructions for all users. Users shall follow these instructions. Following these instructions assures that operations are safe and meet the requirements of the SARP. This document is available on the Internet at: ttp://www.ws/library/t2omi/t2omi.htm. Users are responsible for ensuring they are using the current revision and change notices. Sites may prepare their own document using the word

  3. Lifestyles Based on Health Components in Iran

    Directory of Open Access Journals (Sweden)

    Babaei

    2016-07-01

    Full Text Available Context Lifestyle is a way employed by people, groups and nations and is formed in specific geographical, economic, political, cultural and religious texts. Health depends on lifestyle and is essential to preserve and promote health and improve lifestyle. Objectives The present study aimed to investigate lifestyle based on health-oriented components in Iran. Data Sources The research was conducted through E-banks including scientific information database (SID, Iran medical science databank (Iran Medex, Iran journal databank (Magiran and other databases such as Elsevier, PubMed and google scholar meta search engine regarding the subject from 2000 to 2014. Moreover, Official Iranian statistics and information were applied. The search terms used included lifestyle, health, health promoting behaviors, health-oriented lifestyle and lifestyle in Iran. Study Selection In the primary research, many papers were observed out of which 157 (120 in Farsi and 37 in English were selected. Data Extraction Following the careful study of these papers and excluding the unqualified papers, 19 papers with thorough information and higher relevance with the research purpose were selected. Results After examining articles based on the selected keywords and search strategies, 215 articles (134 in Farsi and 81 in English were obtained. Components of lifestyle and health are increasing in recent years; therefore, 8 (42% and 11 (58% articles were published during 2005 - 2010 and 2011 - 2014, respectively. Among them, there were 3 (16%, 8 (42%, 2 (10.5%, 2 (10.5% and 0 articles on the review of literature, descriptive-analytic, qualitative, analytic and descriptive articles, respectively. Conclusions Due to positive effect of healthy lifestyle on health promotion of individuals, it would be better for the government to provide comprehensive programs and policies in the society to enhance awareness of people about positive effects of health-oriented lifestyle on life and

  4. A risk-based approach to health criteria for radon indoors -report on a WHO initiative

    International Nuclear Information System (INIS)

    Steinhaeusler, F.

    1994-01-01

    The World Health Organization (WHO), Regional Office for Europe, organised a meeting of a working group on indoor air quality in Eilat, Israel, from 28 March to 4 April 1993. The aim was to develop a risk-based approach to health criteria for radon indoors. The Group reviewed the latest epidemiological data from occupational and non-occupational radon exposure, animal experiments and dosimetry. The Group issued 14 conclusions and 23 recommendations on radon related risk to health, on risk management and risk communication. In summary, radon was confirmed as a human carcinogen. Indoor radon exposures resulting in individual risks exceeding 10 -3 per year are to be considered as severe and risk reduction programmes implemented. Guidance on risk management and communication is offered to national authorities. (author)

  5. Evaluation of contrast reproduction method based on the anatomical guidance of the cerebral images reconstruction in positron emission tomography

    International Nuclear Information System (INIS)

    Bataille, F.

    2007-04-01

    Positron emission tomography is a medical imaging modality providing in-vivo volumetric images of functional processes of the human body, which is used for the diagnosis and the following of neuro degenerative diseases. PET efficiency is however limited by its poor spatial resolution, which generates a decrease of the image local contrast and leads to an under-estimation of small cerebral structures involved in the degenerative mechanism of those diseases. This so-called partial volume effect degradation is usually corrected in a post-reconstruction processing framework through the use of anatomical information, whose spatial resolution allows a better discrimination between functional tissues. However, this kind of method has the major drawback of being very sensitive to the residual mismatches on the anatomical information processing. We developed in this thesis an alternative methodology to compensate for the degradation, by incorporating in the reconstruction process both a model of the system impulse response and an anatomically-based image prior constraint. This methodology was validated by comparison with a post-reconstruction correction strategy, using data from an anthropomorphic phantom acquisition and then we evaluated its robustness to the residual mismatches through a realistic Monte Carlo simulation corresponding to a cerebral exam. The proposed algorithm was finally applied to clinical data reconstruction. (author)

  6. Using Mind Maps to Make Student Questioning Effective: Learning Outcomes of a Principle-Based Scenario for Teacher Guidance

    Science.gov (United States)

    Stokhof, Harry; de Vries, Bregje; Bastiaens, Theo; Martens, Rob

    2018-01-01

    Student questioning is an important learning strategy, but rare in many classrooms, because teachers have concerns if these questions contribute to attaining curricular objectives. Teachers face the challenge of making student questioning effective for learning the curriculum. To address this challenge, a principle-based scenario for guiding effective student questioning was developed and tested for its relevance and practicality in two previous studies. In the scenario, which consists of a sequence of pedagogical activities, mind maps support teachers and students to explore and elaborate upon a core curriculum, by raising, investigating, and exchanging student questions. In this paper, a follow-up study is presented that tested the effectiveness of the scenario on student outcomes in terms of attainment of curricular objectives. Ten teachers and their 231 students participated in the study. Pre- and posttest mind maps were used to measure individual and collective learning outcomes of student questioning. Findings show that a majority of students progressed in learning the core curriculum and elaborated upon it. The findings suggest that visualizing knowledge construction in a shared mind map supports students to learn a core curriculum and to refine their knowledge structures.

  7. Visual guidance of forward flight in hummingbirds reveals control based on image features instead of pattern velocity.

    Science.gov (United States)

    Dakin, Roslyn; Fellows, Tyee K; Altshuler, Douglas L

    2016-08-02

    Information about self-motion and obstacles in the environment is encoded by optic flow, the movement of images on the eye. Decades of research have revealed that flying insects control speed, altitude, and trajectory by a simple strategy of maintaining or balancing the translational velocity of images on the eyes, known as pattern velocity. It has been proposed that birds may use a similar algorithm but this hypothesis has not been tested directly. We examined the influence of pattern velocity on avian flight by manipulating the motion of patterns on the walls of a tunnel traversed by Anna's hummingbirds. Contrary to prediction, we found that lateral course control is not based on regulating nasal-to-temporal pattern velocity. Instead, birds closely monitored feature height in the vertical axis, and steered away from taller features even in the absence of nasal-to-temporal pattern velocity cues. For vertical course control, we observed that birds adjusted their flight altitude in response to upward motion of the horizontal plane, which simulates vertical descent. Collectively, our results suggest that birds avoid collisions using visual cues in the vertical axis. Specifically, we propose that birds monitor the vertical extent of features in the lateral visual field to assess distances to the side, and vertical pattern velocity to avoid collisions with the ground. These distinct strategies may derive from greater need to avoid collisions in birds, compared with small insects.

  8. Accuracy and inter-observer variability of 3D versus 4D cone-beam CT based image-guidance in SBRT for lung tumors

    Directory of Open Access Journals (Sweden)

    Sweeney Reinhart A

    2012-06-01

    Full Text Available Abstract Background To analyze the accuracy and inter-observer variability of image-guidance (IG using 3D or 4D cone-beam CT (CBCT technology in stereotactic body radiotherapy (SBRT for lung tumors. Materials and methods Twenty-one consecutive patients treated with image-guided SBRT for primary and secondary lung tumors were basis for this study. A respiration correlated 4D-CT and planning contours served as reference for all IG techniques. Three IG techniques were performed independently by three radiation oncologists (ROs and three radiotherapy technicians (RTTs. Image-guidance using respiration correlated 4D-CBCT (IG-4D with automatic registration of the planning 4D-CT and the verification 4D-CBCT was considered gold-standard. Results were compared with two IG techniques using 3D-CBCT: 1 manual registration of the planning internal target volume (ITV contour and the motion blurred tumor in the 3D-CBCT (IG-ITV; 2 automatic registration of the planning reference CT image and the verification 3D-CBCT (IG-3D. Image quality of 3D-CBCT and 4D-CBCT images was scored on a scale of 1–3, with 1 being best and 3 being worst quality for visual verification of the IGRT results. Results Image quality was scored significantly worse for 3D-CBCT compared to 4D-CBCT: the worst score of 3 was given in 19 % and 7.1 % observations, respectively. Significant differences in target localization were observed between 4D-CBCT and 3D-CBCT based IG: compared to the reference of IG-4D, tumor positions differed by 1.9 mm ± 0.9 mm (3D vector on average using IG-ITV and by 3.6 mm ± 3.2 mm using IG-3D; results of IG-ITV were significantly closer to the reference IG-4D compared to IG-3D. Differences between the 4D-CBCT and 3D-CBCT techniques increased significantly with larger motion amplitude of the tumor; analogously, differences increased with worse 3D-CBCT image quality scores. Inter-observer variability was largest in SI direction and was

  9. Ultrasound guidance to perform intra-articular injection of gadolinium-based contrast material for magnetic resonance arthrography as an alternative to fluoroscopy: the time is now

    Energy Technology Data Exchange (ETDEWEB)

    Messina, Carmelo [Universita degli Studi di Milano, Scuola di Specializzazione in Radiodiagnostica, Milano (Italy); Banfi, Giuseppe [IRCCS Istituto Ortopedico Galeazzi, Milano (Italy); Universita Vita-Salute San Raffaele, Milano (Italy); Aliprandi, Alberto [Universita degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, Milano (Italy); Mauri, Giovanni [Universita degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, Milano (Italy); Istituto Europeo di Oncologia, Unita di Radiologia Interventistica, Milano (Italy); Secchi, Francesco; Sardanelli, Francesco; Sconfienza, Luca Maria [Universita degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, Milano (Italy); IRCCS Policlinico San Donato, Servizio di Radiologia, San Donato, Milanese (Italy)

    2016-05-15

    Magnetic resonance (MR) imaging has been definitively established as the reference standard in the evaluation of joints in the body. Similarly, magnetic resonance arthrography has emerged as a technique that has been proven to increase significantly the diagnostic performance if compared with conventional MR imaging, especially when dealing with fibrocartilage and articular cartilage abnormalities. Diluted gadolinium can be injected in the joint space using different approaches: under palpation using anatomic landmarks or using an imaging guidance, such as fluoroscopy, computed tomography, or ultrasound. Fluoroscopy has been traditionally used, but the involvement of ionizing radiation should represent a remarkable limitation of this modality. Conversely, ultrasound has emerged as a feasible, cheap, quick, and radiation-free modality that can be used to inject joints, with comparable accuracy of fluoroscopy. In the present paper, we discuss the advantages and disadvantages of using fluoroscopy or ultrasound in injecting gadolinium-based contrast agents in joints to perform magnetic resonance arthrography, also in view of the new EuroSAFE Imaging initiative promoted by the European Society of Radiology and the recent updates to the European Atomic Energy Community 2013/59 directive on the medical use of ionizing radiation. (orig.)

  10. CAREER GUIDANCE EXPERIENCE ABROAD

    Directory of Open Access Journals (Sweden)

    Sergey N. Tolstoguzov

    2015-01-01

    Full Text Available The aim of this paper is to describe the experience of careeroriented activities carried out with students of schools in developed and developing countries. Career Guidance in Russia, despite the vast experience of its implementation, is experiencing serious difficulties. In this regard, it is important to take into account the international experience career-oriented activities, such as in the developed countries of North America and the European Union as well as in several Asian countries with rapidly growing economies and a large demographic potential, taking into account the best variants for the Russian education system. Methods. The experience of career-oriented work undertaken with pupils of the USA, Canada, Israel, France, UK, Germany, Denmark, Sweden, Japan, Singapore, China and India is shown on the basis of the comparative analysis of different publications and information sources. The author has made an attempt to generalize the principles of psycho-pedagogical and administrative assistance in professional self-determination of senior pupils abroad. Scientific novelty. The approaches to career-oriented activities in countries with different levels of economic development are compared for the first time. Some principles are revealed. Firstly, the higher the income level per capita in the country, the greater attention is given to vocational guidance. The politics in the developed countries is based on interests of the individual: children’s acquaintance with the world of professions begins already at younger school and the moment of definitive selfdetermination is postponed till the end of their senior stage of education; the possibility of direction change of professional preparation in case of detection of discrepancy of qualities of the pupil to originally selected profile is provided. Career-oriented activity in developing countries, on the contrary, is rigidly coordinated to requirements of economy and a labour market

  11. PIV Logon Configuration Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Glen Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-04

    This document details the configurations and enhancements implemented to support the usage of federal Personal Identity Verification (PIV) Card for logon on unclassified networks. The guidance is a reference implementation of the configurations and enhancements deployed at the Los Alamos National Laboratory (LANL) by Network and Infrastructure Engineering – Core Services (NIE-CS).

  12. Quality of nursing documentation: Paper-based health records versus electronic-based health records.

    Science.gov (United States)

    Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

    2018-02-01

    To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and

  13. On the design of fuzzified trajectory shaping guidance law.

    Science.gov (United States)

    Lin, Chun-Liang; Lin, Yu-Ping; Chen, Kai-Ming

    2009-04-01

    Midcourse guidance is commonly designed to save as much energy as possible so that the missile's final speed can be maximized while entering the homing stage. For this purpose, a competitive guidance design should be able to generate an admissible flight trajectory as to bring the interceptor to a superior altitude for a favorable target engagement. In this paper, a new adaptive trajectory shaping guidance scheme based on the adaptive fuzzy inference system, which is capable of generating a variety of trajectories for efficient target interception, is presented. The guidance law is developed with the aim of saving the interceptor's energy conservation while improving performance robustness. Applications of the presented approach have included a variety of mission oriented guidance, such as cruise missile guidance, anti-ballistic missile guidance, etc.

  14. 21 CFR 601.29 - Guidance documents.

    Science.gov (United States)

    2010-04-01

    ... Manufacturers Assistance (HFM-40), Center for Biologics Evaluation and Research, Food and Drug Administration... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Guidance documents. 601.29 Section 601.29 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS...

  15. Custom-designed Laser-based Heating Apparatus for Triggered Release of Cisplatin from Thermosensitive Liposomes with Magnetic Resonance Image Guidance.

    Science.gov (United States)

    Dou, Yannan N; Weersink, Robert A; Foltz, Warren D; Zheng, Jinzi; Chaudary, Naz; Jaffray, David A; Allen, Christine

    2015-12-13

    Liposomes have been employed as drug delivery systems to target solid tumors through exploitation of the enhanced permeability and retention (EPR) effect resulting in significant reductions in systemic toxicity. Nonetheless, insufficient release of encapsulated drug from liposomes has limited their clinical efficacy. Temperature-sensitive liposomes have been engineered to provide site-specific release of drug in order to overcome the problem of limited tumor drug bioavailability. Our lab has designed and developed a heat-activated thermosensitive liposome formulation of cisplatin (CDDP), known as HTLC, to provide triggered release of CDDP at solid tumors. Heat-activated delivery in vivo was achieved in murine models using a custom-built laser-based heating apparatus that provides a conformal heating pattern at the tumor site as confirmed by MR thermometry (MRT). A fiber optic temperature monitoring device was used to measure the temperature in real-time during the entire heating period with online adjustment of heat delivery by alternating the laser power. Drug delivery was optimized under magnetic resonance (MR) image guidance by co-encapsulation of an MR contrast agent (i.e., gadoteridol) along with CDDP into the thermosensitive liposomes as a means to validate the heating protocol and to assess tumor accumulation. The heating protocol consisted of a preheating period of 5 min prior to administration of HTLC and 20 min heating post-injection. This heating protocol resulted in effective release of the encapsulated agents with the highest MR signal change observed in the heated tumor in comparison to the unheated tumor and muscle. This study demonstrated the successful application of the laser-based heating apparatus for preclinical thermosensitive liposome development and the importance of MR-guided validation of the heating protocol for optimization of drug delivery.

  16. 78 FR 42788 - School-Based Health Center Program

    Science.gov (United States)

    2013-07-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...

  17. 76 FR 22106 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2011-04-20

    ... NIOSH-033] Issuance of Final Guidance Publication AGENCY: National Institute for Occupational Safety and... Health and Human Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The... (CDC) announces the availability of the following publication: NIOSH Current Intelligence Bulletin 63...

  18. 78 FR 78963 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2013-12-27

    ... CDC-2013-0001, NIOSH 134-B] Issuance of Final Guidance Publication AGENCY: National Institute for... Health and Human Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The... Prevention (CDC), announces the availability of the following publication: ``Protecting the Nanotechnology...

  19. Identifying dentists' attitudes towards prevention guidance using Q-sort methodology.

    Science.gov (United States)

    Witton, R V; Moles, D R

    2015-06-01

    To gain insight into the attitudes and motivating factors of dentists working in the English National Health Service (NHS) towards prevention guidance. Q-methodology: an established hybrid quantitative/qualitative technique used in the social sciences to categorise subjects based on their views by considering factors as part of their overall decision-making profile. General Dental Practices offering care under an NHS contract. NHS dentists (n = 26) placed 36 statements about prevention guidance derived from an earlier study into a distribution grid that ranked the statements from "most agree" to "most disagree". Principal components factor analysis was applied to determine the principal patterns in the rankings of statements. Analysis indicated a total of six distinct profiles within the responses, of which three profiles had at least six dentists loading onto them. The first profile was strongly characterised by dentists who appear motivated to provide prevention but financial and time constraints prevent them from doing so. The second was characterised by dentists using prevention guidance but restricting its use to only certain patients. The third was characterised by dentists who appeared "health-focused". They placed importance on working to prevention guidance, but were keen to have greater patient and professional support in achieving this. In this group of dentists Q-methodology identified three main profiles to the delivery of prevention guidance.

  20. Healthy End of Life Project (HELP): a progress report on implementing community guidance on public health palliative care initiatives in Australia.

    Science.gov (United States)

    Grindrod, Andrea; Rumbold, Bruce

    2018-04-01

    Contemporary end of life care policies propose increasing community capacity by developing sustainable skills, policies, structures, and resources to support members of a community in caring for each other at the end of life. Public health approaches to palliative care provide strategies to bring this about. Practical implementation can however be ineffective, principally due to failures to grasp the systemic nature of public health interventions, or to ensure that programs are managed and owned by community members, not the professionals who may have introduced them. This article outlines a comprehensive community development project that identifies local end of life needs and meets them through the efficient use of community resources. The project is the product of a three-phase enquiry. The first phase, carried out in a local community, examined carers' experiences of home-based dying, the networks that supported them during care, and broader community networks with the potential to extend care. Data were collected through in-depth research interviews, focus groups and consultation with a community research reference group. Findings were key issues to be targeted by a local community development strategy. In the second phase, these local findings were compared with other practice accounts to identify themes common to many contexts. A public health palliative care framework was then used to produce an evidence-informed community development model for end of life care. The third phase involves implementing and evaluating this model in different Australian contexts. A major theme emerging in phase one of the enquiry was the reluctance of carers to ask for, or even accept, offers of help from family, friends and community networks despite their evident need for support while providing end of life care at home. Others' willingness to provide support was thus hindered by uncertainty about what to offer, and concern about infringing on people's privacy. To develop

  1. Environmental guidance regulatory bulletin

    International Nuclear Information System (INIS)

    1997-01-01

    This document describes the background on expanding public participation in the Resource Conservation and Recovery Act and DOE's response. The bulletin also describes the changes made by the final rule to existing regulations, guidance provided by EPA in the preamble and in the revised RCRA Public Participation Manual, the relationship between public participation and environmental justice, and DOE's recent public participation and environmental justice initiatives

  2. Knowledge-based public health situation awareness

    Science.gov (United States)

    Mirhaji, Parsa; Zhang, Jiajie; Srinivasan, Arunkumar; Richesson, Rachel L.; Smith, Jack W.

    2004-09-01

    There have been numerous efforts to create comprehensive databases from multiple sources to monitor the dynamics of public health and most specifically to detect the potential threats of bioterrorism before widespread dissemination. But there are not many evidences for the assertion that these systems are timely and dependable, or can reliably identify man made from natural incident. One must evaluate the value of so called 'syndromic surveillance systems' along with the costs involved in design, development, implementation and maintenance of such systems and the costs involved in investigation of the inevitable false alarms1. In this article we will introduce a new perspective to the problem domain with a shift in paradigm from 'surveillance' toward 'awareness'. As we conceptualize a rather different approach to tackle the problem, we will introduce a different methodology in application of information science, computer science, cognitive science and human-computer interaction concepts in design and development of so called 'public health situation awareness systems'. We will share some of our design and implementation concepts for the prototype system that is under development in the Center for Biosecurity and Public Health Informatics Research, in the University of Texas Health Science Center at Houston. The system is based on a knowledgebase containing ontologies with different layers of abstraction, from multiple domains, that provide the context for information integration, knowledge discovery, interactive data mining, information visualization, information sharing and communications. The modular design of the knowledgebase and its knowledge representation formalism enables incremental evolution of the system from a partial system to a comprehensive knowledgebase of 'public health situation awareness' as it acquires new knowledge through interactions with domain experts or automatic discovery of new knowledge.

  3. 76 FR 20992 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-04-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0189] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Low Level Laser System for Aesthetic Use; Availability AGENCY: Food and Drug Administration, HHS...

  4. 75 FR 70271 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2010-11-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0515] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is...

  5. 75 FR 68364 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2010-11-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2008-D-0275] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Full-Field Digital Mammography System; Availability AGENCY: Food and Drug Administration, HHS. [[Page...

  6. 76 FR 16425 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-03-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0028] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Ovarian Adnexal Mass Assessment Score Test System; Availability AGENCY: Food and Drug Administration, HHS...

  7. 76 FR 6622 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-02-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0645] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Contact Cooling System for Aesthetic Use; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

  8. 76 FR 22906 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-04-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2006-D-0094] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Topical Oxygen Chamber for Extremities; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

  9. 76 FR 43332 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-07-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0500] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Focused Ultrasound Stimulator System for Aesthetic Use; Availability AGENCY: Food and Drug Administration...

  10. 76 FR 43690 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2007-D-0149] (Formerly 2007D-0309) Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Electrocardiograph Electrodes; Availability AGENCY: Food and Drug...

  11. 77 FR 14403 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2012-03-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0167] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Norovirus Serological Reagents; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice...

  12. 76 FR 48870 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-08-09

    ... selection inclusion and exclusion criteria section. The revisions define and differentiate the required... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0428] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...

  13. Comparison of haptic guidance and error amplification robotic trainings for the learning of a timing-based motor task by healthy seniors.

    Science.gov (United States)

    Bouchard, Amy E; Corriveau, Hélène; Milot, Marie-Hélène

    2015-01-01

    With age, a decline in the temporal aspect of movement is observed such as a longer movement execution time and a decreased timing accuracy. Robotic training can represent an interesting approach to help improve movement timing among the elderly. Two types of robotic training-haptic guidance (HG; demonstrating the correct movement for a better movement planning and improved execution of movement) and error amplification (EA; exaggerating movement errors to have a more rapid and complete learning) have been positively used in young healthy subjects to boost timing accuracy. For healthy seniors, only HG training has been used so far where significant and positive timing gains have been obtained. The goal of the study was to evaluate and compare the impact of both HG and EA robotic trainings on the improvement of seniors' movement timing. Thirty-two healthy seniors (mean age 68 ± 4 years) learned to play a pinball-like game by triggering a one-degree-of-freedom hand robot at the proper time to make a flipper move and direct a falling ball toward a randomly positioned target. During HG and EA robotic trainings, the subjects' timing errors were decreased and increased, respectively, based on the subjects' timing errors in initiating a movement. Results showed that only HG training benefited learning, but the improvement did not generalize to untrained targets. Also, age had no influence on the efficacy of HG robotic training, meaning that the oldest subjects did not benefit more from HG training than the younger senior subjects. Using HG to teach the correct timing of movement seems to be a good strategy to improve motor learning for the elderly as for younger people. However, more studies are needed to assess the long-term impact of HG robotic training on improvement in movement timing.

  14. Development of a GSI-Based, 2D-VAR Data Assimilation System for Operational Wave Guidance at the National Weather Service

    Science.gov (United States)

    Flampouris, S.; Alves, H.; Pondeca, M.

    2016-02-01

    The US National Centers for Environmental Prediction (NCEP) provides wave guidance to the National Weather Service (NWS) via a suite of operational wave models, which include three global-scale systems. An approach is being developed to include data assimilation into the global wave models using a 2D version of NCEP's grid-point statistical interpolation (2D-GSI), as described in Derber & Rosatti (1989), and Pondeca et al (2011). As a first step to the global implementation of a wave DA system, a prototype is being developed that will consist of adding wave heights as an analysis variable to the operational Real-Time Mesoscale Analysis (RTMA), which provides hourly analyses of several near sea-surface meteorological parameters, and supports a variety of applications within the NWS. The core of the RTMA is a 2D version of the GSI, which is a variational data assimilation system, and the first guess for the wave-height analysis is provided by NCEP's global wave models. For the new application, the RTMA will be modified to reflect background error covariances consistent with wave-height fields for regional and nearshore applications. In addition, quality control modules for in situ and altimeter significant wave height have been developed and integrated into the system. The strengths and the performance of the 2D-GSI are illustrated with both in situ and satellite measurements of significant wave height in the NW Atlantic and the Gulf of Mexico. The validation of follows the typical cross-validation procedure of RTMA products, based on 10% of the observations, for a period of 15 days. The error statistics (mean, root-mean-square) of the wave-height analysis shows significant improvement, relative to the first guess.

  15. US Rocket Propulsion Industrial Base Health Metrics

    Science.gov (United States)

    Doreswamy, Rajiv

    2013-01-01

    The number of active liquid rocket engine and solid rocket motor development programs has severely declined since the "space race" of the 1950s and 1960s center dot This downward trend has been exacerbated by the retirement of the Space Shuttle, transition from the Constellation Program to the Space launch System (SLS) and similar activity in DoD programs center dot In addition with consolidation in the industry, the rocket propulsion industrial base is under stress. To Improve the "health" of the RPIB, we need to understand - The current condition of the RPIB - How this compares to past history - The trend of RPIB health center dot This drives the need for a concise set of "metrics" - Analogous to the basic data a physician uses to determine the state of health of his patients - Easy to measure and collect - The trend is often more useful than the actual data point - Can be used to focus on problem areas and develop preventative measures The nation's capability to conceive, design, develop, manufacture, test, and support missions using liquid rocket engines and solid rocket motors that are critical to its national security, economic health and growth, and future scientific needs. center dot The RPIB encompasses US government, academic, and commercial (including industry primes and their supplier base) research, development, test, evaluation, and manufacturing capabilities and facilities. center dot The RPIB includes the skilled workforce, related intellectual property, engineering and support services, and supply chain operations and management. This definition touches the five main segments of the U.S. RPIB as categorized by the USG: defense, intelligence community, civil government, academia, and commercial sector. The nation's capability to conceive, design, develop, manufacture, test, and support missions using liquid rocket engines and solid rocket motors that are critical to its national security, economic health and growth, and future scientific needs

  16. Health Physics Positions Data Base: Revision 1

    International Nuclear Information System (INIS)

    Kerr, G.D.; Borges, T.; Stafford, R.S.; Lu, P.Y.; Carter, D.

    1994-02-01

    The Health Physics Positions (HPPOS) Data Base of the Nuclear Regulatory Commission (NRC) is a collection of NRC staff positions on a wide range of topics involving radiation protection (health physics). It consists of 328 documents in the form of letters, memoranda, and excerpts from technical reports. The HPPOS Data Base was developed by the NRC Headquarters and Regional Offices to help ensure uniformity in inspections, enforcement, and licensing actions. Staff members of the Oak Ridge National Laboratory (ORNL) have assisted the NRC staff in summarizing the documents during the preparation of this NUREG report. These summaries are also being made available as a open-quotes stand aloneclose quotes software package for IBM and IBM-compatible personal computers. The software package for this report is called HPPOS Version 2.0. A variety of indexing schemes were used to increase the usefulness of the NUREG report and its associated software. The software package and the summaries in the report are written in the context of the open-quotes newclose quotes 10 CFR Part 20 (section section 20.1001--20.2401). The purpose of this NUREG report is to allow interested individuals to familiarize themselves with the contents of the HPPOS Data Base and with the basis of many NRC decisions and regulations. The HPPOS summaries and original documents are intended to serve as a source of information for radiation protection programs at nuclear research and power reactors, nuclear medicine, and other industries that either process or use nuclear materials

  17. Existing ingestion guidance: Problems and recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Mooney, Robert R; Ziegler, Gordon L; Peterson, Donald S [Environmental Radiation Section, Division of Radiation Protection, WA (United States)

    1989-09-01

    Washington State has been developing plans and procedures for responding to nuclear accidents since the early 1970s. A key part of this process has been formulating a method for calculating ingestion pathway concentration guides (CGs). Such a method must be both technically sound and easy to use. This process has been slow and frustrating. However, much technical headway has been made in recent years, and hopefully the experience of the State of Washington will provide useful insight to problems with the existing guidance. Several recommendations are offered on ways to deal with these problems. In January 1986, the state held an ingestion pathway exercise which required the determination of allowed concentrations of isotopes for various foods, based upon reactor source term and field data. Objectives of the exercise were not met because of the complexity of the necessary calculations. A major problem was that the allowed concentrations had to be computed for each isotope and each food group, given assumptions on the average diet. To solve problems identified during that exercise, Washington developed, by March 1986, partitioned CGs. These CGs apportioned doses from each food group for an assumed mix of radionuclides expected to result from a reactor accident. This effort was therefore in place just in time for actual use during the Chernobyl fallout episode in May 1986. This technique was refined and described in a later report and presented at the 1987 annual meeting of the Health Physics Society. Realizing the technical weaknesses which still existed and a need to simplify the numbers for decision makers, Washington State has been developing computer methods to quickly calculate, from an accident specific relative mix of isotopes, CGs which allow a single radionuclide concentration for all food groups. This latest approach allows constant CGs for different periods of time following the accident, instead of peak CGs, which are good only for a short time after the

  18. Existing ingestion guidance: Problems and recommendations

    International Nuclear Information System (INIS)

    Mooney, Robert R.; Ziegler, Gordon L.; Peterson, Donald S.

    1989-01-01

    Washington State has been developing plans and procedures for responding to nuclear accidents since the early 1970s. A key part of this process has been formulating a method for calculating ingestion pathway concentration guides (CGs). Such a method must be both technically sound and easy to use. This process has been slow and frustrating. However, much technical headway has been made in recent years, and hopefully the experience of the State of Washington will provide useful insight to problems with the existing guidance. Several recommendations are offered on ways to deal with these problems. In January 1986, the state held an ingestion pathway exercise which required the determination of allowed concentrations of isotopes for various foods, based upon reactor source term and field data. Objectives of the exercise were not met because of the complexity of the necessary calculations. A major problem was that the allowed concentrations had to be computed for each isotope and each food group, given assumptions on the average diet. To solve problems identified during that exercise, Washington developed, by March 1986, partitioned CGs. These CGs apportioned doses from each food group for an assumed mix of radionuclides expected to result from a reactor accident. This effort was therefore in place just in time for actual use during the Chernobyl fallout episode in May 1986. This technique was refined and described in a later report and presented at the 1987 annual meeting of the Health Physics Society. Realizing the technical weaknesses which still existed and a need to simplify the numbers for decision makers, Washington State has been developing computer methods to quickly calculate, from an accident specific relative mix of isotopes, CGs which allow a single radionuclide concentration for all food groups. This latest approach allows constant CGs for different periods of time following the accident, instead of peak CGs, which are good only for a short time after the

  19. The Effectiveness of the Smart Board-Based Small-Group Graduated Guidance Instruction on Digital Gaming and Observational Learning Skills of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Cattik, Melih; Odluyurt, Serhat

    2017-01-01

    The objective of this study was to teach digital gaming skills to children with autism spectrum disorder (ASD) using a SMART board with a graduated guidance teaching method in a small-group instructional format, to determine the participants' levels of learning by observation, and to determine the views of their families on the conducted…

  20. A VME based health monitoring system

    International Nuclear Information System (INIS)

    Huang Yiming; Wang Chunhong

    2011-01-01

    It introduces a VME based health system for monitoring the working status of VME crates in the BEPCⅡ. It consists of a PC and a VME crate where a CMM (Classic Monitor System) is installed. The CMM module is responsible for collecting data from the power supply and temperature as well as fan speed inside the VME crate and send these data to the PC via the serial port. The author developed EPICS asynchronous driver by using a character-based device protocol StreamDevice. The data is saved into EPICS IOC database in character. Man-machine interface which is designed by BOY displays the running status of the VME crate including the power supply and temperature as well as fan speed. If the value of records display unusual, the color of the value will be changed into red. This can facilitate the maintenance of the VME crates. (authors)

  1. Quality assurance and evidence in career guidance in Europe

    DEFF Research Database (Denmark)

    Plant, Peter

    2011-01-01

    Quality assurance and evidence in career guidance in Europe is based on a particular, positivtic model. Other approaches are largely neglected.......Quality assurance and evidence in career guidance in Europe is based on a particular, positivtic model. Other approaches are largely neglected....

  2. Guidance levels, achievable doses and expectation levels

    International Nuclear Information System (INIS)

    Li, Lianbo; Meng, Bing

    2002-01-01

    The National Radiological Protection Board (NRPB), the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) published their guidance levels and reference doses for typical X-ray examination and nuclear medicine in their documents in 1993, 1994 and 1996 respectively. From then on, the concept of guidance levels or reference doses have been applied to different examinations in the field of radiology and proved to be effective for reduction of patient doses. But the guidance levels or reference doses are likely to have some shortcomings and can do little to make further reduction of patient dose in the radiology departments where patient dose are already below them. For this reason, the National Radiological Protection Board (NRPB) proposed a concept named achievable doses which are based on the mean dose observed for a selected sample of radiology departments. This paper will review and discuss the concept of guidance levels and achievable doses, and propose a new concept referred to as Expectation Levels that will encourage the radiology departments where patient dose are already below the guidance levels to keep patient dose as low as reasonably achievable. Some examples of the expectation levels based on the data published by a few countries are also illustrated in this paper

  3. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

    Science.gov (United States)

    Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-03-01

    The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

  4. An XML-based framework for personalized health management.

    Science.gov (United States)

    Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo

    2006-01-01

    This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

  5. Health Physics Positions Data Base: Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, G.D.; Borges, T.; Stafford, R.S.; Lu, P.Y. [Oak Ridge National Lab., TN (United States); Carter, D. [US Nuclear Regulatory Commission, Washington, DC (United States)

    1994-02-01

    The Health Physics Positions (HPPOS) Data Base of the Nuclear Regulatory Commission (NRC) is a collection of NRC staff positions on a wide range of topics involving radiation protection (health physics). It consists of 328 documents in the form of letters, memoranda, and excerpts from technical reports. The HPPOS Data Base was developed by the NRC Headquarters and Regional Offices to help ensure uniformity in inspections, enforcement, and licensing actions. Staff members of the Oak Ridge National Laboratory (ORNL) have assisted the NRC staff in summarizing the documents during the preparation of this NUREG report. These summaries are also being made available as a {open_quotes}stand alone{close_quotes} software package for IBM and IBM-compatible personal computers. The software package for this report is called HPPOS Version 2.0. A variety of indexing schemes were used to increase the usefulness of the NUREG report and its associated software. The software package and the summaries in the report are written in the context of the {open_quotes}new{close_quotes} 10 CFR Part 20 ({section}{section}20.1001--20.2401). The purpose of this NUREG report is to allow interested individuals to familiarize themselves with the contents of the HPPOS Data Base and with the basis of many NRC decisions and regulations. The HPPOS summaries and original documents are intended to serve as a source of information for radiation protection programs at nuclear research and power reactors, nuclear medicine, and other industries that either process or use nuclear materials.

  6. PSD Increment Consumption Guidance

    Science.gov (United States)

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  7. Widening opportunities for career guidance

    DEFF Research Database (Denmark)

    Poulsen, Bo Klindt; Skovhus, Randi Boelskifte; Thomsen, Rie

    2017-01-01

    This chapter discusses research circles as a way of organising collaboration between career guidance researchers and practitioners. Such collaboration, it is argued, helps resist neoliberal governance mechanisms and supports social justice perspectives among teachers involved in the provision...... of career education in Danish schools. Based on a research and development project on career education, case analysis is used to explore research circles as a means for collaboration between researchers and practitioners. This analysis shows that research circles provide teachers with a space to reflect...... both in and on action. Career education is the key focus of the case presented in this chapter and it is argued that, in order to increase social mobility through education, there is a need to widen opportunities through experience-based activities among pupils in Danish schools. The chapter contends...

  8. Widening opportunities for career guidance

    DEFF Research Database (Denmark)

    Poulsen, Bo Klindt; Skovhus, Randi Boelskifte; Thomsen, Rie

    2018-01-01

    This chapter discusses research circles as a way of organising collaboration between career guidance researchers and practitioners. Such collaboration, it is argued, helps resist neoliberal governance mechanisms and supports social justice perspectives among teachers involved in the provision...... of career education in Danish schools. Based on a research and development project on career education, case analysis is used to explore research circles as a means for collaboration between researchers and practitioners. This analysis shows that research circles provide teachers with a space to reflect...... both in and on action. Career education is the key focus of the case presented in this chapter and it is argued that, in order to increase social mobility through education, there is a need to widen opportunities through experience-based activities among pupils in Danish schools. The chapter contends...

  9. Psychiatric mental health evidence-based practice.

    Science.gov (United States)

    Rice, Michael J

    2008-05-01

    This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

  10. Orion Powered Flight Guidance Burn Options for Near Term Exploration

    Science.gov (United States)

    Fill, Tom; Goodman, John; Robinson, Shane

    2018-01-01

    NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

  11. National ethics guidance in Sub-Saharan Africa on the collection and use of human biological specimens: a systematic review.

    Science.gov (United States)

    Barchi, Francis; Little, Madison T

    2016-10-22

    Ethical and regulatory guidance on the collection and use of human biospecimens (HBS) for research forms an essential component of national health systems in Sub-Saharan Africa (SSA), where rapid advances in genetic- and genomic-based technologies are fueling clinical trials involving HBS and the establishment of large-scale biobanks. An extensive multi-level search for publicly available ethics regulatory guidance was conducted for each SSA country. A second review documented active trials listed in the WHO International Clinical Trials Registry Platform as of January 2015 in which HBS collection was specified in the protocol. Findings were combined to determine the extent to which countries that are study sites for HBS-related research are supported by regulatory guidance language on the collection, use, ownership and storage of biospecimens. Of the 49 SSA countries, 29 had some form of national ethics guidance, yet only 17 provided language relating to HBS-related research, with specific guidance on consent (14), ownership (6), reuse (10), storage (9), and export/import/transfer (13). Ten countries accounted for 84 % of the active clinical trials involving the collection of HBS in SSA. All except one of these countries were found to have some national guidance in the form of regulations, codes of ethics, and/or standard operating procedures; however, only seven of the ten offered any language specific to HBS. Despite the fact that the bulk of registered clinical trials in SSA involving HBS, as well as existing and proposed sites for biorepositories under the H3Africa Initiative, are currently situated in countries with the most complete ethics and regulatory guidance, variability in the regulations themselves may create challenges for planned and future pan-African collaborations and may require legislative action at the national level to revise. Countries in SSA that still lack regulatory guidance on HBS will require extensive health system strengthening in

  12. Safety of magnetic fusion facilities: Guidance

    International Nuclear Information System (INIS)

    1996-05-01

    This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities

  13. Utilization of Mental Health Services in School-Based Health Centers

    Science.gov (United States)

    Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-01-01

    Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

  14. Health related guide values for drinking-water since 1993 as guidance to assess presence of new analytes in drinking-water.

    Science.gov (United States)

    Dieter, Hermann H

    2014-03-01

    Regulatory toxicologists, when going into assessment of a new analyte in drinking-water, very often miss the occasion to revert to scientifically consensual virtually safe lifetime exposure reference doses and corresponding health-related guide values (HRGV) for drinking-water, be those derived either to avoid concern over "threshold effects" or concern over exceedance of an unacceptable non-threshold cancer risk level. They then need a more restrictive precautionary yet science-compatible approach to directly avoid concern over the presence (measured concentration) of a new analyte in drinking-water. Therefore, the German Environment Agency (UBA, Umweltbundesamt) decided in 2003 to extrapolate international toxicological expertise collected since 1993 from assessing "old" analytes in drinking-water on new ones in form of five HRIV=health related indication values. They indicate the reasonable lowest maximal concentration from which on tiered or stepwise human toxicological evaluation of a new analyte might be necessary and meaningful. Their regulatory-toxicological function is that of placeholders as long as a possibly higher scientific HRGV or a surrogate value based on a threshold of toxicological concern (TTC) was not broadly agreed by science. The five-step HRIV scale between 0.01 and 3.0 μg/l combines international toxicological experience gained from "old" analytes since 1993 with the concepts of safety factors (SF(D)) to assess database deficiency and science-related extrapolation factors (EF) to extrapolate experimental data on humans. Each HRIV is valid and safe for a 2 l/day drinking-water exposure scenario either counting for 10% relative source contribution (compounds with threshold effects) or for a lifetime non-threshold cancer risk of up to 10(-6) and is the higher the more positive information exists regarding possible effects at critical toxic endpoints and for length of possible exposure. Past (historical) and present evaluations of "old

  15. School-Based Health Education Programmes, Health-Learning Capacity and Child Oral Health--related Quality of Life

    Science.gov (United States)

    Freeman, Ruth; Gibson, Barry; Humphris, Gerry; Leonard, Helen; Yuan, Siyang; Whelton, Helen

    2016-01-01

    Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster…

  16. HUMAN FACTORS GUIDANCE FOR CONTROL ROOM EVALUATION

    International Nuclear Information System (INIS)

    OHARA, J.; BROWN, W.; STUBLER, W.; HIGGINS, J.; WACHTEL, J.; PERSENSKY, J.J.

    2000-01-01

    The Human-System Interface Design Review Guideline (NUREG-0700, Revision 1) was developed by the US Nuclear Regulatory Commission (NRC) to provide human factors guidance as a basis for the review of advanced human-system interface technologies. The guidance consists of three components: design review procedures, human factors engineering guidelines, and a software application to provide design review support called the ''Design Review Guideline.'' Since it was published in June 1996, Rev. 1 to NUREG-0700 has been used successfully by NRC staff, contractors and nuclear industry organizations, as well as by interested organizations outside the nuclear industry. The NRC has committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool in the face of emerging and rapidly changing technology. This paper addresses the current research to update of NUREG-0700 based on the substantial work that has taken place since the publication of Revision 1

  17. Bridge over troubled water: Guidance crosses | Amundson ...

    African Journals Online (AJOL)

    This article is based on a keynote presentation at an international conference where the focus was cross-over career guidance. Simon and Garfunkel's popular song, "Bridge ... and the future, and building connections. There also was the suggestion that other metaphors could be used as a way to broaden the exploration.

  18. Non-cable vehicle guidance

    Energy Technology Data Exchange (ETDEWEB)

    Daugela, G.C.; Willott, A.M.; Chopiuk, R.G.; Thornton, S.E.

    1988-06-01

    The purpose is to determine the most promising driverless mine vehicle guidance systems that are not dependent on buried cables, and to plan their development. The project is presented in two phases: a preliminary study and literature review to determine whether suitable technologies exist to justify further work; and an in-depth assessment and selection of technologies for vehicle guidance. A large number of guidance elements are involved in a completely automated vehicle. The technologies that hold the best potential for development of guidance systems for mine vehicles are ultrasonics, radar, lasers, dead reckoning, and guidance algorithms. The best approach to adaptation of these technologies is on a step by step basis. Guidance modules that are complete in themselves and are designed to be integrated with other modules can provide short term benefits. Two modules are selected for development: the dragline operations monitor and automated machine control for optimized mining (AMCOM). 99 refs., 20 figs., 40 tabs.

  19. The history and future of dietary guidance in America

    Science.gov (United States)

    Evidence-based dietary guidance in the US has progressed substantially since its inception over 100 years ago. This review describes the historical development and significance of dietary guidance in the US, including the Dietary Guidelines for Americans, and emphasizes the foundations upon which th...

  20. An Assessment of the Implementation of Guidance and Counselling ...

    African Journals Online (AJOL)

    This paper is based on a research study carried out by the author in 2003. The study assessed how Guidance and Counselling Programmes were being implemented in Gweru urban secondary schools at Ordinary level. The assessment focused on such key elements in Guidance and Counselling as time allocation, ...

  1. Strategic Environmental Assessment as catalyst of healthier spatial planning: The Danish guidance and practice

    International Nuclear Information System (INIS)

    Kornov, Lone

    2009-01-01

    A wide range of factors within spatial planning can affect health. There is therefore an important scope for Strategic Environmental Assessment (SEA) of spatial plans to protect and improve human health. Due to the EU Directive 2001/42/EC on SEA, health has been made explicit in Danish legislation and guidance. This paper examines the inclusion of health as a formal component in impact assessment of spatial plans. Based upon a documentary study of 100 environmental reports, the paper analyses and discusses how health impact considerations are incorporated in SEA practice. It is found that health impacts are included in SEA practice and are being interpreted in a broader sense than what the national guidance exemplifies. The frequent included health aspects are noise, drinking water, air pollution, recreation/outdoor life and traffic safety. The primary determinant for health is transport-whether it is at the overall or local planning level. The main conclusion is that SEA shows a potential to catalyse healthier spatial planning. Despite the broad inclusion of health in SEA practice the examination shows potential improvements, hereunder qualification of assessments by better explaining the nature and significance of impacts and by including the distributional aspects of human health impacts. Inclusion from the health sector is put forward as an important institutional mean to secure cross disciplinarily and higher quality assessment

  2. Redefining Health: Implication for Value-Based Healthcare Reform.

    Science.gov (United States)

    Putera, Ikhwanuliman

    2017-03-02

    Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care. To implement value-based healthcare, transformations need to be done by both health providers and patients: establishing true health outcomes, strengthening primary care, building integrated health systems, implementing appropriate health payment schemes that promote value and reduce moral hazards, enabling health information technology, and creating a policy that fits well with a community.

  3. Yes. No. Maybe. That's about as firm as the guidance gets over launching a provider-sponsored health plan. Strategy roundtable.

    Science.gov (United States)

    Crews, J; Ehlen, K J; Goodwin, P; Guy, A; Morrison, G; Parker, S; Peddie, E

    Few participants in our roundtable on provider-sponsored health plans see them the same way. Some are gearing up new products, others are scaling back or getting out. Yet they agreed on one thing: The financial risks are tremendous.

  4. A Formal Investigation of the Organization of Guidance Behavior: Implications for Humans and Autonomous Guidance

    Science.gov (United States)

    Kong, Zhaodan

    Guidance behavior generated either by artificial agents or humans has been actively studied in the fields of both robotics and cognitive science. The goals of these two fields are different. The former is the automatic generation of appropriate or even optimal behavior, while the latter is the understanding of the underlying mechanism. Their challenges, though, are closely related, the most important one being the lack of a unified, formal and grounded framework where the guidance behavior can be modeled and studied. This dissertation presents such a framework. In this framework, guidance behavior is analyzed as the closed-loop dynamics of the whole agent-environment system. The resulting dynamics give rise to interaction patterns. The central points of this dissertation are that: first of all, these patterns, which can be explained in terms of symmetries that are inherent to the guidance behavior, provide building blocks for the organization of behavior; second, the existence of these patterns and humans' organization of their guidance behavior based on these patterns are the reasons that humans can generate successful behavior in spite of all the complexities involved in the planning and control. This dissertation first gives an overview of the challenges existing in both scientific endeavors, such as human and animal spatial behavior study, and engineering endeavors, such as autonomous guidance system design. It then lays out the foundation for our formal framework, which states that guidance behavior should be interpreted as the collection of the closed-loop dynamics resulting from the agent's interaction with the environment. The following, illustrated by examples of three different UAVs, shows that the study of the closed-loop dynamics should not be done without the consideration of vehicle dynamics, as is the common practice in some of the studies in both autonomous guidance and human behavior analysis. The framework, the core concepts of which are

  5. Academic Libraries and Learning Support in Collaboration. Library Based Guidance for Peer Assisted Learning Leaders at Bournemouth University: Theory and Practice.

    OpenAIRE

    Parton, Steve; Fleming, Hugh

    2008-01-01

    This article begins with an overview of the University’s pioneering Peer Assisted Learning Scheme (PAL) and describes how in 2005/6, the Library became involved, collaborating with the PAL Coordinator to develop materials for use by PAL Leaders. PAL is intended to foster cross-year support between students on the same course. It encourages students to support each other and learn co-operatively under the guidance of trained students from the year above - called PAL Leaders. Two documents were...

  6. Development of a health effects based priority ranking system for air emissions reductions from oil refineries in Canada

    International Nuclear Information System (INIS)

    McColl, S.; Gower, S.; Hicks, J.; Shortreed, J.; Craig, L.

    2004-01-01

    This paper presents the concept and methodologies behind the development of a health effects priority ranking tool for the reduction of air emissions from oil refineries. The Health Effects Indicators Decision Index- Versions 2 (Heidi II) was designed to assist policy makers in prioritizing air emissions reductions on the basis of estimated risk to human health. Inputs include facility level rankings of potential health impacts associated with carcinogenic air toxics, non-carcinogenic air toxics and criteria air contaminants for each of the 20 refineries in Canada. Rankings of estimated health impacts are presented on predicted incidence of health effects. Heidi II considers site-specific annual pollutant emission data, ambient air concentrations associated with releases and concentration response functions for various types of health effects. Additional data includes location specific background air concentrations, site-specific population densities, and the baseline incidence of different health effects endpoints, such as cancer, non-cancer illnesses and cardiorespiratory illnesses and death. Air pollutants include the 29 air toxics reported annually in Environment Canada's National Pollutant Release Inventory. Three health impact ranking outputs are provided for each facility: ranking of pollutants based on predicted number of annual cases of health effects; ranking of pollutants based on simplified Disability Adjusted Life Years (DALYs); and ranking of pollutants based on more complex DALYs that consider types of cancer, systemic disease or types of cardiopulmonary health effects. Rankings rely on rough statistical estimates of predicted incidence rates for health endpoints. The models used to calculate rankings can provide useful guidance by comparing estimated health impacts. Heidi II has demonstrated that it is possible to develop a consistent and objective approach for ranking priority reductions of air emissions. Heidi II requires numerous types and

  7. Resources available for school based mental health services in ...

    African Journals Online (AJOL)

    Resources available for school based mental health services in Enugu urban and head teachers' knowledge of childhood mental health problems. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ...

  8. Redefining Health: Implication for Value-Based Healthcare Reform

    OpenAIRE

    Putera, Ikhwanuliman

    2017-01-01

    Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should ...

  9. Radiation protection guidance to Federal agencies for occupational exposure. Recommendations approved by the President. Part II The President

    International Nuclear Information System (INIS)

    Thomas, Lee M.

    1987-01-01

    This memorandum transmits recommendations that would update previous guidance to Federal agencies for the protection of workers exposed to ionizing radiation. These recommendations were developed cooperatively by the Nuclear Regulatory Commission, the Occupational Safety and Health Administration, the Mine Safety and Health Administration, the Department of Defense, the Department of Energy, the National Aeronautics and Space Administration, the Department of Commerce, the Department of Transportation, the Department of Health and Human Services, and the Environmental Protection Agency. In addition, the National Council on Radiation Protection and Measurements (NCRP), the National Academy of Sciences (NAS), the Conference of Radiation Control Program Directors (CRCPD) of the States, and the Health Physics Society were consulted during the development of this guidance. These recommendations are based on consideration of (1) current scientific understanding of effects on health from ionizing radiation, (2) recommendations of international and national organizations involved in radiation protection, (3) proposed 'Federal Radiation Protection Guidance for Occupational Exposure' published on January 23, 1981 (46 FR 7836) and public comments on that proposed guidance, and (4) the collective experience of the Federal agencies in the control of occupational exposure to ionizing radiation. A summary of the considerations that led to these recommendations is provided

  10. Mental Health Services in School-Based Health Centers: Systematic Review

    Science.gov (United States)

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  11. International guidance activities

    International Nuclear Information System (INIS)

    Richardson, Allan C.B.

    1989-01-01

    International principles for setting Protective Action Guides (PAGs) are contained in two key documents that contain identical statements. One is Publication Number 40 of the ICRP, which was issued in 1985. The title is 'Protection of the Public in the Event of Major Radiation Accidents, Principles for Planning'. The other is the IAEA's Safety Series Publication Number 72, also issued in 1985, written by many of the same authors and titled, 'Principles for Establishing Intervention Levels'. The principles that were set forth in these documents were identical, were incomplete, and they are, unfortunately, the only principles that are now in effect, while proposed revisions go through one draft after another. There are several such draft revisions that are of significance. The most important is that of the ICRP. The basic guidance that applies to most planned exposure to radiation is ICRP Publication 26. That document has been under revision by the Commission for a number of years, and the new version will, for the first time, include recommendations for emergency response. They are now getting close to closure, and I think it should be a very much improved and useful document. But it isn't finished yet. Such guidance doesn't get developed in a vacuum, and there have been a couple of parallel efforts which have provided significant input to the ICRP, which is essentially a behind-closed-doors effort. These other efforts are more open. One of these is being carried out within the IAEA, which has convened annual meetings of national experts for a number of years in Vienna, to generate a replacement for Safety Series No. 72, mentioned earlier. There is a meeting scheduled this December to complete this effort; and, hopefully, we will reach closure at that meeting on at least the basic principles. The Nuclear Energy Agency (NEA) has also been at work. It has convened a group of experts from member nations that have been developing recommendations. There is an overlap

  12. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2006-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with 10 Code of Federal Regulations (CFR) 1.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous location where the activities subject to these

  13. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2008-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package (also known as the 'RH-TRU 72-B cask') and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with Title 10 Code of Federal Regulations (CFR) 71.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. The CBFO will evaluate the issue and notify the NRC if required.In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous

  14. Nature-based strategies for improving urban health and safety

    Science.gov (United States)

    Michelle C. Kondo; Eugenia C. South; Charles C. Branas

    2015-01-01

    Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature...

  15. Development of Science-Based Permitting Guidance for Geological Sequestration of CO2 in Deep Saline Aquifers Based on Modeling and Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jean-Philippe Nicot; Renaud Bouroullec; Hugo Castellanos; Susan Hovorka; Srivatsan Lakshminarasimhan; Jeffrey Paine

    2006-06-30

    Underground carbon storage may become one of the solutions to address global warming. However, to have an impact, carbon storage must be done at a much larger scale than current CO{sub 2} injection operations for enhanced oil recovery. It must also include injection into saline aquifers. An important characteristic of CO{sub 2} is its strong buoyancy--storage must be guaranteed to be sufficiently permanent to satisfy the very reason that CO{sub 2} is injected. This long-term aspect (hundreds to thousands of years) is not currently captured in legislation, even if the U.S. has a relatively well-developed regulatory framework to handle carbon storage, especially in the operational short term. This report proposes a hierarchical approach to permitting in which the State/Federal Government is responsible for developing regional assessments, ranking potential sites (''General Permit'') and lessening the applicant's burden if the general area of the chosen site has been ranked more favorably. The general permit would involve determining in the regional sense structural (closed structures), stratigraphic (heterogeneity), and petrophysical (flow parameters such as residual saturation) controls on the long-term fate of geologically sequestered CO{sub 2}. The state-sponsored regional studies and the subsequent local study performed by the applicant will address the long-term risk of the particular site. It is felt that a performance-based approach rather than a prescriptive approach is the most appropriate framework in which to address public concerns. However, operational issues for each well (equivalent to the current underground injection control-UIC-program) could follow regulations currently in place. Area ranking will include an understanding of trapping modes. Capillary (due to residual saturation) and structural (due to local geological configuration) trappings are two of the four mechanisms (the other two are solubility and mineral trappings

  16. Adolescent Health Care in School-Based Health Centers. Position Statement

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2008

    2008-01-01

    School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

  17. 77 FR 16123 - Draft Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls...

    Science.gov (United States)

    2012-03-19

    ... Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document... Drug Administration 21 CFR Part 866 Draft Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Nucleic Acid-Based In Vitro Diagnostic Devices for the...

  18. Into the Curriculum. Guidance: Sense of Self, Self-Esteem; Health: Clean Hands, Clean Books; Mathematics/Science: What's the Heaviest Thing in the Library Media Center?; Reading/Language Arts: Merry-Go-Round Mooo-ving Picture Show; Social Studies: I Came to School By !; Social Studies: Revolutionary War Facts.

    Science.gov (United States)

    School Library Media Activities Monthly, 2001

    2001-01-01

    Provides six fully developed library media activities that are designed for use with specific curriculum units in guidance, health, mathematics, science, reading, language arts, and social studies. Library media skills, curriculum objectives, grade levels, resources, instructional roles, procedures, evaluation, and follow-up are described for each…

  19. Population-based health funding under attack

    African Journals Online (AJOL)

    The frustrated heads of health in these top-performing three provinces ... buck' results, and for 'funding to follow functionality and service delivery'. The ... benefiting from this system, which puts medicines closer to their homes, with a targeted ...

  20. Guidance and justification in particularistic ethics.

    Science.gov (United States)

    Kihlbom, U

    2000-10-01

    This paper argues that, contrary to a common line of criticism followed by scholars such as Helga Kuhse, a particularistic version of virtue ethics properly elaborated, can provide sound moral guidance and a satisfactory account for moral justification of our opinions regarding, for instance, health care practice. In the first part of the paper, three criteria for comparing normative theories with respect to action-guiding power are outlined, and it is argued that the presented particularistic version of virtue ethics actually can provide more guidance than the universalistic theories followed by Kuhse and others. In the second part of the paper it is claimed that universalist normative theories have serious problems accounting for the role that moral principles are supposed to play in the justification, of moral opinions, whereas the present version of virtue ethics accommodates a plausible alternative idea of justification without invoking moral principles or eschewing objectivity.

  1. A Three-Dimensional Cooperative Guidance Law of Multimissile System

    Directory of Open Access Journals (Sweden)

    Xing Wei

    2015-01-01

    Full Text Available In order to conduct saturation attacks on a static target, the cooperative guidance problem of multimissile system is researched. A three-dimensional guidance model is built using vector calculation and the classic proportional navigation guidance (PNG law is extended to three dimensions. Based on this guidance law, a distributed cooperative guidance strategy is proposed and a consensus protocol is designed to coordinate the time-to-go commands of all missiles. Then an expert system, which contains two extreme learning machines (ELM, is developed to regulate the local proportional coefficient of each missile according to the command. All missiles can arrive at the target simultaneously under the assumption that the multimissile network is connected. A simulation scenario is given to demonstrate the validity of the proposed method.

  2. General RMP Guidance - Appendix D: OSHA Guidance on PSM

    Science.gov (United States)

    OSHA's Process Safety Management (PSM) Guidance on providing complete and accurate written information concerning process chemicals, process technology, and process equipment; including process hazard analysis and material safety data sheets.

  3. The continuum of behavior guidance.

    Science.gov (United States)

    Nelson, Travis

    2013-01-01

    Behavior guidance is a continuum of techniques, basic and advanced, fundamental to the provision of quality dental care for pediatric patients. This practice must be individualized, pairing the correct method of behavior guidance with each child. To select the appropriate technique, the clinician must have a thorough understanding of each aspect of the continuum and anticipate parental expectations, child temperament, and the technical procedures necessary to complete care. By effectively using techniques within the continuum of behavior guidance, a healing relationship with the family is maintained while addressing dental disease and empowering the child to receive dental treatment throughout their lifetime. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Regulatory guidance for license renewal

    International Nuclear Information System (INIS)

    Thoma, John A.

    1991-01-01

    The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)

  5. Target volume geometric change and/or deviation from the cranium during fractionated stereotactic radiotherapy for brain metastases: potential pitfalls in image guidance based on bony anatomy alignment.

    Science.gov (United States)

    Ohtakara, Kazuhiro; Hoshi, Hiroaki

    2014-12-01

    This study sought to evaluate the potential geometrical change and/or displacement of the target relative to the cranium during fractionated stereotactic radiotherapy (FSRT) for treating newly developed brain metastases. For 16 patients with 21 lesions treated with image-guided frameless FSRT in 5 or 10 fractions using a 6-degree-of-freedom image guidance system-integrated platform, the unenhanced computed tomography or T2-weighted magnetic resonance images acquired until the completion of FSRT were fused to the planning image datasets for comparison. Significant change was defined as ≥3-mm change in the tumour diameter or displacement of the tumour centroid. FSRT was started 1 day after planning image acquisition. Tumour shrinkage, deviation and both were observed in 2, 1 and 1 of the 21 lesions, respectively, over a period of 7-13 days. Tumour shrinkage or deviation resulted in an increase or decrease in the marginal dose to the tumour, respectively, and a substantial increase in the irradiated volume for the surrounding tissue irrespective of the pattern of alteration. No obvious differences in the clinical and treatment characteristics were noted among the populations with or without significant changes in tumour volume or position. Target deformity and/or deviation can unexpectedly occur even during relatively short-course FSRT, inevitably leading to a gradual discrepancy between the planned and actually delivered doses to the tumour and surrounding tissue. To appropriately weigh the treatment outcome against the planned dose distribution, target deformity and/or deviation should also be considered in addition to the immobilisation accuracy, as image guidance with bony anatomy alignment does not necessarily guarantee accurate target localisation until completion of FSRT. © 2014 The Royal Australian and New Zealand College of Radiologists.

  6. Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review.

    Science.gov (United States)

    Toivonen, Kirsti I; Zernicke, Kristin; Carlson, Linda E

    2017-08-31

    Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date. The objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility). Databases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes. Of 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables. Preliminary evidence suggests

  7. A translation table for patient-centered comparative effectiveness research: guidance to improve the value of research for clinical and health policy decision-making.

    Science.gov (United States)

    Tunis, Sean R; Messner, Donna A; Mohr, Penny; Gliklich, Richard E; Dubois, Robert W

    2012-05-01

    This article provides background and context for a series of papers stemming from a collaborative effort by Outcome Sciences, Inc., the National Pharmaceutical Council and the Center for Medical Technology Policy to use a stakeholder-driven process to develop a decision tool to select appropriate methods for comparative effectiveness research. The perceived need and origins of the 'translation table' concept for method selection are described and the legislative history and role of the Patient-Centered Outcomes Research Institute are reviewed. The article concludes by stressing the significance of this effort for future health services and clinical research, and the importance of consulting end-users--patients, providers, payers and policy-makers--in the process of defining research questions and approaches to them.

  8. Apply an Augmented Reality in a Mobile Guidance to Increase Sense of Place for Heritage Places

    Science.gov (United States)

    Chang, Yu-Lien; Hou, Huei-Tse; Pan, Chao-Yang; Sung, Yao-Ting; Chang, Kuo-En

    2015-01-01

    Based on the sense of place theory and the design principles of guidance and interpretation, this study developed an augmented reality mobile guidance system that used a historical geo-context-embedded visiting strategy. This tool for heritage guidance and educational activities enhanced visitor sense of place. This study consisted of 3 visitor…

  9. The Marketisation of Guidance Services in Germany, France and Britain.

    Science.gov (United States)

    Rees, Teresa; Bartlett, Will; Watts, A. G.

    1999-01-01

    Compares developments in Britain, France, and Germany, focusing on the trends toward marketing adult career guidance services. Describes how Germany's centralized system and the quasi-market based system in France might apply in Britain. (JOW)

  10. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  11. Supporting Adolescents with Guidance and Employment (SAGE).

    Science.gov (United States)

    Ringwalt, C L; Graham, L A; Paschall, M J; Flewelling, R L; Browne, D C

    1996-01-01

    Supporting Adolescents with Guidance and Employment (SAGE) is a multifaceted, community-based violence-prevention program. Its target is African-American male adolescents in Durham, North Carolina. Public health professionals, county government officials, and local businessmen collaborated in its development and implementation. The program is based on the paradigm of risk and protective factors, in which various risk factors for youth violence are buffered by modifiable, protective psychosocial processes. SAGE includes an eight-month African-American Rites of Passage program (adult mentoring, African-American culture and history lessons, and manhood and conflict-resolution training), a six-week summer employment component, and a 12-week entrepreneurial experience. Of the 260 youth recruited, 88 were randomly assigned to receive all three program components, 85 were assigned to the summer employment and entrepreneurial components only, and 87 were assigned to a delayed program or control condition. We compared these three groups' psychosocial and behavioral outcomes using survey data and archival records. Program implementation data include attendance records; mentor-youth activity logs pre- and postprogram focus group discussions; and telephone interviews with parents, program staff, and participants. The mean age of the adolescents recruited into the program was 14. Half reported receiving free lunches at school; half were not living with a father; and one quarter reported that their mothers had not completed high school. During the previous year, many had engaged in various violence-related behaviors, including fighting (49%) and carrying a gun (22%). Youths in each program condition were similar with respect to key demographic and behavioral characteristics. The key components of the SAGE program represent increasingly popular but untested approaches. Preliminary results reveal that these youths are involved in violent behavior both as perpetrators and as

  12. Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

    Science.gov (United States)

    Dyess, Susan MacLeod

    2015-01-01

    It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

  13. SPLC Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  14. CDM Convective Forecast Planning guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The CDM Convective Forecast Planning (CCFP) guidance product provides a foreast of en-route aviation convective hazards. The forecasts are updated every 2 hours and...

  15. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...... `agent´ on the educational "market´, assisting (potential) students into and around the `marketplace´. Consequently, guidance is also an important `agent´ for educational institutions that increasingly use marketing strategies to promote themselves on the market to attract and hold on to their “customers......” in order for the institutions to increase their ´market value´, `sales” and “turnover”. Thus, the expansion of guidance is nurtured by the expansion of the logic of marketization and consumerism. Drawing on Foucauldian perspectives in educational research, which highlight the expansion of powerful...

  16. Based Sexual Health Services in Malawi

    African Journals Online (AJOL)

    Erah

    To more effectively address individuals' and couples' sexual and reproductive health needs, innovative service delivery ... We collected qualitative data from six focus group discussions and 10 husband-wife in- .... Counseling partners together in their home may .... young men (13.2 percent versus 3.9 percent in ages.

  17. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  18. Key performance indicators for the assessment of pediatric pharmacotherapeutic guidance.

    Science.gov (United States)

    Barrett, Jeffrey S; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

    2008-07-01

    Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25-50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient

  19. Support for Offering Sexual Health Services through School-Based Health Clinics

    Science.gov (United States)

    Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey

    2016-01-01

    Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…

  20. The logic of tax-based financing for health care.

    Science.gov (United States)

    Bodenheimer, T; Sullivan, K

    1997-01-01

    Employment-based health insurance faces serious problems. For the first time, the number of Americans covered by such health insurance is falling. Employers strongly oppose the employer mandate approach to extending health insurance. Employment-based financing is regressive and complex. Serious debate is needed on an alternative solution to financing health care for all Americans. Taxation represents a clear alternative to employment-based health care financing. The major criterion for choosing a tax is equity, with simplicity a second criterion. An earmarked, progressive individual income tax is a fair and potentially simple tax with which to finance health care. The political feasibility of such a tax is greater than that of employer mandate legislation.

  1. Utilization of Mental Health Services in School-Based Health Centers.

    Science.gov (United States)

    Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-08-01

    We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

  2. Place shaping to create health and wellbeing using health impact assessment: health geography applied to develop evidence-based practice.

    Science.gov (United States)

    Learmonth, Alyson; Curtis, Sarah

    2013-11-01

    In a political milieu where there is pressure towards localised and participative decisionmaking, and an environment of global recession and environmental degradation, it is crucial that population health considerations inform strategic decisions. The paper puts forward 'place shaping to create health and wellbeing' as a strategic tool, drawing on ideas that are fundamental in health geography, and argues that this is an important emerging application of Health Impact Assessment (HIA), as part of evidence-based practice. These views developed primarily from case study work in the North East of England aiming to enhance health and wellbeing in a population with significant health disadvantages. © 2013 Elsevier Ltd. All rights reserved.

  3. Towards Web-based representation and processing of health information

    DEFF Research Database (Denmark)

    Gao, S.; Mioc, Darka; Yi, X.L.

    2009-01-01

    facilitated the online processing, mapping and sharing of health information, with the use of HERXML and Open Geospatial Consortium (OGC) services. It brought a new solution in better health data representation and initial exploration of the Web-based processing of health information. Conclusion: The designed......Background: There is great concern within health surveillance, on how to grapple with environmental degradation, rapid urbanization, population mobility and growth. The Internet has emerged as an efficient way to share health information, enabling users to access and understand data....... For the representation of health information through Web-mapping applications, there still lacks a standard format to accommodate all fixed (such as location) and variable (such as age, gender, health outcome, etc) indicators in the representation of health information. Furthermore, net-centric computing has not been...

  4. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    Science.gov (United States)

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  5. Guidance on Dependence Assessment in SPAR-H

    Energy Technology Data Exchange (ETDEWEB)

    April M. Whaley

    2012-06-01

    As part of the effort to develop the SPAR-H user guidance, particular attention was paid to the assessment of dependence in order to address user questions about proper application of dependence. This paper presents a discussion of dependence from a psychological perspective and provides guidance on applying this information during the qualitative analysis of dependence to ensure more realistic and appropriate dependence assessments with the SPAR-H method. While this guidance was developed with SPAR-H in mind, it may be informative to other human reliability analysis methods that also use a THERP-based dependence approach, particularly if applied at the human failure event level.

  6. WODA Technical Guidance on Underwater Sound from Dredging.

    Science.gov (United States)

    Thomsen, Frank; Borsani, Fabrizio; Clarke, Douglas; de Jong, Christ; de Wit, Pim; Goethals, Fredrik; Holtkamp, Martine; Martin, Elena San; Spadaro, Philip; van Raalte, Gerard; Victor, George Yesu Vedha; Jensen, Anders

    2016-01-01

    The World Organization of Dredging Associations (WODA) has identified underwater sound as an environmental issue that needs further consideration. A WODA Expert Group on Underwater Sound (WEGUS) prepared a guidance paper in 2013 on dredging sound, including a summary of potential impacts on aquatic biota and advice on underwater sound monitoring procedures. The paper follows a risk-based approach and provides guidance for standardization of acoustic terminology and methods for data collection and analysis. Furthermore, the literature on dredging-related sounds and the effects of dredging sounds on marine life is surveyed and guidance on the management of dredging-related sound risks is provided.

  7. Failure diagnosis using deep belief learning based health state classification

    International Nuclear Information System (INIS)

    Tamilselvan, Prasanna; Wang, Pingfeng

    2013-01-01

    Effective health diagnosis provides multifarious benefits such as improved safety, improved reliability and reduced costs for operation and maintenance of complex engineered systems. This paper presents a novel multi-sensor health diagnosis method using deep belief network (DBN). DBN has recently become a popular approach in machine learning for its promised advantages such as fast inference and the ability to encode richer and higher order network structures. The DBN employs a hierarchical structure with multiple stacked restricted Boltzmann machines and works through a layer by layer successive learning process. The proposed multi-sensor health diagnosis methodology using DBN based state classification can be structured in three consecutive stages: first, defining health states and preprocessing sensory data for DBN training and testing; second, developing DBN based classification models for diagnosis of predefined health states; third, validating DBN classification models with testing sensory dataset. Health diagnosis using DBN based health state classification technique is compared with four existing diagnosis techniques. Benchmark classification problems and two engineering health diagnosis applications: aircraft engine health diagnosis and electric power transformer health diagnosis are employed to demonstrate the efficacy of the proposed approach

  8. The management of anovulatory infertility in women with polycystic ovary syndrome : an analysis of the evidence to support the development of global WHO guidance

    NARCIS (Netherlands)

    Balen, Adam H; Morley, Lara C; Misso, Marie; Franks, Stephen; Legro, Richard S; Wijeyaratne, Chandrika N; Stener-Victorin, Elisabet; Fauser, Bart C J M; Norman, Robert J; Teede, Helena

    2016-01-01

    BACKGROUND: Here we describe the consensus guideline methodology, summarise the evidence-based recommendations we provided to the World Health Organisation (WHO) for their consideration in the development of global guidance and present a narrative review on the management of anovulatory infertility

  9. A school-based public health model to reduce oral health disparities.

    Science.gov (United States)

    Dudovitz, Rebecca N; Valiente, Jonathan E; Espinosa, Gloria; Yepes, Claudia; Padilla, Cesar; Puffer, Maryjane; Slavkin, Harold C; Chung, Paul J

    2018-12-01

    Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four hundred ninety-one parents received oral health education and 89 served as community oral health volunteers; 3,399 screenings and fluoride applications were performed on 2,776 children. Sixty-six percent of children had active dental disease, 27 percent had visible tooth decay, and 6 percent required emergent care. Of the 623 students who participated for two consecutive years, 56 percent had fewer or no visible caries at follow-up, while only 17 percent had additional disease. Annual program cost was $69.57 per child. Using a broad based, oral health coalition, a school-based universal screening and fluoride varnishing program can improve the oral health of children with a high burden of untreated dental diseases. © 2017 American Association of Public Health Dentistry.

  10. Early school leaving and lifelong guidance

    DEFF Research Database (Denmark)

    Plant, Peter; Oomen, Annemarie

    Early school leaving (ESL) is costly for the individual, for society and for the economy. Not just in economic terms, but also in terms of low self esteem, and the risk of social exclusion. More, and, in particular, better education can lead to positive outcomes, in relation to employment, level...... of salaries, better health, less crime, higher social cohesion, lower public and social costs and higher productivity. This is why ESL is a policy focal point. In these terms, lifelong guidance has a key role to play in terms of both prevention, intervention, and of compensation strategies....

  11. Quality in career guidance: The Danish case

    DEFF Research Database (Denmark)

    Plant, Peter

    2011-01-01

    Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach......Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach...

  12. Greater fruit selection following an appearance-based compared with a health-based health promotion poster

    Science.gov (United States)

    2016-01-01

    Abstract Background This study investigated the impact of an appearance-based compared with a traditional health-based public health message for healthy eating. Methods A total of 166 British University students (41 males; aged 20.6 ± 1.9 years) were randomized to view either an appearance-based (n = 82) or a health-based (n = 84) fruit promotion poster. Intentions to consume fruit and immediate fruit selection (laboratory observation) were assessed immediately after poster viewing, and subsequent self-report fruit consumption was assessed 3 days later. Results Intentions to consume fruit were not predicted by poster type (largest β = 0.03, P = 0.68) but were associated with fruit-based liking, past consumption, attitudes and social norms (smallest β = 0.16, P = 0.04). Immediate fruit selection was greater following the appearance-based compared with the health-based poster (β = −0.24, P poster (β = −0.22, P = 0.03), but this effect became non-significant on consideration of participant characteristics (β = −0.15, P = 0.13), and was instead associated with fruit-based liking and past consumption (smallest β = 0.24, P = 0.03). Conclusions These findings demonstrate the clear value of an appearance-based compared with a health-based health promotion poster for increasing fruit selection. A distinction between outcome measures and the value of a behavioural measure is also demonstrated. PMID:28158693

  13. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long-term mortality impact.

    Science.gov (United States)

    Perry, Henry B; Rassekh, Bahie M; Gupta, Sundeep; Freeman, Paul A

    2017-06-01

    There is limited evidence about the long-term effectiveness of integrated community-based primary health care (CBPHC) in improving maternal, neonatal and child health. However, the interventions implemented and the approaches used by projects with such evidence can provide guidance for ending preventable child and maternal deaths by the year 2030. A database of 700 assessments of the effectiveness of CBPHC in improving maternal, neonatal and child health has been assembled, as described elsewhere in this series. A search was undertaken of these assessments of research studies, field project and programs (hereafter referred to as projects) with more than a single intervention that had evidence of mortality impact for a period of at least 10 years. Four projects qualified for this analysis: the Matlab Maternal Child Health and Family Planning (MCH-FP) P in Bangladesh; the Hôpital Albert Schweitzer in Deschapelles, Haiti; the Comprehensive Rural Health Project (CRHP) in Jamkhed, India; and the Society for Education, Action and Research in Community Health (SEARCH) in Gadchiroli, India. These four projects have all been operating for more than 30 years, and they all have demonstrated reductions in infant mortality, 1- to 4-year mortality, or under-5 mortality for at least 10 years. They share a number of characteristics. Among the most notable of these are: they provide comprehensive maternal, child health and family planning services, they have strong community-based programs that utilize community health workers who maintain regular contact with all households, they have develop strong collaborations with the communities they serve, and they all have strong referral capabilities and provide first-level hospital care. The shared features of these projects provide guidance for how health systems around the world might improve their effectiveness in improving maternal, neonatal and child health. Strengthening these features will contribute to achieving the goal of

  14. A Review of Hip Hop-Based Interventions for Health Literacy, Health Behaviors, and Mental Health.

    Science.gov (United States)

    Robinson, Cendrine; Seaman, Elizabeth L; Montgomery, LaTrice; Winfrey, Adia

    2017-07-01

    African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health. We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results. Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent. The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.

  15. Research Circles - a method for developing guidance practices

    DEFF Research Database (Denmark)

    2012-01-01

    This video reports on our work with using research circles to improve our understanding of how to provide guidance and counseling to help young people in danger of dropping out of school. The video is based on the paper: Research Circles -- a method for developing guidance practices, and was pres......This video reports on our work with using research circles to improve our understanding of how to provide guidance and counseling to help young people in danger of dropping out of school. The video is based on the paper: Research Circles -- a method for developing guidance practices......, and was presented at the Conference for Social Justice, Prosperity and Sustainable Employment 2012 by assistant professor Helle Merete Nordentoft from DPU (http://edu.au.dk/). The film communicating the research paper was created by Mie Nørgaard...

  16. Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

    Science.gov (United States)

    Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

    2017-10-01

    Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

  17. Visual search guidance is best after a short delay.

    Science.gov (United States)

    Schmidt, Joseph; Zelinsky, Gregory J

    2011-03-25

    Search displays are typically presented immediately after a target cue, but in the real-world, delays often exist between target designation and search. Experiments 1 and 2 asked how search guidance changes with delay. Targets were cued using a picture or text label, each for 3000ms, followed by a delay up to 9000ms before the search display. Search stimuli were realistic objects, and guidance was quantified using multiple eye movement measures. Text-based cues showed a non-significant trend towards greater guidance following any delay relative to a no-delay condition. However, guidance from a pictorial cue increased sharply 300-600ms after preview offset. Experiment 3 replicated this guidance enhancement using shorter preview durations while equating the time from cue onset to search onset, demonstrating that the guidance benefit is linked to preview offset rather than a more complete encoding of the target. Experiment 4 showed that enhanced guidance persists even with a mask flashed at preview offset, suggesting an explanation other than visual priming. We interpret our findings as evidence for the rapid consolidation of target information into a guiding representation, which attains its maximum effectiveness shortly after preview offset. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. IoT based mobile health hub

    Science.gov (United States)

    Thomas, Diljo; Vineeth, V. L.; Siddharth, P. G.; Shanmugasundaram, M.

    2017-11-01

    Technological innovations have a great influence on bio medical field. Even in this advanced era people are struggling due to lack of medical attention or delay in arranging adequate health care. Most of the hospitals have emergency vehicle facility and they are successful in providing emergency response to the needy patient. But the delay in arranging medical attention in hospital is still a big issue. One solution to the above problem is to provide a channel of communication between the emergency vehicle and hospital such that the patient information along with the vitals can be made available to the hospital prior to the arrival of emergency vehicle. This paper proposes such a system where the patient information and vitals are measured and uploaded to a cloud facility. This information helps the doctor to arrange quick medical response.

  19. 75 FR 32952 - Draft Guidance for Industry and Food and Drug Administration Staff; “‘Harmful and Potentially...

    Science.gov (United States)

    2010-06-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0281] Draft Guidance for Industry and Food and Drug Administration Staff; ```Harmful and Potentially Harmful... Food, Drug, and Cosmetic Act.'' This draft guidance provides written guidance to industry and FDA staff...

  20. 77 FR 69634 - Guidance for Industry on Evaluating the Effectiveness of Anticoccidial Drugs in Food-Producing...

    Science.gov (United States)

    2012-11-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0784] Guidance for Industry on Evaluating the Effectiveness of Anticoccidial Drugs in Food-Producing Animals... Effectiveness of Anticoccidial Drugs in Food-Producing Animals.'' The guidance provides guidance to industry for...

  1. Applying health information technology and team-based care to residency education.

    Science.gov (United States)

    Brown, Kristy K; Master-Hunter, Tara A; Cooke, James M; Wimsatt, Leslie A; Green, Lee A

    2011-01-01

    Training physicians capable of practicing within the Patient-centered Medical Home (PCMH) is an emerging area of scholarly inquiry within residency education. This study describes an effort to integrate PCMH principles into teaching practices within a university-based residency setting and evaluates the effect on clinical performance. Using participant feedback and clinical data extracted from an electronic clinical quality management system, we retrospectively examined performance outcomes at two family medicine residency clinics over a 7-year period. Instructional approaches were identified and clinical performance patterns analyzed. Alumni ratings of the practice-based curriculum increased following institution of the PCMH model. Clinical performance outcomes indicated improvements in the delivery of clinical care to patients. Implementation of instructional methodologies posed some challenges to residency faculty, particularly in development of consistent scheduling of individualized feedback sessions. Residents required the greatest support and guidance in managing point-of-care clinical reminders during patient encounters. Teaching practices that take into consideration the integration of team-based care and use of electronic health technologies can successfully be used to deliver residency education in the context of the PCMH model. Ongoing assessment provides important information to residency directors and faculty in support of improving the quality of clinical instruction.

  2. Using video-based observation research methods in primary care health encounters to evaluate complex interactions.

    Science.gov (United States)

    Asan, Onur; Montague, Enid

    2014-01-01

    The purpose of this paper is to describe the use of video-based observation research methods in primary care environment and highlight important methodological considerations and provide practical guidance for primary care and human factors researchers conducting video studies to understand patient-clinician interaction in primary care settings. We reviewed studies in the literature which used video methods in health care research, and we also used our own experience based on the video studies we conducted in primary care settings. This paper highlighted the benefits of using video techniques, such as multi-channel recording and video coding, and compared "unmanned" video recording with the traditional observation method in primary care research. We proposed a list that can be followed step by step to conduct an effective video study in a primary care setting for a given problem. This paper also described obstacles, researchers should anticipate when using video recording methods in future studies. With the new technological improvements, video-based observation research is becoming a promising method in primary care and HFE research. Video recording has been under-utilised as a data collection tool because of confidentiality and privacy issues. However, it has many benefits as opposed to traditional observations, and recent studies using video recording methods have introduced new research areas and approaches.

  3. Base excision repair, aging and health span

    Czech Academy of Sciences Publication Activity Database

    Xu, G.; Herzig, M.; Rotrekl, Vladimír; Walter, Ch. A.

    2008-01-01

    Roč. 129, 7-8 (2008), s. 366-382 ISSN 0047-6374 Institutional research plan: CEZ:AV0Z50390512 Keywords : base excision repair * aging * DNA damage Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.915, year: 2008

  4. Value based health care real estate strategies

    NARCIS (Netherlands)

    van der Voordt, Theo; van der Voordt, DJM; Dijkstra, K

    2009-01-01

    Subject/Research problem
    The healthcare sector in the Netherlands is shifting from a governmentally steered domain towards regulated market forces and performance-based financing. Organizational changes, new ideas about care and cure, demographical developments and technological innovations play

  5. Query Health: standards-based, cross-platform population health surveillance.

    Science.gov (United States)

    Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

    2014-01-01

    Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

  6. Effectiveness of Education Based on the Health Belief Model on Performing Preventive Measures for Breast Cancer Among Female Teachers in Zahedan

    Directory of Open Access Journals (Sweden)

    Khadijeh Kalan-Farmanfarma

    2014-06-01

    Full Text Available Introduction: Preventive behaviors such as screening tests have an important role in prevention and control of breast cancer. Therefore, this study aimed to determine the effect of educational programs on preventive behaviors of breast cancer based on the health belief model among female teachers of guidance schools in Zahedan city. Materials and Methods: This quasi-experimental study was performed on 240 female teachers from (120 participants in each of the control and intervention groups Zahedan guidance schools. The data-gathering tool was a multipart questionnaire containing demographic variables, knowledge and health belief model structures. An educational program was performed based on the health belief model in five sessions through lectures, training videos, question and answer session for participants in the intervention group. Questionnaires were filled before and two months after the intervention in the two groups. Data was analyzed by independent T-test, chi-square and multiple linear regressions using SPSS-15 software. Results: There was no meaningful difference in the mean scores of knowledge, health belief model constructs, and performance between the two groups before the educational intervention, but the mean scores of variables increased significantly after the intervention (P< 0.05. Conclusion: The health belief model was effective to promote preventive behaviors. Hence, educational interventions with an emphasis on raising awareness, change in beliefs and improving self-efficacy regarding breast cancer are recommended

  7. Building an evidence base for occupational health interventions

    NARCIS (Netherlands)

    Verbeek, Jos; Husman, Kaj; van Dijk, Frank; Jauhiainen, Merja; Pasternack, Iris; Vainio, Harri

    2004-01-01

    This article summarizes arguments for building an evidence base for occupational health. Evidence is needed on the most effective ways of eliminating health hazards in the workplace and at work, enhancing healthy behavior or the empowerment of workers, and preventing and treating occupational

  8. Community Based Health Insurance Knowledge and Willingness to ...

    African Journals Online (AJOL)

    Community Based Health Insurance Knowledge and Willingness to Pay; A Survey of a Rural Community in ... Journal Home > Vol 6, No 1 (2012) > ... and is the most appropriate insurance model for rural areas where incomes are unstable.

  9. EPA guidance mental health care of migrants

    DEFF Research Database (Denmark)

    Bhugra, D; Gupta, S; Schouler-Ocak, M

    2014-01-01

    Migration is an increasingly commonplace phenomenon for a number of reasons. People migrate from rural to urban areas or across borders for reasons including economic, educational or political. There is increasing recent research evidence from many countries in Europe that indicates that migrants...

  10. Draft Guidance for Protective Action Strategies Development

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Jeong, Seung Young; Kim, Wanjoo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-10-15

    National nuclear emergency preparedness and response (EPR) framework has been improved since the Fukushima accident in 2011. There are still many needs to be amended and improved in regulatory requirements and technical criteria to warrant efficacy of the EPR framework. As an important part of the framework, protective actions have to be implemented with optimized and justified manner during whole emergency phases. In this study, to enhance protective action strategies in response to severe accident or general emergency, existing procedures were reviewed. And generic guidance to develop protective action recommendations (PARs) was proposed considering revised EPZ and recent technical information on protective action strategies. The generic guidance for PARs based on facility status was introduced. Revision of EPZ and some recent information on protective action strategies, such as staged evacuation, specific approach for rapidly progressing accident were considered. It would be employed as a basis to develop site-specific strategies of PARs and regulatory guidance for emergency plan by nuclear licensee. It was focused on an early phase of nuclear emergency. Further efforts to develop site specific strategies of PARs and strategies which cover full range of nuclear emergency would be followed by several stake holders.

  11. In Respect to the Cognitive Load Theory: Adjusting Instructional Guidance with Student Expertise.

    Science.gov (United States)

    Schilling, Jim

    2017-01-01

    The amount of guidance supplied by educators to students in allied health programs is a factor in student learning. According to the cognitive load theory of learning, without adequate instructional support, novice learners will be overwhelmed and unable to store information, while unnecessary guidance supplied to advanced students will cause extraneous cognitive load on the working memory system. Adjusting instructional guidance for students according to their level of expertise to minimize extraneous cognitive load and optimize working memory storage capacity will enhance learning effectiveness. Novice students presented with complex subject matter require significant guidance during the initial stages, using strategies such as worked examples. As students comprehend information, instructional guidance needs to gradually fade to avoid elevated extraneous cognitive load from the expertise reversal effect. An instructional strategy that utilizes a systemic (fixed) or adjustable (adaptive) tapering of guidance to students in allied health programs depending on their expertise will optimize learning capability.

  12. South African HIV self-testing policy and guidance considerations

    Directory of Open Access Journals (Sweden)

    Francois Venter

    2017-10-01

    Full Text Available The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

  13. International Conference on Harmonisation; guidance on Q10 Pharmaceutical Quality System; availability. Notice.

    Science.gov (United States)

    2009-04-08

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."

  14. One Chance to Get it Right: understanding the new guidance for care of the dying person.

    Science.gov (United States)

    Sykes, Nigel

    2015-09-01

    Following criticism of the Liverpool Care of the Dying Pathway (LCP), widely used to guide care of dying people in British health-care settings, the UK Government set up an independent review which in 2013 recommended that use of the LCP be discontinued. In response, the Leadership Alliance for the Care of Dying People, a coalition of a wide range of stakeholders, recently published guidance entitled One Chance to Get it Right. This guidance contains five Priorities of Care for the dying person that are intended to guide clinical staff and will inform Care Quality Commission inspections of health-care providers. This article summarizes the background to One Chance to Get it Right and the guidance it contains. One Chance to Get it Right, More Care, Less Pathway and related guidance documents. The need to improve the standard of end-of-life care in every clinical setting. The value of a pathway-based approach to end-of-life care in a context where well-implemented programmes of staff education in the subject are lacking. Public concern with, and scrutiny of, the quality of dying in the UK health-care system, particularly in hospitals but also the ability of patients to die well at home where that is their place of choice. Effective methods of teaching end of life care to all clinical staff; the effect upon families of caring for a dying relative at home; the optimum type, quantity and source of external support to informal carers that is perceived by them as adequate and enables the ill person to die well in in their own home; fuller understanding of the physiology of dying. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Nature-Based Strategies for Improving Urban Health and Safety.

    Science.gov (United States)

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C

    2015-10-01

    Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.

  16. Home-based carers’ perceptions of health promotion on sexual health communication in Vhembe District

    Directory of Open Access Journals (Sweden)

    Dorah U. Ramathuba

    2015-05-01

    Full Text Available Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. Objective: The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.

  17. Outcome-based health equity across different social health insurance schemes for the elderly in China.

    Science.gov (United States)

    Liu, Xiaoting; Wong, Hung; Liu, Kai

    2016-01-14

    Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health

  18. The Developing Role of Evidence-Based Environmental Health

    Directory of Open Access Journals (Sweden)

    Surindar Dhesi

    2015-10-01

    Full Text Available There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

  19. Guidance for closure of existing DOE LLW disposal sites

    International Nuclear Information System (INIS)

    Blanchfield, L.

    1987-01-01

    During FY 1986, a closure guidance document was developed. The purpose of this document is to provide guidance in support of DOE Order 5820.2 to site operating contractors for the stabilization and closure of existing low-level waste (LLW) shallow land disposal sites at US Department of Energy (DOE) facilities. Guidance is provided to aid operators in placing existing LLW sites in a closed conditions, i.e., a condition in which a nonoperational site meets postclosure performance requirements and can be shown, within a high degree of confidence, to perform as anticipated in the future, under the most cost-effective maintenance approach. Guidance is based on the philosophy that closure should be planned and performed using a systems approach. Plans for FY 1987 call for revision of the document to incorporate more information on closure of LLW sites also containing radioactive mixed waste and/or transuranic waste. 4 references, 3 figures, 2 tables

  20. Method for plant operation guidance by knowledge engineering technique

    International Nuclear Information System (INIS)

    Kiguchi, Takashi; Yoshida, Kenichi; Motoda, Hiroshi; Kobayashi, Setsuo

    1983-01-01

    A method for plant operation guidance has been developed by using the Knowledge Engineering technique. The method is characterized by its capability of handling plant dynamics. The knowledge-base includes plant simulation programs as tools to evaluate dynamic behaviors as well as production rules of ''if..., then...'' type. The inference engine is thus capable of predicting plant dynamics and making decisions in accordance with time progress. The performance of the guidance method was evaluated by simulation tests assuming various abnormal situations of a BWR power plant. It was shown that the method can detect each of the abnormal events along the course of their occurrence, and provide the guidance for corrective actions. The operation guidance method proposed in this paper is general and is applicable not only to nuclear power plants but also to other plants such as chemical production plants and fossile power plants. (author)

  1. Value-Based Health Care Delivery, Preventive Medicine and the Medicalization of Public Health

    OpenAIRE

    Vilhelmsson, Andreas

    2017-01-01

    The?real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a??value-based health care delivery?. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges.?In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of?a better healthcare for all, with real bene...

  2. Community-Based Rehabilitation in Bangladesh, Health Components Need to be Integrated with Primary Health Care

    Directory of Open Access Journals (Sweden)

    Md Shahidur Rahman

    2018-01-01

    Full Text Available Community-based rehabilitation (CBR is defined as a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities. The role of CBR is to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed. Health components of CBR as per WHO guidelines are grossly neglected in Bangladesh. Some government and non-government organizations are working independently, but health components are inadequately addressed. We observed that primary health care, if integrated with medical rehabilitation of disabled, will better address the need and help bring disabled into mainstream of development. Health care providers at grass root level need to be trained in CBR activities which can be arranged centrally with health ministry, social welfare ministry and rehabilitation specialists. In this review we have tried to reveal the health components of CBR in global and Bangladesh context and importance of integrating health components of CBR with primary health care.

  3. Using the Knowledge Base of Health Services Research to Redefine Health Care Systems.

    Science.gov (United States)

    Brook, Robert H; Vaiana, Mary E

    2015-10-01

    This Perspective discusses 12 key facts derived from 50 years of health services research and argues that this knowledge base can stimulate innovative thinking about how to make health care systems safer, more efficient, more cost effective, and more patient centered, even as they respond to the needs of diverse communities.

  4. Consensus standard requirements and guidance

    International Nuclear Information System (INIS)

    Putman, V.L.

    1995-01-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

  5. Focus on Chronic Exposure for Deriving Drinking Water Guidance Underestimates Potential Risk to Infants

    Directory of Open Access Journals (Sweden)

    Helen Goeden

    2018-03-01

    Full Text Available In 2007, the Minnesota Department of Health (MDH developed new risk assessment methods for deriving human health-based water guidance (HBG that incorporated the assessment of multiple exposure durations and life stages. The methodology is based on US Environmental Protection Agency recommendations for protecting children’s health (US EPA 2002. Over the last 10 years, the MDH has derived multiple duration (e.g., short-term, subchronic, and chronic water guidance for over 60 chemicals. This effort involved derivation of multiple duration reference doses (RfDs and selection of corresponding water intake rates (e.g., infant, child, and lifetime. As expected, RfDs typically decreased with increasing exposure duration. However, the corresponding HBG frequently did not decrease with increasing duration. For more than half of the chemicals, the shorter duration HBG was lower than chronic HBG value. Conventional wisdom has been that chronic-based values will be the most conservative and will therefore be protective of less than chronic exposures. However, the MDH’s experience highlights the importance of evaluating short-term exposures. For many chemicals, elevated intake rates early in life, coupled with short-term RfDs, resulted in the lowest HBG. Drinking water criteria based on chronic assessments may not be protective of short-term exposures in highly exposed populations such as formula-fed infants.

  6. Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy.

    Science.gov (United States)

    Kim, Jung-In; Lee, Hanyoung; Wu, Hong-Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

    2017-09-01

    The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system. The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy. The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding

  7. Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

    Directory of Open Access Journals (Sweden)

    Steve Gillard

    2012-07-01

    Full Text Available Abstract Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services. These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision

  8. Diabetes mellitus: preliminary health-promotion activity based on ...

    African Journals Online (AJOL)

    Objectives: To investigate the effects of a service-learning-based health promotion elective in influencing knowledge of diabetes mellitus (DM) and ways to prevent it. Method: A computer-based quiz, an information poster, interactive models and a take-home information leaflet on DM were developed as part of an exhibit ...

  9. Health Care Leadership: Managing Knowledge Bases as Stakeholders.

    Science.gov (United States)

    Rotarius, Timothy

    Communities are composed of many organizations. These organizations naturally form clusters based on common patterns of knowledge, skills, and abilities of the individual organizations. Each of these spontaneous clusters represents a distinct knowledge base. The health care knowledge base is shown to be the natural leader of any community. Using the Central Florida region's 5 knowledge bases as an example, each knowledge base is categorized as a distinct type of stakeholder, and then a specific stakeholder management strategy is discussed to facilitate managing both the cooperative potential and the threatening potential of each "knowledge base" stakeholder.

  10. Evaluating community-based public health leadership training.

    Science.gov (United States)

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  11. Vertical guidance of shearers

    International Nuclear Information System (INIS)

    Pocock, J.

    1985-01-01

    Mining Engineers have always been aware of the basic need to avoid contamination of the mined product, by controlling the cutting horizon at the coal face. The ability to maintain the optimum cutting horizon results in more effective roof control and ensures a safer and more efficient working environment, for men and machinery. The cost of treatment in the surface coal preparation plant is reduced. Transportation through the total mine system of material finally destined for the spoil heap is minimised. A reduction in product contamination is achieved and makes more effective use of the mine capacity. These benefits make possible significant improvements in productivity and financial returns. Exploitation of micro computer based systems has enabled the successful development of equipment which employs sensors to detect the very low natural gamma radiation from roof strata; to determine and allow control of the position of the cut relative to the roof and floor. This paper reviews the experience gained by the National Coal Board, particularly in South Yorkshire Area, with the vertical steering of ranging drum shearers. It outlines the benefits and considers the future for this technology and its contribution to total coal face automation

  12. Attitudes to, and experience of, pooled sampling for sexually transmitted infection testing: a web-based survey of English sexual health services.

    Science.gov (United States)

    Shaw, Jonathan; Saunders, John Michael; Hughes, Gwenda

    2018-05-01

    Chlamydia trachomatis and Neisseria gonorrhoeae testing guidance recommends extragenital screening with locally validated nucleic acid amplification tests, with anatomical sites tested separately. Evidence supports multi-patient combined aliquot pooled sampling (PS) for population screening; evidence for within-patient PS is sparse. Within-patient PS could be more cost-effective for triple-site testing, but requires distinct clinical pathways and consideration over loss of information to guide risk assessments and treatment. We explored PS attitudes and practices amongst clinicians in England. A cross-sectional web-based survey was distributed to clinical leads of sexual health services throughout England in February 2016. Fifty-two (52/216, 23%) services responded. One service reported current within-patient PS and two were awaiting implementation. Of the 49 services not pooling, five were considering implementation. Concerns raised included the inability to distinguish infection site(s) (36/52, 69%), absence of national guidance (34/52, 65%) and reduced assay performance (18/52, 34%). Only 8/52 (15%) considered the current level of evidence sufficient to support PS, with 40/52 (77%) requesting further validation studies and 39/52 (77%) national guidance. PS was rarely used by respondents to this survey, although the response rate was low. The clinical challenges presented by PS need to be addressed through further development of the evidence base.

  13. Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

    Science.gov (United States)

    Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

    2004-01-01

    This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

  14. 21 CFR 10.115 - Good guidance practices.

    Science.gov (United States)

    2010-04-01

    ... understanding, or other communications directed to individual persons or firms. (c) What other terms have a... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... communication that are excluded from the definition of guidance document to informally communicate new or...

  15. Determinants of nutrition guidance practices of primary-care physicians

    NARCIS (Netherlands)

    Hiddink, G.J.

    1996-01-01


    The aim of the studies described in this thesis was to analyze nutrition guidance practices of primary-care physicians (PCPs), their nutritional attitudes and knowledge and their interest in the role of nutrition in health and disease. A second objective was to identify the determinants

  16. Characteristics of school-based health services associated with students' mental health.

    Science.gov (United States)

    Denny, Simon; Howie, Hamish; Grant, Sue; Galbreath, Ross; Utter, Jennifer; Fleming, Theresa; Clark, Terryann

    2018-01-01

    Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students' mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students' mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March-November 2012. Students' mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students' mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.

  17. Evaluating the Sharing Stories youth theatre program: an interactive theatre and drama-based strategy for sexual health promotion among multicultural youth.

    Science.gov (United States)

    Roberts, Meagan; Lobo, Roanna; Sorenson, Anne

    2017-03-01

    Issue addressed Rates of sexually transmissible infections among young people are high, and there is a need for innovative, youth-focused sexual health promotion programs. This study evaluated the effectiveness of the Sharing Stories youth theatre program, which uses interactive theatre and drama-based strategies to engage and educate multicultural youth on sexual health issues. The effectiveness of using drama-based evaluation methods is also discussed. Methods The youth theatre program participants were 18 multicultural youth from South East Asian, African and Middle Eastern backgrounds aged between 14 and 21 years. Four sexual health drama scenarios and a sexual health questionnaire were used to measure changes in knowledge and attitudes. Results Participants reported being confident talking to and supporting their friends with regards to safe sex messages, improved their sexual health knowledge and demonstrated a positive shift in their attitudes towards sexual health. Drama-based evaluation methods were effective in engaging multicultural youth and worked well across the cultures and age groups. Conclusions Theatre and drama-based sexual health promotion strategies are an effective method for up-skilling young people from multicultural backgrounds to be peer educators and good communicators of sexual health information. Drama-based evaluation methods are engaging for young people and an effective way of collecting data from culturally diverse youth. So what? This study recommends incorporating interactive and arts-based strategies into sexual health promotion programs for multicultural youth. It also provides guidance for health promotion practitioners evaluating an arts-based health promotion program using arts-based data collection methods.

  18. Job-based health benefits in 2002: some important trends.

    Science.gov (United States)

    Gabel, Jon; Levitt, Larry; Holve, Erin; Pickreign, Jeremy; Whitmore, Heidi; Dhont, Kelley; Hawkins, Samantha; Rowland, Diane

    2002-01-01

    Based on a national survey of 2,014 randomly selected public and private firms with three or more workers, this paper reports changes in employer-based health insurance from spring 2001 to spring 2002. The cost of health insurance rose 12.7 percent, the highest rate of growth since 1990. Employee contributions for health insurance rose in 2002, from $30 to $38 for single coverage and from $150 to $174 for family coverage. Deductibles and copayments rose also, and employers adopted formularies and three-tier cost-sharing formulas to control prescription drug expenses. PPO and HMO enrollment rose, while the percentage of small employers offering health benefits fell. Because increasing claims expenses rather than the underwriting cycle are the major driver of rising premiums, double-digit growth appears likely to continue.

  19. Guidance and Control Architecture Design and Demonstration for Low Ballistic Coefficient Atmospheric Entry

    Science.gov (United States)

    Swei, Sean

    2014-01-01

    We propose to develop a robust guidance and control system for the ADEPT (Adaptable Deployable Entry and Placement Technology) entry vehicle. A control-centric model of ADEPT will be developed to quantify the performance of candidate guidance and control architectures for both aerocapture and precision landing missions. The evaluation will be based on recent breakthroughs in constrained controllability/reachability analysis of control systems and constrained-based energy-minimum trajectory optimization for guidance development operating in complex environments.

  20. Measuring health indicators and allocating health resources: a DEA-based approach.

    Science.gov (United States)

    Yang, Chih-Ching

    2016-02-03

    This paper suggests new empirical DEA models for the measurement of health indicators and the allocation of health resources. The proposed models were developed by first suggesting a population-based health indicator. By introducing the suggested indicator into DEA models, a new approach that solves the problem of health resource allocation has been developed. The proposed models are applied to an empirical study of Taiwan's health system. Empirical findings show that the suggested indicator can successfully accommodate the differences in health resource demands between populations, providing more reliable performance information than traditional indicators such as physician density. Using our models and a commonly used allocation mechanism, capitation, to allocate medical expenditures, it is found that the proposed model always obtains higher performance than those derived from capitation, and the superiority increases as allocated expenditures rise.

  1. PERCEPTION STUDENT OF DEPARTMENT GUIDANCE AND COUNSELING AT UNIVERSITAS MUHAMMADIYAH METRO INTO SCHOOL COUNSELOR PROFESSION

    Directory of Open Access Journals (Sweden)

    SERLI NOVITA SARI

    2015-06-01

    Full Text Available Abstract: Guidance and Counseling Teaching profession is a profession with dignity and requiring scientific competence and qualifications. Many emerging negative perception, even from students of guidance and counseling to the profession of guidance and counseling. The problem in this research is formulated as follows: "What are the perceptions students of Guidance and Counselling, University of Muhammadiyah Metro the teaching profession Counseling?". The goal is to find out how students' perceptions of Guidance and Counselling, University of Muhammadiyah Metro the teaching profession Guidance and Counseling. The method used is quantitative descriptive. The population is students of guidance and counseling, the sample totaled 175 students. Instruments used in the form of Likert scale. The data analysis technique used percentages. The results showed that students' perceptions BK UM Metro is at a very high category to the teaching profession Guidance and Counseling. Suggestions put forward are: Based on these results, the researchers gave some suggestions are as follows: 1 for lecturers to add hours of practicum BK for students, and provide student guidance and counseling opportunities to interact more with teacher guidance and counseling directly in schools, and 2 the students are expected to apply to run a positive perception of the teaching profession Counseling well. Keywords: Perception, Student, Guidance and Counseling

  2. Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012).

    Science.gov (United States)

    Oliveira-Campos, Maryane; Nunes, Marília Lavocart; Madeira, Fátima de Carvalho; Santos, Maria Goreth; Bregmann, Silvia Reise; Malta, Deborah Carvalho; Giatti, Luana; Barreto, Sandhi Maria

    2014-01-01

    This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

  3. "Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

    Science.gov (United States)

    Mukherjee, Dhrubodhi; Saxon, Verletta

    2018-01-27

    This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

  4. Development of Safety Review Guidance for Research and Training Reactors

    International Nuclear Information System (INIS)

    Oh, Kju-Myeng; Shin, Dae-Soo; Ahn, Sang-Kyu; Lee, Hoon-Joo

    2007-01-01

    The KINS already issued the safety review guidance for pressurized LWRs. But the safety review guidance for research and training reactors were not developed. So, the technical standard including safety review guidance for domestic research and training reactors has been applied mutates mutandis to those of nuclear power plants. It is often difficult for the staff to effectively perform the safety review of applications for the permit by the licensee, based on peculiar safety review guidance. The NRC and NSC provide the safety review guidance for test and research reactors and European countries refer to IAEA safety requirements and guides. The safety review guide (SRG) of research and training reactors was developed considering descriptions of the NUREG- 1537 Part 2, previous experiences of safety review and domestic regulations for related facilities. This study provided the safety review guidance for research and training reactors and surveyed the difference of major acceptance criteria or characteristics between the SRG of pressurized light water reactor and research and training reactors

  5. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    Science.gov (United States)

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. 75 FR 17143 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological...

    Science.gov (United States)

    2010-04-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0495] Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological and Physical Medicine Device Guidance Documents; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

  7. 78 FR 14557 - Guidance for Industry and Food and Drug Administration Staff: Investigational Device Exemption...

    Science.gov (United States)

    2013-03-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0010] Guidance for Industry and Food and Drug Administration Staff: Investigational Device Exemption Guidance for Retinal Prostheses; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The...

  8. 76 FR 61103 - Draft Guidance for Industry and Food and Drug Administration Staff; De Novo Classification...

    Science.gov (United States)

    2011-10-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0689] Draft Guidance for Industry and Food and Drug Administration Staff; De Novo Classification Process... appropriate, and other forms of information technology. Draft Guidance for Industry and Food and Drug...

  9. 78 FR 55727 - Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food...

    Science.gov (United States)

    2013-09-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0928] Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food Additive... guidance for industry (GFI 221) entitled ``Recommendations for Preparation and Submission of Animal Food...

  10. 77 FR 74671 - Guidance for Industry: Questions and Answers Regarding Food Facility Registration (Fifth Edition)

    Science.gov (United States)

    2012-12-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1002] Guidance for Industry: Questions and Answers Regarding Food Facility Registration (Fifth Edition) AGENCY... announcing the availability of a guidance for industry entitled ``Questions and Answers Regarding Food...

  11. 78 FR 5185 - Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD...

    Science.gov (United States)

    2013-01-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0847] Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD) Designations... public comment ``Draft Guidance for Industry and Food and Drug Administration Staff on Humanitarian Use...

  12. 75 FR 44267 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological...

    Science.gov (United States)

    2010-07-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-N-0495] Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological and Physical Medicine Device Guidance Document; Reopening of Comment Period AGENCY: Food and Drug...

  13. 78 FR 66743 - Draft Guidance for Industry on Bioequivalence Recommendations for Iron Sucrose; Availability

    Science.gov (United States)

    2013-11-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2007-D-0369] Draft Guidance for Industry on Bioequivalence Recommendations for Iron Sucrose; Availability AGENCY... guidance, FDA recommended an in vivo fasting BE study with pharmacokinetic endpoints and in vitro studies...

  14. 77 FR 60126 - Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment; Availability

    Science.gov (United States)

    2012-10-02

    .... SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry... this guidance to the Division of Drug Information, Center for Drug Evaluation and Research, Food and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0971...

  15. 75 FR 62820 - Screening Framework Guidance for Providers of Synthetic Double-Stranded DNA

    Science.gov (United States)

    2010-10-13

    ... Providers of Synthetic Double- Stranded DNA AGENCY: Department of Health and Human Services, Office of the.... Government has developed Guidance that provides a framework for screening synthetic double-stranded DNA (dsDNA). This document, the Screening Framework Guidance for Providers of Synthetic Double-Stranded DNA...

  16. attitude of secondary school students towards guidance

    African Journals Online (AJOL)

    Elizabeth Egbochuku

    gender and school location significantly influenced students' attitude towards guidance ... students respond and perceive guidance and counselling services will, to ... counsellors will be appointed in post-primary institutions and tertiary levels.

  17. Evidence-based guidelines, time-based health outcomes, and the Matthew effect

    NARCIS (Netherlands)

    M.L.E. Essink-Bot (Marie-Louise); M.E. Kruijshaar (Michelle); J.J.M. Barendregt (Jan); L.G.A. Bonneux (Luc)

    2007-01-01

    textabstractBackground: Cardiovascular risk management guidelines are 'risk based'; health economists' practice is 'time based'. The 'medical' risk-based allocation model maximises numbers of deaths prevented by targeting subjects at high risk, for example, elderly and smokers. The time-based model

  18. Evidence-based guidelines, time-based health outcomes, and the Matthew effect

    NARCIS (Netherlands)

    Essink-Bot, Marie-Louise; Kruijshaar, Michelle E.; Barendregt, Jan J.; Bonneux, Luc G. A.

    2007-01-01

    BACKGROUND: Cardiovascular risk management guidelines are 'risk based'; health economists' practice is 'time based'. The 'medical' risk-based allocation model maximises numbers of deaths prevented by targeting subjects at high risk, for example, elderly and smokers. The time-based model maximises

  19. Horizontal schools-based health programme in rural Kenya.

    Science.gov (United States)

    Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina

    2017-09-01

    Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Time based management in health care system: The chosen aspects

    Directory of Open Access Journals (Sweden)

    Joanna Kobza

    2014-08-01

    Full Text Available Time-based management (TBM is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms. Over the past two decades a systematic review of Polish literature (since 1990 and peer reviewed articles published in international journals based on PubMed/Medline (2001–2011 have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary

  1. [Time based management in health care system: the chosen aspects].

    Science.gov (United States)

    Kobza, Joanna; Syrkiewicz-Świtała, Magdalena

    2014-01-01

    Time-based management (TBM) is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms). Over the past two decades a systematic review of Polish literature (since 1990) and peer reviewed articles published in international journals based on PubMed/Medline (2001-2011) have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary.

  2. HealthTWITTER Initiative: Design of a Social Networking Service Based Tailored Application for Diabetes Self-Management.

    Science.gov (United States)

    Kim, Hye Hyeon; Seo, Hwa Jeong

    2014-07-01

    Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.

  3. Guidance documents relating to landfills and contaminants

    Energy Technology Data Exchange (ETDEWEB)

    Schomaker, N.B.; Zunt, D.A.

    1990-01-01

    The Environmental Protection Agency is developing and updating a series of Technical Guidance Documents to provide best engineering control technology to meet the needs of the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response Compensation and Liability Act (CERCLA), respectively. These documents are the compilation of the research efforts to date relating to containment of pollutants from waste disposal to the land as relates to residuals management. The specific areas of research being conducted under the RCRA land disposal program relates to laboratory, pilot and field validation studies in cover systems, waste leaching and solidification, liner systems and disposal facility evaluation. The specific areas of research being conducted under the CERCLA uncontrolled waste sites (Superfund) program relate to in situ treatment, solidification/stabilization for treating hazardous waste, combustion technologies, best demonstrated available technology (BDAT), on-site treatment technologies, emerging biosystems, expert systems, personnel health protection equipment, and site and situation assessment. The Guidance Documents are intended to assist both the regulated community and the permitting authorities, as well as the Program Offices, and Regions, as well as the states and other interested parties, with the latest information relevant to waste management.

  4. Handling Internet-Based Health Information: Improving Health Information Web Site Literacy Among Undergraduate Nursing Students.

    Science.gov (United States)

    Wang, Weiwen; Sun, Ran; Mulvehill, Alice M; Gilson, Courtney C; Huang, Linda L

    2017-02-01

    Patient care problems arise when health care consumers and professionals find health information on the Internet because that information is often inaccurate. To mitigate this problem, nurses can develop Web literacy and share that skill with health care consumers. This study evaluated a Web-literacy intervention for undergraduate nursing students to find reliable Web-based health information. A pre- and postsurvey queried undergraduate nursing students in an informatics course; the intervention comprised lecture, in-class practice, and assignments about health Web site evaluation tools. Data were analyzed using Wilcoxon and ANOVA signed-rank tests. Pre-intervention, 75.9% of participants reported using Web sites to obtain health information. Postintervention, 87.9% displayed confidence in using an evaluation tool. Both the ability to critique health Web sites (p = .005) and confidence in finding reliable Internet-based health information (p = .058) increased. Web-literacy education guides nursing students to find, evaluate, and use reliable Web sites, which improves their ability to deliver safer patient care. [J Nurs Educ. 2017;56(2):110-114.]. Copyright 2017, SLACK Incorporated.

  5. Vibration-based structural health monitoring of harbor caisson structure

    Science.gov (United States)

    Lee, So-Young; Lee, So-Ra; Kim, Jeong-Tae

    2011-04-01

    This study presents vibration-based structural health monitoring method in foundation-structure interface of harbor caisson structure. In order to achieve the objective, the following approaches are implemented. Firstly, vibration-based response analysis method is selected and structural health monitoring (SHM) technique is designed for harbor caisson structure. Secondly, the performance of designed SHM technique for harbor structure is examined by FE analysis. Finally, the applicability of designed SHM technique for harbor structure is evaluated by dynamic tests on a lab-scaled caisson structure.

  6. Current materiality guidance for auditors

    OpenAIRE

    McKee, Thomas E.; Eilifsen, Aasmund

    2000-01-01

    Auditors have to make materiality judgments on every audit. This is a difficult process, as both quantitative and qualitative factors have to be evaluated. Additionally, there is no formal guidance for how to implement the materiality concepts discussed in the auditing standards. Although they are sometimes difficult to make, good materiality judgments are crucial for the conduct of a successful audit as poor judgments can result in an audit that is ineffective and/or inefficient. This report...

  7. 2011 Army Strategic Planning Guidance

    Science.gov (United States)

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  8. Vocational guidance in social volunteering

    Directory of Open Access Journals (Sweden)

    Nikolay S. Pryazhnikov

    2017-03-01

    Full Text Available The paper discusses the possibilities and limitations of vocational guidance in the social volunteering system. The essence of volunteer work is closely related with assistance to desperate people in searching for the meaning of living, often coinciding with labour activity that are deemed in terms of “the main matter of life” and “the leading activity”. For adolescents, it is the choice of career, and for adults, it is the work proper (i.e. an essential condition for personal self-realization. The problem of “forced volunteering” for experts in vocational guidance also means that they often have to work voluntarily and unselfishly outside the official guidelines. To clarify the terms «volunteer» and «a person in desperate need of help» the study used the method of analyzing the documents, e.g. the Regulations on Social Volunteering, the generalization of psychological sources, the initial survey of university students as active supporters of the volunteer movement, On the essence of volunteering and the place of career guidance in selfless social work. Vocational guidance is not excluded from the general system of volunteerism, but has an insufficiently defined status and low popularity among participants in social volunteering. Also, the problem of «forced volunteering» of experts in career counseling, which often requires voluntary and unselfish performance of quality work outside the framework of official instructions, is also indicated. Simultaneously, positive aspects of such disinterested career initiatives are noted, in particular, less control by the official inspectors (or customers and, accordingly, greater freedom of creativity than when someone else does the work.

  9. Utilization of health services in relation to mental health problems in adolescents: A population based survey

    Science.gov (United States)

    Zachrisson, Henrik D; Rödje, Kjetil; Mykletun, Arnstein

    2006-01-01

    Background Only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeks and receives help from specialist health services. The objective of this study was to a) examine help-seeking for symptoms of anxiety and depression in relation to symptom load dimensionally, b) identify the level of specialization in mental health among service-providers, and c) identify associations between mental health problems and contact with different types of health services. Methods This cross-sectional school-based study (response-rate 88%, n = 11154) is based on Norwegian health surveys among 15 and 16 year olds. Results We found a dose-response association between symptom-load and help seeking. Only 34% of individuals with mental symptom-load above 99th percentile reported help-seeking in the last 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists or psychologists), the remaining were mainly in contact with GPs. Mental health problems increased help seeking to all twelve service providers examined. Conclusion It might not be reasonable to argue that all adolescents with case-level mental health problems are in need of treatment. However, concerning the 99th percentile, claiming treatment need is less controversial. Even in the Norwegian context where mental health services are relatively available and free of charge, help-seeking in individuals with the highest symptom-loads is still low. Most help seekers achieved contact with health care providers, half of them at a non specialized level. Our results suggest that adolescents' recognition of mental health problems or intention to seek help for these are the major "filters" restricting treatment. PMID:16480522

  10. Adolescent health care: improving access by school-based service.

    Science.gov (United States)

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  11. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  12. Providing Career Guidance for Young Women.

    Science.gov (United States)

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  13. Health decision making: lynchpin of evidence-based practice.

    Science.gov (United States)

    Spring, Bonnie

    2008-01-01

    Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

  14. Evidence-based approach for continuous improvement of occupational health.

    Science.gov (United States)

    Manzoli, Lamberto; Sotgiu, Giovanni; Magnavita, Nicola; Durando, Paolo

    2015-01-01

    It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries.

  15. Improving the quality of the evidence base of health informatics.

    Science.gov (United States)

    Talmon, Jan

    2008-11-06

    Evaluation of health informatics technology has had attention from quite a few researchers in health informatics in the last few decades. In the early nineties of the past century several working groups and research projects have discussed evaluation methods and methodologies. Despite these activities, evaluation of health informatics has not received the recognition it deserves. In this presentation we will reiterate the arguments put forward in the Declaration of Innsbruck to consider evaluation an essential element of the evidence base of health informatics. Not only are evaluation studies essential, it is also required that such studies are properly reported. A joint effort of the IMIA, EFMI and AMIA working groups on evaluation has resulted in a guideline for reporting the results of evaluation studies of health informatics applications (STARE-HI). STARE-HI is currently endorsed by EFMI. The general assembly of IMIA has adopted STARE-HI as an official IMIA document. Endorsement from AMIA is being sought. A pilot study in which STARE-HI was applied to assess the quality of current reporting clearly indicates that there is quite some room for improvement. Application of guidelines such as STARE-HI would contribute to a further improvement of the evidence base of health informatics and would open the road for high quality reviews and meta-analyses.

  16. Mobile-Based Medical Health Application - Medi-Chat App

    Directory of Open Access Journals (Sweden)

    Mustapha Adamu Mohammed

    2017-05-01

    Full Text Available The aftermath of the development and implementation of the Android operating system and its associated Application Programming InterfacesAPI by Google culminated in the development more mobile device-enabled applications designed for our day-to-day businesses and personal use however in recent times we are experiencing a massive revolution in the use of mobile technology in the health sectors of our economy and this revolution is termed as Mobile Health Technology MHT.This new technological breakthrough has enabled the development of powerful android applications that enabled people tract and monitor the treat of heart and kidney related diseases as well as the monitoring and evaluation certain drug prescriptions. It has also changed the way we communicate with our specialist doctors from phone text to mobile-based communication. All these interventions provided by MHT have drastically increased the efficient and effective provision of health care delivery on one side and providing a common platform for prospective patients to easily interact with health professionals for medical advice and subsequent treatment of their diseases. Moreover In Ghana It would provide a much efficient and cost effective way of improving health-care methodologies in this 21st century which is characterized by information and communication technology. In this paper the main goal is to develop a mobile health application that provides common platform prospective patients and specialist doctors give free consultation and health tips on health related conditions thereby reducing the difficulty and challenges uncounted in accessing free medical health care at the already overburdened hospitals polyclinics and health centers in Ghana.

  17. Gender-based violence: a crucial challenge for public health.

    Science.gov (United States)

    Sanjel, S

    2013-01-01

    This article attempts to summarize the situations of gender-based violence, a major public health issue. Due to the unequal power relations between men and women, women are violated either in family, in the community or in the State. Gender-based violence takes different forms like physical, sexual or psychological/ emotional violence. The causes of gender-based violence are multidimensional including social, economic, cultural, political and religious. The literatures written in relation to the gender-based violence are accessed using electronic databases as PubMed, Medline and Google scholar, Google and other Internet Websites between 1994 and first quarter of 2013 using an internet search from the keywords such as gender-based violence, women violence, domestic violence, wife abuse, violence during pregnancy, women sexual abuse, political gender based violence, cultural gender-based violence, economical gender-based violence, child sexual abuse and special forms of gender-based violence in Nepal. As GBVs remain one of the most rigorous challenges of women's health and well-being, it is one of the indispensable issues of equity and social justice. To create a gender-based violence free environment, a lot works has to be done. Hence, it is suggested to provide assistance to the victims of violence developing the mechanism to support them.

  18. Teaching aseptic technique for central venous access under ultrasound guidance: a randomized trial comparing didactic training alone to didactic plus simulation-based training.

    Science.gov (United States)

    Latif, Rana K; Bautista, Alexander F; Memon, Saima B; Smith, Elizabeth A; Wang, Chenxi; Wadhwa, Anupama; Carter, Mary B; Akca, Ozan

    2012-03-01

    Our goal was to determine whether simulation combined with didactic training improves sterile technique during ultrasound (US)-guided central venous catheter (CVC) insertion compared with didactic training alone among novices. We hypothesized that novices who receive combined didactic and simulation-based training would perform similarly to experienced residents in aseptic technique, knowledge, and perception of comfort during US-guided CVC insertion on a simulator. Seventy-two subjects were enrolled in a randomized, controlled trial of an educational intervention. Fifty-four novices were randomized into either the didactic group or the simulation combined with didactic group. Both groups received didactic training but the simulation combined with didactic group also received simulation-based CVC insertion training. Both groups were tested by demonstrating US-guided CVC insertion on a simulator. Aseptic technique was scored on 8 steps as "yes/no" and also using a 7-point Likert scale with 7 being "excellent technique" by a rater blinded to subject randomization. After initial testing, the didactic group was offered simulation-based training and retesting. Both groups also took a pre- and posttraining test of knowledge and rated their comfort with US and CVC insertion pre- and posttraining on a 5-point Likert scale. Subsequently, 18 experienced residents also took the test of knowledge, rated their comfort level, and were scored while performing aseptic US-guided CVC insertion using a simulator. The simulation combined with didactic group achieved a 167% (95% confidence interval [CI] 133%-167%) incremental increase in yes/no scores and 115% (CI 112%-127%) incremental increase in Likert scale ratings on aseptic technique compared with novices in the didactic group. Compared with experienced residents, simulation combined with didactic trained novices achieved an increase in aseptic scores with a 33.3% (CI 16.7%-50%) increase in yes/no ratings and a 20% (CI 13

  19. Analysis of the new health management based on health internet of things and cloud computing

    Science.gov (United States)

    Liu, Shaogang

    2018-05-01

    With the development and application of Internet of things and cloud technology in the medical field, it provides a higher level of exploration space for human health management. By analyzing the Internet of things technology and cloud technology, this paper studies a new form of health management system which conforms to the current social and technical level, and explores its system architecture, system characteristics and application. The new health management platform for networking and cloud can achieve the real-time monitoring and prediction of human health through a variety of sensors and wireless networks based on information and can be transmitted to the monitoring system, and then through the software analysis model, and gives the targeted prevention and treatment measures, to achieve real-time, intelligent health management.

  20. School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews.

    Science.gov (United States)

    Shackleton, Nichola; Jamal, Farah; Viner, Russell M; Dickson, Kelly; Patton, George; Bonell, Christopher

    2016-04-01

    Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.