Guidelines prescribed by general practitioners to patients with acute ...

African Journals Online (AJOL)

The aim of this study was to investigate the guidelines prescribed by general practitioners (GPs) to patients with acute low back pain (ALBP) regarding 'return to work'. Methods: A systematic sample of 212 GPs, selected from a list supplied by the Health Professions Council of South Africa (HPCSA), was selected to complete ...

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

Science.gov (United States)

Susi, Frank; Mundell, Robert

1980-01-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

Maintaining formal models of living guidelines efficiently

NARCIS (Netherlands)

Seyfang, Andreas; Martínez-Salvador, Begoña; Serban, Radu; Wittenberg, Jolanda; Miksch, Silvia; Marcos, Mar; Ten Teije, Annette; Rosenbrand, Kitty C J G M

2007-01-01

Translating clinical guidelines into formal models is beneficial in many ways, but expensive. The progress in medical knowledge requires clinical guidelines to be updated at relatively short intervals, leading to the term living guideline. This causes potentially expensive, frequent updates of the

Transport properties site descriptive model. Guidelines for evaluation and modelling

International Nuclear Information System (INIS)

Berglund, Sten; Selroos, Jan-Olof

2004-04-01

This report describes a strategy for the development of Transport Properties Site Descriptive Models within the SKB Site Investigation programme. Similar reports have been produced for the other disciplines in the site descriptive modelling (Geology, Hydrogeology, Hydrogeochemistry, Rock mechanics, Thermal properties, and Surface ecosystems). These reports are intended to guide the site descriptive modelling, but also to provide the authorities with an overview of modelling work that will be performed. The site descriptive modelling of transport properties is presented in this report and in the associated 'Strategy for the use of laboratory methods in the site investigations programme for the transport properties of the rock', which describes laboratory measurements and data evaluations. Specifically, the objectives of the present report are to: Present a description that gives an overview of the strategy for developing Site Descriptive Models, and which sets the transport modelling into this general context. Provide a structure for developing Transport Properties Site Descriptive Models that facilitates efficient modelling and comparisons between different sites. Provide guidelines on specific modelling issues where methodological consistency is judged to be of special importance, or where there is no general consensus on the modelling approach. The objectives of the site descriptive modelling process and the resulting Transport Properties Site Descriptive Models are to: Provide transport parameters for Safety Assessment. Describe the geoscientific basis for the transport model, including the qualitative and quantitative data that are of importance for the assessment of uncertainties and confidence in the transport description, and for the understanding of the processes at the sites. Provide transport parameters for use within other discipline-specific programmes. Contribute to the integrated evaluation of the investigated sites. The site descriptive modelling of

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

NARCIS (Netherlands)

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

2003-01-01

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

Formalized 2003 ESH/ESC Hypertension Guidelines in Hospital and General Practice

Czech Academy of Sciences Publication Activity Database

Peleška, Jan; Anger, Z.; Buchtela, David; Tomečková, Marie; Veselý, Arnošt; Zvárová, Jana

22 Suppl. 2, - (2004), s. 253 ISSN 0263-6352. [European Meeting on Hypertension /14./. 13.06.2004-17.06.2004, Paris] R&D Projects: GA MŠk LN00B107 Keywords : hypertension guidelines * electronic form Subject RIV: BA - General Mathematics

Guidelines for a graph-theoretic implementation of structural equation modeling

Science.gov (United States)

Grace, James B.; Schoolmaster, Donald R.; Guntenspergen, Glenn R.; Little, Amanda M.; Mitchell, Brian R.; Miller, Kathryn M.; Schweiger, E. William

2012-01-01

Structural equation modeling (SEM) is increasingly being chosen by researchers as a framework for gaining scientific insights from the quantitative analyses of data. New ideas and methods emerging from the study of causality, influences from the field of graphical modeling, and advances in statistics are expanding the rigor, capability, and even purpose of SEM. Guidelines for implementing the expanded capabilities of SEM are currently lacking. In this paper we describe new developments in SEM that we believe constitute a third-generation of the methodology. Most characteristic of this new approach is the generalization of the structural equation model as a causal graph. In this generalization, analyses are based on graph theoretic principles rather than analyses of matrices. Also, new devices such as metamodels and causal diagrams, as well as an increased emphasis on queries and probabilistic reasoning, are now included. Estimation under a graph theory framework permits the use of Bayesian or likelihood methods. The guidelines presented start from a declaration of the goals of the analysis. We then discuss how theory frames the modeling process, requirements for causal interpretation, model specification choices, selection of estimation method, model evaluation options, and use of queries, both to summarize retrospective results and for prospective analyses. The illustrative example presented involves monitoring data from wetlands on Mount Desert Island, home of Acadia National Park. Our presentation walks through the decision process involved in developing and evaluating models, as well as drawing inferences from the resulting prediction equations. In addition to evaluating hypotheses about the connections between human activities and biotic responses, we illustrate how the structural equation (SE) model can be queried to understand how interventions might take advantage of an environmental threshold to limit Typha invasions. The guidelines presented provide for

Modeling Guidelines for Code Generation in the Railway Signaling Context

Science.gov (United States)

Ferrari, Alessio; Bacherini, Stefano; Fantechi, Alessandro; Zingoni, Niccolo

2009-01-01

recommendations has been performed for the automotive control systems domain in order to enforce code generation [7]. The MAAB guidelines have been found profitable also in the aerospace/avionics sector [1] and they have been adopted by the MathWorks Aerospace Leadership Council (MALC). General Electric Transportation Systems (GETS) is a well known railway signaling systems manufacturer leading in Automatic Train Protection (ATP) systems technology. Inside an effort of adopting formal methods within its own development process, GETS decided to introduce system modeling by means of the MathWorks tools [2], and in 2008 chose to move to code generation. This article reports the experience performed by GETS in developing its own modeling standard through customizing the MAAB rules for the railway signaling domain and shows the result of this experience with a successful product development story.

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project.

Science.gov (United States)

Lord, J; Willis, S; Eatock, J; Tappenden, P; Trapero-Bertran, M; Miners, A; Crossan, C; Westby, M; Anagnostou, A; Taylor, S; Mavranezouli, I; Wonderling, D; Alderson, P; Ruiz, F

2013-12-01

National Institute for Health and Care Excellence (NICE) clinical guidelines (CGs) make recommendations across large, complex care pathways for broad groups of patients. They rely on cost-effectiveness evidence from the literature and from new analyses for selected high-priority topics. An alternative approach would be to build a model of the full care pathway and to use this as a platform to evaluate the cost-effectiveness of multiple topics across the guideline recommendations. In this project we aimed to test the feasibility of building full guideline models for NICE guidelines and to assess if, and how, such models can be used as a basis for cost-effectiveness analysis (CEA). A 'best evidence' approach was used to inform the model parameters. Data were drawn from the guideline documentation, advice from clinical experts and rapid literature reviews on selected topics. Where possible we relied on good-quality, recent UK systematic reviews and meta-analyses. Two published NICE guidelines were used as case studies: prostate cancer and atrial fibrillation (AF). Discrete event simulation (DES) was used to model the recommended care pathways and to estimate consequent costs and outcomes. For each guideline, researchers not involved in model development collated a shortlist of topics suggested for updating. The modelling teams then attempted to evaluate options related to these topics. Cost-effectiveness results were compared with opinions about the importance of the topics elicited in a survey of stakeholders. The modelling teams developed simulations of the guideline pathways and disease processes. Development took longer and required more analytical time than anticipated. Estimates of cost-effectiveness were produced for six of the nine prostate cancer topics considered, and for five of eight AF topics. The other topics were not evaluated owing to lack of data or time constraints. The modelled results suggested 'economic priorities' for an update that differed from

Guideline validation in multiple trauma care through business process modeling.

Science.gov (United States)

Stausberg, Jürgen; Bilir, Hüseyin; Waydhas, Christian; Ruchholtz, Steffen

2003-07-01

Clinical guidelines can improve the quality of care in multiple trauma. In our Department of Trauma Surgery a specific guideline is available paper-based as a set of flowcharts. This format is appropriate for the use by experienced physicians but insufficient for electronic support of learning, workflow and process optimization. A formal and logically consistent version represented with a standardized meta-model is necessary for automatic processing. In our project we transferred the paper-based into an electronic format and analyzed the structure with respect to formal errors. Several errors were detected in seven error categories. The errors were corrected to reach a formally and logically consistent process model. In a second step the clinical content of the guideline was revised interactively using a process-modeling tool. Our study reveals that guideline development should be assisted by process modeling tools, which check the content in comparison to a meta-model. The meta-model itself could support the domain experts in formulating their knowledge systematically. To assure sustainability of guideline development a representation independent of specific applications or specific provider is necessary. Then, clinical guidelines could be used for eLearning, process optimization and workflow management additionally.

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

DEFF Research Database (Denmark)

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

2010-01-01

Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care...... Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high-grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients...... breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre-oxygenation in the obese patients should be performed in the head-up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor...

Development of a shower exposure model for benzene : background work for potential recommended update to the recently derived drinking water guidelines

International Nuclear Information System (INIS)

Knafla, A.L.; Carey, J.

2009-01-01

Chloroform exposure was first identified in showers. Shower exposures were then examined for other volatile substances. This presentation discussed the development of a shower exposure model for benzene and included background work for potential recommended updates to the recently derived drinking water guidelines. Specifically, the presentation addressed the relevance for oil and gas sites and the influence on the drinking water guideline. Issues and limitation with Health Canada's Khrisnan model were identified. The advantages of an alternate model development were also presented. Model structure was examined with particular reference to how model exposures are modelled and the risk associated with taking showers with impacted water. Two general types of models were discussed, notably the simple model used to estimate exposures and the integrated physiologically-based pharmacokinetic model. The relevance of the drinking water guideline revision to the petroleum industry was addressed. It was concluded that future water quality guidelines will likely incorporate shower exposures. tabs., figs.

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

International Nuclear Information System (INIS)

1995-12-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-01

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

Towards a traceable clinical guidelines application. A model-driven approach.

Science.gov (United States)

Domínguez, E; Pérez, B; Zapata, M

2010-01-01

The goal of this research is to provide an overall framework to enable model-based development of clinical guideline-based decision support systems (GBDSSs). The automatically generated GBDSSs are aimed at providing guided support to the physician during the application of guidelines and automatically storing guideline application data for traceability purposes. The development process of a GBDSS for a guideline is based on model-driven development (MDD) techniques which allow us to carry out such a process automatically, making development more agile and saving on human resource costs. We use UML Statecharts to represent the dynamics of guidelines and, based on this model, we use a MDD-based tool chain to generate the guideline-dependent components of each GBDSS in an automatic way. In particular, as for the traceability capabilities of each GBDSS, MDD techniques are combined with database schema mappings for metadata management in order to automatically generate the GBDSS-persistent component as one of the main contributions of this paper. The complete framework has been implemented as an Eclipse plug-in named GBDSSGenerator which, starting from the statechart representing a guideline, allows the development process to be carried out automatically by only selecting different menu options the plug-in provides. We have successfully validated our overall approach by generating the GBDSS for different types of clinical guidelines, even for laboratory guidelines. The proposed framework allows the development of clinical guideline-based decision support systems in an automatic way making this process more agile and saving on human resource costs.

Chapter A6. Section 6.0. General Information and Guidelines

Science.gov (United States)

Wilde, Franceska D.; Radtke, Dean B.

2005-01-01

This report summarizes information, guidelines, and minimum requirements that apply generally to the seven field-measurement sections that comprise the rest of Chapter A6 of this U.S. Geological Survey (USGS) National Field Manual for the Collection of Water-Quality Data (NFM). Protocols are specified for establishing and maintaining data records, use of field-measurement instruments and methods, and quality assurance of data-collection and reporting methods that are relevant to surface-water and ground-water field-measurement activities.

Implementing guidelines in general practice: evaluation of process and outcome of care in chronic diseases.

NARCIS (Netherlands)

Schellevis, F.G.; Eijk, J.T.M. van; Lisdonk, E.H. van de; Velden, J. van der; Weel, C. van

1994-01-01

In a prospective longitudinal study over 21 months the performance of general practitioners and the disease status of their patients was measured during the formulation and implementation of guidelines on follow-up care. Data on 15 general practitioners and on 613 patients with hypertension, 95 with

[The management of osteoarthritis by general practitioners in Germany : Comparison of self-reported behaviour with international guidelines.

NARCIS (Netherlands)

Rosemann, T.J.; Joos, S.; Szecsenyi, J.

2008-01-01

BACKGROUND: In most countries, guidelines for the treatment of osteoarthritis (OA) are available. However, in Germany, no guideline for the primary care sector is available. The care provider of most patients is the general practitioner (GP). The aim of the study was to investigate the approaches in

Guideline Knowledge Representation Model (GLIKREM)

Czech Academy of Sciences Publication Activity Database

Buchtela, David; Peleška, Jan; Veselý, Arnošt; Zvárová, Jana; Zvolský, Miroslav

2008-01-01

Roč. 4, č. 1 (2008), s. 17-23 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : knowledge representation * GLIF model * guidelines Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/articles/200812/34/1.html

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

NARCIS (Netherlands)

Marres, H.A.M.

2008-01-01

In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and

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

Science.gov (United States)

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

2001-01-01

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

Management of venous leg ulcers in general practice - a practical guideline.

Science.gov (United States)

Sinha, Sankar; Sreedharan, Sadhishaan

2014-09-01

Chronic venous leg ulcers are the most common wounds seen in general practice. Their management can be both challenging and time-consuming. To produce a short practical guideline incorporating the TIME concept and A2BC2D approach to help general practitioners and their practice nurses in delivering evidence-based initial care to patients with chronic venous leg ulcers. Most chronic venous leg ulcers can be managed effectively in the general practice setting by following the simple, evidence-based approach described in this article. Figure 1 provides a flow chart to aid in this process. Figure 2 illustrates the principles of management in general practice. Effective management of chronic ulcers involves the assessment of both the ulcer and the patient. The essential requirements of management are to debride the ulcer with appropriate precautions, choose dressings that maintain adequate moisture balance, apply graduated compression bandage after evaluation of the arterial circulation and address the patient's concerns, such as pain and offensive wound discharge.

An integrated continuous improvement model of TPM, TPS and TQM for boosting profitability of manufacturing industries: An innovative model & guideline

Directory of Open Access Journals (Sweden)

Haftu Hailu

2018-01-01

Full Text Available The purpose of this research is to develop an integrated literature based TPM, TPS and TQM mod-el through PDCA cycle, and implementation guideline for the implementation of the model. At this time very few studies are available on this research area, even this research on integrated model of TPM, TPS and TQM practices, and implementation guideline are not corresponding. The method-ology to develop the model and the implementation guideline is based on identifying the uniqueness and common practices of TPM, TPS and TQM systems, existing practice of the integration and implementation guideline, identifying the existing gaps on the model and implementation guideline, developing new integrated TPM, TPS and TQM practice model, and implementation guideline. Previous very few studies of uniqueness, common practices and implementation guideline of the three systems are preserved. The findings of this research, an integrated cutting-edge model of TPM, TPS and TQM practices and implementation guidelines are developed. The originality / value of the developed model and implementation guideline enable manufacturing industries continuously to be competitive and profitable.

Methods of Medical Guidelines Modelling in GLIF.

Czech Academy of Sciences Publication Activity Database

Buchtela, David; Anger, Z.; Peleška, Jan (ed.); Tomečková, Marie; Veselý, Arnošt; Zvárová, Jana

2005-01-01

Roč. 11, - (2005), s. 1529-1532 ISSN 1727-1983. [EMBEC'05. European Medical and Biomedical Conference /3./. Prague, 20.11.2005-25.11.2005] Institutional research plan: CEZ:AV0Z10300504 Keywords : medical guidelines * knowledge modelling * GLIF model Subject RIV: BD - Theory of Information

Best-practices guidelines for L2PSA development and applications. Volume 1 - General

International Nuclear Information System (INIS)

Raimond, E.; Pichereau, F.; Durin, T.; Rahni, N.; Loeffler, H.; Roesch, O.; Lajtha, G.; Santamaria, C.S.; Dienstbier, J.; Rydl, A.; Holmberg, J.E.; Lindholm, I.; Maennistoe, I.; Pauli, E.M.; Dirksen, G.; Grindon, L.; Peers, K.; Bassi, C.; Hulqvist, G.; Parozzi, F.; Polidoro, F.; Cazzoli, E.; Vitazkova, J.; Burgazzi, L.; Brinkman, H.; Seidel, A.; Schubert, B.; Wohlstein, R.; Guentay, S.; Oury, L.; Ngatchou, C.; Siltanen, S.; Niemela, I.; Routamo, T.; Vincon, L.; Helstroem, P.

2010-01-01

The objective of this coordinated action was to develop best practice guidelines for the performance and application of Level 2 PSA with a view to achieve harmonisation at EU level and to allow a meaningful and practical uncertainty evaluation in a Level 2 PSA. Specific relationships with communities in charge of nuclear reactor safety (utilities, safety authorities, vendors, and research or services companies) have been established in order to define the current needs in terms of guidelines for Level 2 PSA development and application. An international workshop was organised in Hamburg, with the support of VATTENFALL, in November 2008. The Level 2 PSA experts from ASAMPSA2 project partners have proposed some guidelines for the development and application of L2PSA based on their experience, open literature, and on information available from international cooperation (EC Severe Accident network of Excellence - SARNET, IAEA standards, OECD-NEA publications and workshop). There are a large number of technical issues addressed in the guideline which are not all covered with the same level of detail in the first version of the guideline. This version was submitted for external review in November 2010 by severe accident and PSA experts (especially from SARNET and OECD-NEA members). The feedback of the external review will be dis cussed during an international open works hop planned for March 2011 and all outcomes will be taken into consideration in the final version of this guideline (June 2011). The guideline includes 3 volumes: - Volume 1 - General considerations on L2PSA. - Volume 2 - Technical recommendations for Gen II and III reactors. - Volume 3 - Specific considerations for future reactors (Gen IV). The recommendations formulated in the guideline should not be considered as 'mandatory' but should help Level 2 PSA developers to achieve high quality studies with limited time and resources. It may also help Level 2 PSA reviewers by positioning one specific study in

Record of responses to public comments on proposed general guidelines for recommendation of sites for nuclear waste repositories

International Nuclear Information System (INIS)

1983-01-01

The Nuclear Waste Policy Act of 1982 (Public Law 97-425, referred to in this document as the Act) assigned to the US Department of Energy (DOE) the authority for the disposal of high-level radioactive waste and spent nuclear fuel. Among other provisions, the Act specifies a process and schedule for the siting of two geologic repositories for this purpose. The Act requires that the DOE issue general guidelines for the recommendation of sites for repositories. The guidelines are to be developed in consultation with three Federal agencies (the Council on Environmental Quality, the US Environmental Protection Agency, and the US Geological Survey) and with interested Governors and issued with the concurrence of the US Nuclear Regulatory Commission. To meet this directive, the DOE convened a task force of program experts to develop proposed guidelines, issued the proposed guidelines on February 7, 1983, and invited comments from the specified Federal agencies, interested Governors, and the general public. Public hearings on the proposed guidelines were held in March at the following locations: Chicago, New Orleans, Washington, DC, Salt Lake City, and Seattle. After considering the resulting comments and preparing responses to them, the task force prepared a draft of this comment-response document and a set of alternative guidelines; these documents were issued on May 27, 1983. This document summarizes the record of comments that directly led to the alternative guidelines of May 27, 1983. It contains synopses of comments, presents the responses of the task force to the comments, and briefly describes how the proposed guidelines of February 7, 1983, were revised to produce the alternative guidelines of May 27, 1983. 13 references

Guidelines for system modeling: pre-accident human errors, rev.0

Energy Technology Data Exchange (ETDEWEB)

Kang, Dae Il; Jung, W. D.; Lee, Y. H.; Hwang, M. J.; Yang, J. E

2004-01-01

The evaluation results of Human Reliability Analysis (HRA) of pre-accident human errors in the probabilistic safety assessment (PSA) for the Korea Standard Nuclear Power Plant (KSNP) using the ASME PRA standard show that more than 50% of 10 items to be improved are related to the identification and screening analysis for them. Thus, we developed a guideline for modeling pre-accident human errors for the system analyst to resolve some items to be improved for them. The developed guideline consists of modeling criteria for the pre-accident human errors (identification, qualitative screening, and common restoration errors) and detailed guidelines for pre-accident human errors relating to testing, maintenance, and calibration works of nuclear power plants (NPPs). The system analyst use the developed guideline and he or she applies it to the system which he or she takes care of. The HRA analyst review the application results of the system analyst. We applied the developed guideline to the auxiliary feed water system of the KSNP to show the usefulness of it. The application results of the developed guideline show that more than 50% of the items to be improved for pre-accident human errors of auxiliary feed water system are resolved. The guideline for modeling pre-accident human errors developed in this study can be used for other NPPs as well as the KSNP. It is expected that both use of the detailed procedure, to be developed in the future, for the quantification of pre-accident human errors and the guideline developed in this study will greatly enhance the PSA quality in the HRA of pre-accident human errors.

Guidelines for system modeling: pre-accident human errors, rev.0

International Nuclear Information System (INIS)

Kang, Dae Il; Jung, W. D.; Lee, Y. H.; Hwang, M. J.; Yang, J. E.

2004-01-01

The evaluation results of Human Reliability Analysis (HRA) of pre-accident human errors in the probabilistic safety assessment (PSA) for the Korea Standard Nuclear Power Plant (KSNP) using the ASME PRA standard show that more than 50% of 10 items to be improved are related to the identification and screening analysis for them. Thus, we developed a guideline for modeling pre-accident human errors for the system analyst to resolve some items to be improved for them. The developed guideline consists of modeling criteria for the pre-accident human errors (identification, qualitative screening, and common restoration errors) and detailed guidelines for pre-accident human errors relating to testing, maintenance, and calibration works of nuclear power plants (NPPs). The system analyst use the developed guideline and he or she applies it to the system which he or she takes care of. The HRA analyst review the application results of the system analyst. We applied the developed guideline to the auxiliary feed water system of the KSNP to show the usefulness of it. The application results of the developed guideline show that more than 50% of the items to be improved for pre-accident human errors of auxiliary feed water system are resolved. The guideline for modeling pre-accident human errors developed in this study can be used for other NPPs as well as the KSNP. It is expected that both use of the detailed procedure, to be developed in the future, for the quantification of pre-accident human errors and the guideline developed in this study will greatly enhance the PSA quality in the HRA of pre-accident human errors

Design patterns for modelling guidelines

NARCIS (Netherlands)

Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce

2005-01-01

It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be

Air quality model guideline

International Nuclear Information System (INIS)

Idriss, A.; Spurrell, F.

2009-06-01

Alberta Environment has developed a guidelines for operations and proposed operations that require approvals under the province's Environmental Protection and Enhancement Act or that operate under a code of practice for emissions to the atmosphere. In an effort to ensure consistency in the use of dispersion models for regulatory applications in Alberta, this document provided detailed guidance on suitable methods and approaches that should be employed to assess air quality from emission sources, specifically, information required to demonstrate that a source meets the Alberta ambient air quality objectives. The document outlined the statutory authority and provided an overview of the approach. It provided detailed advice on the types and uses of dispersion models with particular reference to the modelling protocol, input data, and output interpretation. Guidance on the application of regulatory models were also presented. Various models were described and their intended uses were explained. Internet addresses for different modelling resources were also offered. Last, some information about regional modelling in the province of Alberta was discussed. 40 refs., 4 tabs., 7 figs., 3 appendices.

[The management of osteoarthritis by general practitioners in Germany: comparison of self-reported behaviour with international guidelines].

Science.gov (United States)

Rosemann, T; Joos, S; Szecsenyi, J

2008-01-01

In most countries, guidelines for the treatment of osteoarthritis (OA) are available. However, in Germany, no guideline for the primary care sector is available. The care provider of most patients is the general practitioner (GP). The aim of the study was to investigate the approaches in diagnosing and treating OA of German GPs and to assess adherence to international guidelines. Cross-sectional study using a structured questionnaire with a random sample of 144 GPs. Regarding diagnosis, the importance of X-rays was overestimated. Regarding treatment approaches, exercising and weight reduction were regarded as primary treatment targets. Pharmacological treatment approaches were somewhat guideline oriented, but conservative approaches such as physical therapy were overestimated as invasive treatments such as intra-articular injections were underestimated in its benefit. Establishing a guideline specifically for primary care and increasing guideline adherence could help to prevent the present overuse of X-rays and the high amount of referrals to orthopaedics, save costs and reduce inadequate treatments.

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

International Nuclear Information System (INIS)

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

2007-01-01

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

75 FR 22631 - Notice of Continuance for General Clearance for Guidelines, Applications, and Reporting Forms

Science.gov (United States)

2010-04-29

... NATIONAL FOUNDATION FOR THE ARTS AND HUMANITIES Notice of Continuance for General Clearance for Guidelines, Applications, and Reporting Forms AGENCY: Institute of Museum and Library Services. ACTION... of higher education, library and museum professional associations, and museum and library...

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

Directory of Open Access Journals (Sweden)

Mazza Danielle

2013-01-01

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

Management of spontaneous pneumothorax compared to British Thoracic Society (BTS) 2003 guidelines: a district general hospital audit.

Science.gov (United States)

Medford, Andrew Rl; Pepperell, Justin Ct

2007-10-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.

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

International Nuclear Information System (INIS)

Morcos, S.K.; Thomsen, H.S.; Webb, J.A.W.

2001-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-09-01

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

General guidelines for recommendation of sites for nuclear waste repositories

International Nuclear Information System (INIS)

1983-01-01

These guidelines were developed in accordance with the requirements of Section 112(a) of the Nuclear Waste Policy Act of 1982 for use by the Secretary of Energy in evaluating the suitability of sites for the development of repositories. The guidelines will be used for suitability evaluations and determinations made pursuant to Section 112(b) and any preliminary suitability determinations required by Section 114(f). The guidelines set forth in this Part are intended to complement the requirements set forth in the Act, 10 CFR Part 60, and 40 CFR Part 191. In applying these guidelines, the DOE will resolve any inconsistencies between these guidelines and the above documents in a manner determined by the DOE to most closely agree with the intent of the Act

ORGEST: Regional guidelines and silvicultural models for sustainable forest management

Energy Technology Data Exchange (ETDEWEB)

Piqué, Míriam; Vericat, Pau; Beltrán, Mario

2017-11-01

Aim of the study: To develop regional guidelines for sustainable forest management. Area of the study: Forests of Catalonia (NE Spain). Material and methods: The process of developing the forest management guidelines (FMG) started by establishing a thorough classification of forest types at stand level. This classification hinges on two attributes: tree species composition and site quality based on ecological variables, which together determine potential productivity. From there, the management guidelines establish certain objectives and silvicultural models for each forest type. The forest type classifications, like the silvicultural models, were produced using both existing and newly-built growth models based on data from the National Forest Inventory (NFI) and expert knowledge. The effort involved over 20 expert working groups in order to better integrate the expertise and vision of different sectorial agents. Main results: The FMG consist in quantitative silvicultural models that include typical silvicultural variables, technical descriptions of treatments and codes of good practice. Guidelines now cover almost all forest types in Catalonia (spanning up to 90% of the Catalan forest area). Different silvicultural models have been developed for pure and mixed stands, different site quality classes (2–3 classes per species), and even- and multi-aged stands. Research highlights: FMG: i) orient the management of private and public forests, (ii) provide a technical scaffold for efficient allocation/investment of public subsidies in forest management, and (iii) bridge forest planning instruments at regional (strategic-tactical) and stand (operational) level.

ORGEST: Regional guidelines and silvicultural models for sustainable forest management

International Nuclear Information System (INIS)

Piqué, Míriam; Vericat, Pau; Beltrán, Mario

2017-01-01

Aim of the study: To develop regional guidelines for sustainable forest management. Area of the study: Forests of Catalonia (NE Spain). Material and methods: The process of developing the forest management guidelines (FMG) started by establishing a thorough classification of forest types at stand level. This classification hinges on two attributes: tree species composition and site quality based on ecological variables, which together determine potential productivity. From there, the management guidelines establish certain objectives and silvicultural models for each forest type. The forest type classifications, like the silvicultural models, were produced using both existing and newly-built growth models based on data from the National Forest Inventory (NFI) and expert knowledge. The effort involved over 20 expert working groups in order to better integrate the expertise and vision of different sectorial agents. Main results: The FMG consist in quantitative silvicultural models that include typical silvicultural variables, technical descriptions of treatments and codes of good practice. Guidelines now cover almost all forest types in Catalonia (spanning up to 90% of the Catalan forest area). Different silvicultural models have been developed for pure and mixed stands, different site quality classes (2–3 classes per species), and even- and multi-aged stands. Research highlights: FMG: i) orient the management of private and public forests, (ii) provide a technical scaffold for efficient allocation/investment of public subsidies in forest management, and (iii) bridge forest planning instruments at regional (strategic-tactical) and stand (operational) level.

Preventive evidence into practice (PEP study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Harris Mark F

2013-01-01

Full Text Available Abstract Background There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession. Methods We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20% and increased adherence to guideline recommendations for: the management of CVD and diabetes risk factors (by 20%; and lifestyle and physiological risk factors of patients at risk (by 5%. Thirty-two general practices will be randomised in a 1:1 allocation to receive either the intervention or continue with usual care, after stratification by state. The intervention will be delivered through: small group education; audit of patient records to determine preventive care; and practice facilitation visits adapted to the needs of the practices. Outcome data will be extracted from electronic medical records and patient questionnaires, and qualitative evaluation from provider and patient interviews. Discussion We plan to disseminate study findings widely and directly inform implementation strategies by governments, professional bodies, and non-government organisations including the partner organisations.

[Summary of the practice guideline 'TIA' (first revision) from the Dutch College of General Practitioners

NARCIS (Netherlands)

Wiersma, T.; Binsbergen, J.J. van; Verhoeven, S.; Bentum, S.T.B. van; Goudswaard, A.N.

2005-01-01

The new practice guideline of the Dutch College of General Practitioners on the management of patients with a TIA resembles the first version, but there are some important changes: The concept TIA has been narrowed to a neurological deficit that has resolved spontaneously by the time the patient

Generalizing on best practices in image processing: a model for promoting research integrity: Commentary on: Avoiding twisted pixels: ethical guidelines for the appropriate use and manipulation of scientific digital images.

Science.gov (United States)

Benos, Dale J; Vollmer, Sara H

2010-12-01

Modifying images for scientific publication is now quick and easy due to changes in technology. This has created a need for new image processing guidelines and attitudes, such as those offered to the research community by Doug Cromey (Cromey 2010). We suggest that related changes in technology have simplified the task of detecting misconduct for journal editors as well as researchers, and that this simplification has caused a shift in the responsibility for reporting misconduct. We also argue that the concept of best practices in image processing can serve as a general model for education in best practices in research.

Methodological guidelines

Energy Technology Data Exchange (ETDEWEB)

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

1999-04-01

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

Methodological guidelines

International Nuclear Information System (INIS)

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

1999-01-01

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

nestor Guideline for Preservation Planning – a Process Model

Directory of Open Access Journals (Sweden)

Sabine Schrimpf

2014-02-01

Full Text Available The nestor guideline for preservation planning is the latest in a series of nestor publications. nestor is the German competence network for digital preservation and it offers all interested parties from the private and public domains the possibility to participate in working groups. The guideline for preservation planning is the result of such a working group, which discussed the conceptual and practical issues of implementing the OAIS Functional Entity “Preservation Planning”.The guideline describes a process model and offers some guidance on potential implementations. It integrates and builds on recognized community concepts like Significant Properties, the OAIS Designated Community, the National Archives of Australia’s Performance Model, the PREMIS concept of Intellectual Entities and Representations, and the PLANET’s approach to preservation planning. Furthermore, it introduces the concepts “intended use” (Nutzungsziele, “information type” (Informationstyp and “preservation group” (Erhaltungsgruppe. The purpose of these new categories is that information objects shall be grouped by information type (e.g., audio, video, text… and intended use (e.g., reading for pleasure, search for specific information… to preservation groups for automatic processing. Significant properties can then be derived for whole preservation groups. The file format alone is considered as not completely sufficient for such categorisation. Some exemplary implementation solutions of the new concepts are presented in an annex.The guideline takes into account that resources for preservation planning and preservation actions are limited and has therefore adopted 4 premises: adequacy, financial viability, automation, and authenticity of archived objects. Its pragmatic approach becomes apparent in the definition and explanation of these dimensions. The guideline is written from the point of view of representatives of memory institutions, i

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-04-12

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

7 CFR 622.5 - Guidelines.

Science.gov (United States)

2010-01-01

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

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

DEFF Research Database (Denmark)

Brandes, Axel; Overgaard, Mikkel; Plauborg, Liane

2013-01-01

with a mean age of 74.811.2 years. The mean CHADS(2) and CHA(2)DS(2)-VASc scores were 1.9 +/- 1.3 and 3.5 +/- 1.8, respectively. Of the patients, 12.4% and 4.04%, respectively, were at truly low risk, with a CHADS(2) and CHA(2)DS(2)-VASc score 0 (P ... proportion of patients with nonvalvular AF do not receive guideline-adherent antithrombotic treatment in primary care. MethodsWe performed a cross-sectional survey of antithrombotic treatment using data of AF patients from general practices. ResultsSixty-four general practitioners enrolled 1743 patients......) score. Applying the CHA(2)DS(2)-VASc score, this proportion was only 53.4%. Antiplatelet drug treatment was in adherence to the guidelines (CHADS(2) and CHA(2)DS(2)-VASc score of 1) in only 31% and 12% of the patients, respectively. ConclusionsAntithrombotic treatment of AF patients is in general well...

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

International Nuclear Information System (INIS)

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

2004-01-01

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

10 CFR 960.3 - Implementation guidelines.

Science.gov (United States)

2010-01-01

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

10 CFR 960.5 - Preclosure guidelines.

Science.gov (United States)

2010-01-01

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

10 CFR 960.4 - Postclosure guidelines.

Science.gov (United States)

2010-01-01

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

General Business Model Patterns for Local Energy Management Concepts

International Nuclear Information System (INIS)

Facchinetti, Emanuele; Sulzer, Sabine

2016-01-01

The transition toward a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered, and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed, and compared. Through a market review, a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.

General Business Model Patterns for Local Energy Management Concepts

Energy Technology Data Exchange (ETDEWEB)

Facchinetti, Emanuele, E-mail: emanuele.facchinetti@hslu.ch; Sulzer, Sabine [Lucerne Competence Center for Energy Research, Lucerne University of Applied Science and Arts, Horw (Switzerland)

2016-03-03

The transition toward a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered, and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed, and compared. Through a market review, a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.

General Quality Control (QC) Guidelines for SAM Methods

Science.gov (United States)

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

Nuclear Waste Policy Act of 1982; proposed general guidelines for recommendation of sites for nuclear waste repositories

International Nuclear Information System (INIS)

Anon.

1983-01-01

In accordance with the requirements of the Nuclear Waste Policy Act of 1982 (Pub. L. 97-425), hereinafter referred to as the Act, the Department of Energy is proposing general guidelines for the recommendation of sites for repositories for disposal of high-level radioactive waste and spent nuclear fuel in geologic formations. These guidelines are based on the criteria that the Department has used in its National Waste Terminal Storage program, the criteria proposed by the Nuclear Regulatory Commission (NRC), and the environmental standards proposed by the Environmental Protection Agency. These guidelines establish the performance requirements for a geologic repository system, specify how the Department will implement its site-selection program, and define the technical qualifications that candidate sites must meet in the various steps of the site-selection process mandated by the Act. After considering comments from the public; consulting with the Council on Environmental Quality, the Administrator of the Environmental Protection Agency, the Director of the Geological Survey, and interested Governors; and obtaining NRC concurrence, the Department will issue these guidelines in final form as a new Part 960 to Title 10 of the Code of Federal Regulations (10 CFR Part 960)

Proposed Guideline Revisions for Dental Sedation and General Anesthesia: Why Target the Safest Level of Sedation?

Science.gov (United States)

Dionne, Raymond A

2016-09-01

Recently proposed revisions to the American Dental Association's Guidelines for the Use of Sedation and General Anesthesia by Dentists, aimed at improving safety in dental offices, differentiate between levels of sedation based on drug-induced changes in physiologic and behavioral states. However, the author of this op-ed is concerned the proposed revisions may have far-reaching and unintended consequences.

Guidelines for Description

NARCIS (Netherlands)

Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

2013-01-01

The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

10 CFR 960.4-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

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

Delivering stepped care for depression in general practice : Results of a survey amongst general practitioners in the Netherlands

NARCIS (Netherlands)

Sinnema, Henny; Franx, Gerdien; Spijker, Jan; Ruiter, Marijke; van Haastrecht, Harry; Verhaak, Peter; Nuyen, Jasper

2013-01-01

Background: Revised guidelines for depression recommend a stepped care approach. Little is known about the implementation of the stepped care model by general practitioners (GPs) in daily practice. Objectives: To evaluate the performance of Dutch GPs in their general practice regarding important

Critical factors influencing physicians' intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model.

Science.gov (United States)

Hsiao, Ju-Ling; Chen, Rai-Fu

2016-01-16

With the widespread use of information communication technologies, computerized clinical practice guidelines are developed and considered as effective decision supporting tools in assisting the processes of clinical activities. However, the development of computerized clinical practice guidelines in Taiwan is still at the early stage and acceptance level among major users (physicians) of computerized clinical practice guidelines is not satisfactory. This study aims to investigate critical factors influencing physicians' intention to computerized clinical practice guideline use through an integrative model of activity theory and the technology acceptance model. The survey methodology was employed to collect data from physicians of the investigated hospitals that have implemented computerized clinical practice guidelines. A total of 505 questionnaires were sent out, with 238 completed copies returned, indicating a valid response rate of 47.1 %. The collected data was then analyzed by structural equation modeling technique. The results showed that attitudes toward using computerized clinical practice guidelines (γ = 0.451, p technology) factors mentioned in the activity theory should be carefully considered when introducing computerized clinical practice guidelines. Managers should pay much attention on those identified factors and provide adequate resources and incentives to help the promotion and use of computerized clinical practice guidelines. Through the appropriate use of computerized clinical practice guidelines, the clinical benefits, particularly in improving quality of care and facilitating the clinical processes, will be realized.

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

Science.gov (United States)

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

2013-03-01

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

[The practice guideline 'Vaginal discharge' (first revision) from the Dutch College of General Practitioners; a response from the perspective of gynaecology].

Science.gov (United States)

Hogewoning, C J A; Ottervanger, H P; Adriaanse, A H; Trum, J W

2007-06-16

The Dutch College of General Practitioners (NHG) revised their practice guideline on vaginal discharge. From a gynaecological point of view, relocation of cervix problems from this guideline to the NHG guideline 'The STD consultation' is not practical. Moreover, the role of simple, but effective diagnosis with a microscope in the primary-care setting cannot be overemphasized. The reluctance to oral treatment is rather inopportune, because once-only ingestion has the advantage of promoting compliance. As physical examination is not always necessary in a recurrent Candida infection, treatment performed by the patient with imidazole compounds is a possibility that does not always result in abuse or increased resistance.

10 CFR 960.5-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

Mung'ayi, V; Karuga, R

2010-08-01

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

Consensus-based training and assessment model for general surgery.

Science.gov (United States)

Szasz, P; Louridas, M; de Montbrun, S; Harris, K A; Grantcharov, T P

2016-05-01

Surgical education is becoming competency-based with the implementation of in-training milestones. Training guidelines should reflect these changes and determine the specific procedures for such milestone assessments. This study aimed to develop a consensus view regarding operative procedures and tasks considered appropriate for junior and senior trainees, and the procedures that can be used as technical milestone assessments for trainee progression in general surgery. A Delphi process was followed where questionnaires were distributed to all 17 Canadian general surgery programme directors. Items were ranked on a 5-point Likert scale, with consensus defined as Cronbach's α of at least 0·70. Items rated 4 or above on the 5-point Likert scale by 80 per cent of the programme directors were included in the models. Two Delphi rounds were completed, with 14 programme directors taking part in round one and 11 in round two. The overall consensus was high (Cronbach's α = 0·98). The training model included 101 unique procedures and tasks, 24 specific to junior trainees, 68 specific to senior trainees, and nine appropriate to all. The assessment model included four procedures. A system of operative procedures and tasks for junior- and senior-level trainees has been developed along with an assessment model for trainee progression. These can be used as milestones in competency-based assessments. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Interconnection Guidelines

Science.gov (United States)

The Interconnection Guidelines provide general guidance on the steps involved with connecting biogas recovery systems to the utility electrical power grid. Interconnection best practices including time and cost estimates are discussed.

Demonstration of a computer model for residual radioactive material guidelines, RESRAD

International Nuclear Information System (INIS)

Yu, C.; Yuan, Y.C.; Zielen, A.J.; Wallo, A. III

1989-01-01

A computer model was developed to calculate residual radioactive material guidelines for the US Department of Energy (DOE). This model, called RESRAD, can be run on IBM or IBM-compatible microcomputer. Seven potential exposure pathways from contaminated soil are analyzed, including external radiation exposure and internal radiation exposure from inhalation and food digestion. The RESRAD code has been applied to several DOE sites to derive soil cleanup guidelines. The experience gained indicates that a comprehensive set of site-specific hydrogeologic and geochemical input parameters must be used for a realistic pathway analysis. The RESRAD code is a useful tool; it is easy to run and very user-friendly. 6 refs., 12 figs

Whitebark pine planting guidelines

Science.gov (United States)

Ward McCaughey; Glenda L. Scott; Kay L. Izlar

2009-01-01

This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...

40 CFR 766.12 - Testing guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Testing guidelines. 766.12 Section 766... DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.12 Testing guidelines. Analytical test methods must be developed using methods equivalent to those described or reviewed in Guidelines for the...

Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

Science.gov (United States)

Marson, Daniel

2016-09-01

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

Advanced human-system interface design review guideline. Evaluation procedures and guidelines for human factors engineering reviews

Energy Technology Data Exchange (ETDEWEB)

O`Hara, J.M.; Brown, W.S. [Brookhaven National Lab., Upton, NY (United States); Baker, C.C.; Welch, D.L.; Granda, T.M.; Vingelis, P.J. [Carlow International Inc., Falls Church, VA (United States)

1994-07-01

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

Advanced human-system interface design review guideline. Evaluation procedures and guidelines for human factors engineering reviews

International Nuclear Information System (INIS)

O'Hara, J.M.; Brown, W.S.; Baker, C.C.; Welch, D.L.; Granda, T.M.; Vingelis, P.J.

1994-07-01

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

10 CFR 960.5-1 - System guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false System guidelines. 960.5-1 Section 960.5-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-1 System guidelines. (a) Qualifying conditions—(1) Preclosure...

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

Science.gov (United States)

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

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study

Bioassay guideline 1: general guidlines for bioassay programs

International Nuclear Information System (INIS)

1980-01-01

This guideline is the first of a series of documents which elaborate criteria for bioassay programs, to be presented as recommendations to the Atomic Energy Control Board. It specifies which workers require routine bioassays, the accuracy and frequency of measurements, the dose levels at which specific actions must be taken, and the documentation required

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

[Summary of the practice guideline 'Vaginal discharge' (first revision) from the Dutch College of General Practitioners].

Science.gov (United States)

Boukes, F S; Boeke, A J P; Dekker, J H; Wiersma, T; Goudswaard, A N

2007-06-16

The 1996 practice guideline of the Dutch College of General Practitioners (NHG) on vaginal discharge has been updated. Most women who visit their doctor with complaints about vaginal discharge do not have an increased risk of a sexually-transmitted disease. Investigations into vaginal discharge comprise history taking, physical examination and microscopic analysis in the laboratory of the general practitioner. Additional investigation into Chlamydia, gonorrhoea and Trichomonas infection is only necessary if the patient history reveals an increased risk of a sexually-transmitted disease. A Candida infection or bacterial vaginosis should only be treated if the patient experiences bothersome complaints. Treatment of a Candida infection consists of a vaginally applied imidazole compound. Bacterial vaginosis can be treated with oral administration of metronidazole. Patients with vaginal fluor can be examined and, if necessary, treated by their general practitioner. Referral to a gynaecologist is rarely necessary.

Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice.

Science.gov (United States)

Basedow, Martin; Runciman, William B; Lipworth, Wendy; Esterman, Adrian

2016-11-01

Clinical practice guidelines (CPGs) have been shown to improve processes of care and health outcomes, but there is often a discrepancy between recommendations for care and clinical practice. This study sought to explore general practitioner (GP) attitudes towards CPGs, in general and specifically for osteoarthritis (OA), with the implications for translating OA care into practice. A self-administered questionnaire was conducted in January 2013 with a sample of 228 GPs in New South Wales and South Australia. Seventy-nine GPs returned questionnaires (response rate 35%). Nearly all GPs considered that CPGs support decision-making in practice (94%) and medical education (92%). Very few respondents regarded CPGs as a threat to clinical autonomy, and most recognised that individual patient circumstances must be taken into account. Shorter CPG formats were preferred over longer and more comprehensive formats, with preferences being evenly divided among respondents for short, 2-3-page summaries, flowcharts or algorithms and single page checklists. GPs considered accessibility to CPGs to be important, and electronic formats were popular. Familiarity and use of The Royal Australian College of General Practitioners OA Guideline was poor, with most respondents either not aware of it (30%; 95% confidence interval (CI) 27 - 41%), had never used it (19%; 95% CI 12 - 29%) or rarely used it (34%; 95% CI 25-45%). If CPGs are to assist with the translation of evidence into practice, they must be easily accessible and in a format that encourages use.

[Summary of the practice guideline 'Viral hepatitis and other liver diseases' (second revision) from the Dutch College of General Practitioners].

Science.gov (United States)

Bouma, M; van Geldrop, W J; Numans, M E; Wiersma, Tj; Goudswaard, A N

2008-12-06

The revised Dutch College of General Practitioners' practice guideline 'Viral hepatitis and other liver diseases' offers advice in the diagnosis and management of viral hepatitis A, B and C and other liver diseases. The guideline is important for general practitioners as well as specialists in internal medicine and gastroenterology. The emphasis is on the management of chronic hepatitis B en C, because the prevalence of these diseases has increased in the Netherlands and, in addition, the treatment options for chronic hepatitis have improved. Consequently, timely recognition and adequate referral of patients with chronic hepatitis B or hepatitis C have become more important. However, many patients with a chronic liver disease have no symptoms. Therefore, the general practitioner should be aware that a patient visiting the practice with fatigue and malaise could have a liver disease if he or she belongs to a high-risk group or has had high-risk contacts. If the general practitioner repeatedly finds increased liver transaminase values during routine examination of asymptomatic patients, additional diagnostic tests should be performed. Further tests should focus on viral hepatitis as well as on non-alcoholic fatty liver disease and non-alcoholic steatohepatitis or, depending on the history-taking, liver damage due to excessive alcohol, medication or drug use.

Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

NARCIS (Netherlands)

Sinnema, H.; Terluin, B.; Wensing, M.; Volker, D.; Franx, G.; van Balkom, A.J.L.M.; de Lange, J.

2013-01-01

Background: The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to

Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

NARCIS (Netherlands)

Sinnema, H.; Terluin, B.; Wensing, M.; Volker, D.; Franx, G.; Balkom, A. van; Lange, J.

2013-01-01

BACKGROUND: The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to

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

NARCIS (Netherlands)

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

2003-01-01

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Guidelines for Using Building Information Modeling for Energy Analysis of Buildings

Directory of Open Access Journals (Sweden)

Thomas Reeves

2015-12-01

Full Text Available Building energy modeling (BEM, a subset of building information modeling (BIM, integrates energy analysis into the design, construction, and operation and maintenance of buildings. As there are various existing BEM tools available, there is a need to evaluate the utility of these tools in various phases of the building lifecycle. The goal of this research was to develop guidelines for evaluation and selection of BEM tools to be used in particular building lifecycle phases. The objectives of this research were to: (1 Evaluate existing BEM tools; (2 Illustrate the application of the three BEM tools; (3 Re-evaluate the three BEM tools; and (4 Develop guidelines for evaluation, selection and application of BEM tools in the design, construction and operation/maintenance phases of buildings. Twelve BEM tools were initially evaluated using four criteria: interoperability, usability, available inputs, and available outputs. Each of the top three BEM tools selected based on this initial evaluation was used in a case study to simulate and evaluate energy usage, daylighting performance, and natural ventilation for two academic buildings (LEED-certified and non-LEED-certified. The results of the case study were used to re-evaluate the three BEM tools using the initial criteria with addition of the two new criteria (speed and accuracy, and to develop guidelines for evaluating and selecting BEM tools to analyze building energy performance. The major contribution of this research is the development of these guidelines that can help potential BEM users to identify the most appropriate BEM tool for application in particular building lifecycle phases.

Food pattern modeling shows that the 2010 Dietary Guidelines for sodium and potassium cannot be met simultaneously

Science.gov (United States)

Maillot, Matthieu; Monsivais, Pablo; Drewnowski, Adam

2013-01-01

The 2010 US Dietary Guidelines recommended limiting intake of sodium to 1500 mg/d for people older than 50 years, African Americans, and those suffering from chronic disease. The guidelines recommended that all other people consume less than 2300 mg sodium and 4700 mg of potassium per day. The theoretical feasibility of meeting the sodium and potassium guidelines while simultaneously maintaining nutritional adequacy of the diet was tested using food pattern modeling based on linear programming. Dietary data from the National Health and Nutrition Examination Survey 2001-2002 were used to create optimized food patterns for 6 age-sex groups. Linear programming models determined the boundary conditions for the potassium and sodium content of the modeled food patterns that would also be compatible with other nutrient goals. Linear programming models also sought to determine the amounts of sodium and potassium that both would be consistent with the ratio of Na to K of 0.49 and would cause the least deviation from the existing food habits. The 6 sets of food patterns were created before and after an across-the-board 10% reduction in sodium content of all foods in the Food and Nutrition Database for Dietary Studies. Modeling analyses showed that the 2010 Dietary Guidelines for sodium were incompatible with potassium guidelines and with nutritionally adequate diets, even after reducing the sodium content of all US foods by 10%. Feasibility studies should precede or accompany the issuing of dietary guidelines to the public. PMID:23507224

40 CFR 799.11 - Availability of test guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Availability of test guidelines. 799.11... General Provisions § 799.11 Availability of test guidelines. (a) The TSCA and FIFRA guidelines for the...-487-4650). (b) The OECD guidelines for the various study plans are available from the following...

Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands

NARCIS (Netherlands)

Vos, H.M.M.; Delft, D.H. Van; Kleijn, M.J.J. de; Nielen, M.M.; Schellevis, F.G.; Lagro-Janssen, A.L.M.

2014-01-01

RATIONALE, AIMS AND OBJECTIVES: In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective

Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands.

NARCIS (Netherlands)

Vos, H.M.M.; Delft, D.H.W.J.M. van; Kleijn, M.J.J. de; Nielen, M.M.J.; Schellevis, F.G.; Lagro-Janssen, A.L.M.

2014-01-01

Rationale, aims and objectives; In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective

Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands

NARCIS (Netherlands)

Vos, H.M.M.; Van Delft, D.H.W.J.; de Kleijn, M.J.J.; Nielen, M.M.J.; Schellevis, F.G.; Lagro-Janssen, A.L.M.

2014-01-01

Rationale, aims and objectives In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

IMAGE Programming Guidelines

Energy Technology Data Exchange (ETDEWEB)

Stehfest, E; De Waal, L.

2010-09-15

This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.

Data Qualification guidelines

International Nuclear Information System (INIS)

Edwards, T.B.; Shine, E.P.

1992-01-01

Data Qualification (DQ) is a formal, technical process whose objective is to affirm that experimental data are suitable for their intended use. Although it is not possible to develop a fixed recipe for the DQ process to cover all test situations, these general guidelines have been developed for the Nuclear Engineering Section to establish a framework for qualifying data from steady-state processing. These guidelines outline the role of the DQ team providing insight into the planning and conducting of the DQ process

Guidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research: A Multidisciplinary View.

Science.gov (United States)

Luo, Wei; Phung, Dinh; Tran, Truyen; Gupta, Sunil; Rana, Santu; Karmakar, Chandan; Shilton, Alistair; Yearwood, John; Dimitrova, Nevenka; Ho, Tu Bao; Venkatesh, Svetha; Berk, Michael

2016-12-16

As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community. ©Wei Luo, Dinh Phung, Truyen Tran, Sunil Gupta, Santu Rana, Chandan Karmakar, Alistair Shilton, John Yearwood, Nevenka Dimitrova, Tu Bao Ho, Svetha Venkatesh, Michael Berk. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.12.2016.

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

Science.gov (United States)

Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

2018-06-18

To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Assessing biocomputational modelling in transforming clinical guidelines for osteoporosis management.

Science.gov (United States)

Thiel, Rainer; Viceconti, Marco; Stroetmann, Karl

2011-01-01

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

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

Science.gov (United States)

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

2011-01-01

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

The new hypertension guidelines.

Science.gov (United States)

Stern, Ralph H

2013-10-01

The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

Using whole disease modeling to inform resource allocation decisions: economic evaluation of a clinical guideline for colorectal cancer using a single model.

Science.gov (United States)

Tappenden, Paul; Chilcott, Jim; Brennan, Alan; Squires, Hazel; Glynne-Jones, Rob; Tappenden, Janine

2013-06-01

To assess the feasibility and value of simulating whole disease and treatment pathways within a single model to provide a common economic basis for informing resource allocation decisions. A patient-level simulation model was developed with the intention of being capable of evaluating multiple topics within National Institute for Health and Clinical Excellence's colorectal cancer clinical guideline. The model simulates disease and treatment pathways from preclinical disease through to detection, diagnosis, adjuvant/neoadjuvant treatments, follow-up, curative/palliative treatments for metastases, supportive care, and eventual death. The model parameters were informed by meta-analyses, randomized trials, observational studies, health utility studies, audit data, costing sources, and expert opinion. Unobservable natural history parameters were calibrated against external data using Bayesian Markov chain Monte Carlo methods. Economic analysis was undertaken using conventional cost-utility decision rules within each guideline topic and constrained maximization rules across multiple topics. Under usual processes for guideline development, piecewise economic modeling would have been used to evaluate between one and three topics. The Whole Disease Model was capable of evaluating 11 of 15 guideline topics, ranging from alternative diagnostic technologies through to treatments for metastatic disease. The constrained maximization analysis identified a configuration of colorectal services that is expected to maximize quality-adjusted life-year gains without exceeding current expenditure levels. This study indicates that Whole Disease Model development is feasible and can allow for the economic analysis of most interventions across a disease service within a consistent conceptual and mathematical infrastructure. This disease-level modeling approach may be of particular value in providing an economic basis to support other clinical guidelines. Copyright © 2013 International

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

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-07-01

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

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

International Nuclear Information System (INIS)

Carter, R.J.

1997-07-01

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

A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial.

Science.gov (United States)

Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming; Maindal, Helle Terkildsen; Petersen, Karin Dam; Bendtsen, Mette Dahl; Jensen, Martin Bach

2016-10-21

Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS). In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate. Practices were randomised (1:1) and stratified by practice size to MuIS (28 practices) or a passive implementation strategy (PaIS; 32 practices). Included were patients with LBP aged 18 to 65 years who were able to complete questionnaires, had no serious underlying pathology, and were not pregnant. We developed a MuIS including outreach visits, quality reports, and the STarT Back Tool for subgrouping patients with LBP. Both groups were offered the usual dissemination of guidelines, guideline-concordant structuring of the medical record, and a new referral opportunity for patients with psycho-social problems. In an intention-to-treat analysis, the primary and secondary outcomes pertained to the patient, and a cost-effectiveness analysis was performed from a healthcare sector perspective. Patients and the assessment of outcomes were blinded. Practices and caregivers delivering the interventions were not blinded. Between January 2013 and July 2014, 60 practices were included, of which 54 practices (28 MuIS, 26 PaIS) included 1101 patients (539 MuIS, 562 PaIS). Follow-up data for the primary outcome were available on 100 % of these patients. Twenty-seven patients (5.0 %) in the MuIS group were referred to secondary care vs. 59 patients (10.5 %) in the PaIS group. The adjusted odds ratio (AOR) was 0.52 [95 % CI 0.30 to 0.90; p = 0.020]. The MuIS was cost-saving £-93.20 (£406.51 vs. £499.71 per patient

Introduction to generalized linear models

CERN Document Server

Dobson, Annette J

2008-01-01

Introduction Background Scope Notation Distributions Related to the Normal Distribution Quadratic Forms Estimation Model Fitting Introduction Examples Some Principles of Statistical Modeling Notation and Coding for Explanatory Variables Exponential Family and Generalized Linear Models Introduction Exponential Family of Distributions Properties of Distributions in the Exponential Family Generalized Linear Models Examples Estimation Introduction Example: Failure Times for Pressure Vessels Maximum Likelihood Estimation Poisson Regression Example Inference Introduction Sampling Distribution for Score Statistics Taylor Series Approximations Sampling Distribution for MLEs Log-Likelihood Ratio Statistic Sampling Distribution for the Deviance Hypothesis Testing Normal Linear Models Introduction Basic Results Multiple Linear Regression Analysis of Variance Analysis of Covariance General Linear Models Binary Variables and Logistic Regression Probability Distributions ...

12 CFR 618.8015 - Policy guidelines.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Policy guidelines. 618.8015 Section 618.8015 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618.8015 Policy guidelines. (a) The board of directors of each System bank or association providing...

Effectiveness of a multifaceted implementation strategy compared to usual care on low back pain guideline adherence among general practitioners.

Science.gov (United States)

Suman, Arnela; Schaafsma, Frederieke G; van de Ven, Peter M; Slottje, Pauline; Buchbinder, Rachelle; van Tulder, Maurits W; Anema, Johannes R

2018-05-11

To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. The implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain. Adherence was measured using performance indicators based on 3 months data extracted from the contacts with patients with low back pain recorded in the electronic medical records of participating general practitioners. Performance indicators were compared between two groups: a usual care group and an implementation group. Performance indicators were referrals to consultations with medical specialists, to diagnostic imaging, and to psychosocial and/or occupational physician consultations, and inquiries about psychosocial and occupational risk factors. The electronic medical records of 5130 patient contacts for LBP were analysed; 2453 patient contacts in the usual care group and 2677 patient contacts in the implementation group. Overall, rates of referral and of recorded inquiries regarding psychosocial and occupational risk factors remained low in both groups over time. The only statistically significant difference found was a reduction in the number of referrals to neurologists in the implementation group (from 100 (7%) to 50 (4%)) compared to the usual care group (from 48 (4%) to 50 (4%), (p strategy did not result in improved guideline adherence among general practitioners, and it is not recommended for widespread use. However, baseline referral rates in participating practices were already low, possibly leaving only little room for improvement. Inquiries for psychosocial and

Summary guidelines

Energy Technology Data Exchange (ETDEWEB)

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

1999-09-01

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

Testing the generalized partial credit model

OpenAIRE

Glas, Cornelis A.W.

1996-01-01

The partial credit model (PCM) (G.N. Masters, 1982) can be viewed as a generalization of the Rasch model for dichotomous items to the case of polytomous items. In many cases, the PCM is too restrictive to fit the data. Several generalizations of the PCM have been proposed. In this paper, a generalization of the PCM (GPCM), a further generalization of the one-parameter logistic model, is discussed. The model is defined and the conditional maximum likelihood procedure for the method is describe...

General guidelines for safe and expeditious international transport of samples subjected to biological dosimetry assessment.

Science.gov (United States)

Di Giorgio, Marina; Radl, Analía; Taja, María R; Bubniak, Ruth; Deminge, Mayra; Sapienza, Carla; Vázquez, Marina; Baciu, Florian; Kenny, Pat

2014-06-01

It has been observed that victims of accidental overexposures show better chance of survival if they receive medical treatment early. The increased risk of scenarios involving mass casualties has stimulated the scientific community to develop tools that would help the medical doctors to treat victims. The biological dosimetry has become a routine test to estimate the dose, supplementing physical and clinical dosimetry. In case of radiation emergencies, in order to provide timely and effectively biological dosimetry assistance it is essential to guarantee an adequate transport of blood samples in principal, for providing support to countries that do not have biodosimetry laboratories. The objective of the present paper is to provide general guidelines, summarised in 10 points, for timely and proper receiving and sending of blood samples under National and International regulations, for safe and expeditious international transport. These guidelines cover the classification, packaging, marking, labelling, refrigeration and documentation requirements for the international shipping of blood samples and pellets, to provide assistance missions with a tool that would contribute with the preparedness for an effective biodosimetric response in cases of radiological or nuclear emergencies. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

Science.gov (United States)

2013-01-01

Background Although the United Kingdom’s (UK’s) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools. Methods Twenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions. Results Factors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies. Conclusions Students’ educational experiences differ due to diverse interpretations of GMC guidelines, educators’ perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically. PMID:23578257

25 CFR 163.81 - Assessment guidelines.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Assessment guidelines. 163.81 Section 163.81 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GENERAL FORESTRY REGULATIONS Program Assessment § 163.81 Assessment guidelines. Assessments shall be national in scope and shall include: (a) An...

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

DEFF Research Database (Denmark)

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

2016-01-01

BACKGROUND: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from p...

Cancer screening guidelines.

Science.gov (United States)

Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

2001-03-15

Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

Development of environmental guidelines for electronic appliances

DEFF Research Database (Denmark)

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

1994-01-01

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

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

Directory of Open Access Journals (Sweden)

Bart Verhees

2017-12-01

Full Text Available Point-of-care testing (POCT—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

Science.gov (United States)

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

2017 publication guidelines for structural modelling of small-angle scattering data from biomolecules in solution: an update.

Science.gov (United States)

Trewhella, Jill; Duff, Anthony P; Durand, Dominique; Gabel, Frank; Guss, J Mitchell; Hendrickson, Wayne A; Hura, Greg L; Jacques, David A; Kirby, Nigel M; Kwan, Ann H; Pérez, Javier; Pollack, Lois; Ryan, Timothy M; Sali, Andrej; Schneidman-Duhovny, Dina; Schwede, Torsten; Svergun, Dmitri I; Sugiyama, Masaaki; Tainer, John A; Vachette, Patrice; Westbrook, John; Whitten, Andrew E

2017-09-01

In 2012, preliminary guidelines were published addressing sample quality, data acquisition and reduction, presentation of scattering data and validation, and modelling for biomolecular small-angle scattering (SAS) experiments. Biomolecular SAS has since continued to grow and authors have increasingly adopted the preliminary guidelines. In parallel, integrative/hybrid determination of biomolecular structures is a rapidly growing field that is expanding the scope of structural biology. For SAS to contribute maximally to this field, it is essential to ensure open access to the information required for evaluation of the quality of SAS samples and data, as well as the validity of SAS-based structural models. To this end, the preliminary guidelines for data presentation in a publication are reviewed and updated, and the deposition of data and associated models in a public archive is recommended. These guidelines and recommendations have been prepared in consultation with the members of the International Union of Crystallography (IUCr) Small-Angle Scattering and Journals Commissions, the Worldwide Protein Data Bank (wwPDB) Small-Angle Scattering Validation Task Force and additional experts in the field.

Guidelines for conducting pharmaceutical budget impact analyses for submission to public drug plans in Canada.

Science.gov (United States)

Marshall, Deborah A; Douglas, Patrick R; Drummond, Michael F; Torrance, George W; Macleod, Stuart; Manti, Orlando; Cheruvu, Lokanadha; Corvari, Ron

2008-01-01

Until now, there has been no standardized method of performing and presenting budget impact analyses (BIAs) in Canada. Nevertheless, most drug plan managers have been requiring this economic data to inform drug reimbursement decisions. This paper describes the process used to develop the Canadian BIA Guidelines; describes the Guidelines themselves, including the model template; and compares this guidance with other guidance on BIAs. The intended audience includes those who develop, submit or use BIA models, and drug plan managers who evaluate BIA submissions. The Patented Medicine Prices Review Board (PMPRB) initiated the development of the Canadian BIA Guidelines on behalf of the National Prescription Drug Utilisation Information System (NPDUIS). The findings and recommendations from a needs assessment with respect to BIA submissions were reviewed to inform guideline development. In addition, a literature review was performed to identify existing BIA guidance. The detailed guidance was developed on this basis, and with the input of the NPDUIS Advisory Committee, including drug plan managers from multiple provinces in Canada and a representative from the Canadian Agency for Drugs and Technologies in Health. A Microsoft Excel-based interactive model template was designed to support BIA model development. Input regarding the guidelines and model template was sought from each NPDUIS Advisory Committee member to ensure compatibility with existing drug plan needs. Decisions were made by consensus through multiple rounds of review and discussion. Finally, BIA guidance in Canadian provinces and other countries were compared on the basis of multiple criteria. The BIA guidelines consist of three major sections: Analytic Framework, Inputs and Data Sources, and Reporting Format. The Analytic Framework section contains a discussion of nine general issues surrounding BIAs (model design, analytic perspective, time horizon, target population, costing, scenarios to be compared

Undertreatment of urinary incontinence in general practice.

NARCIS (Netherlands)

Penning-van Beest, F.J.A.; Sturkenboom, M.C.; Bemelmans, B.L.H.; Herings, R.M.C.

2005-01-01

BACKGROUND: In the urinary incontinence guidelines that are issued by the Dutch College of General Practitioners, treatment guidelines are related to the type of incontinence. It is unknown whether treatment of urinary incontinence in general practice complies with these guidelines. OBJECTIVE: To

Generalized, Linear, and Mixed Models

CERN Document Server

McCulloch, Charles E; Neuhaus, John M

2011-01-01

An accessible and self-contained introduction to statistical models-now in a modernized new editionGeneralized, Linear, and Mixed Models, Second Edition provides an up-to-date treatment of the essential techniques for developing and applying a wide variety of statistical models. The book presents thorough and unified coverage of the theory behind generalized, linear, and mixed models and highlights their similarities and differences in various construction, application, and computational aspects.A clear introduction to the basic ideas of fixed effects models, random effects models, and mixed m

Initiatives for regional dialogue consideration of regional disarmament guidelines

International Nuclear Information System (INIS)

Marschik, R.

1994-01-01

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

Global Imaging referral guidelines

International Nuclear Information System (INIS)

Kawooya, M.; Perez, M.; Lau, L.; Reeed, M.

2010-01-01

The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Allan Riis

2016-10-01

Full Text Available Abstract Background Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS. Methods In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate. Practices were randomised (1:1 and stratified by practice size to MuIS (28 practices or a passive implementation strategy (PaIS; 32 practices. Included were patients with LBP aged 18 to 65 years who were able to complete questionnaires, had no serious underlying pathology, and were not pregnant. We developed a MuIS including outreach visits, quality reports, and the STarT Back Tool for subgrouping patients with LBP. Both groups were offered the usual dissemination of guidelines, guideline-concordant structuring of the medical record, and a new referral opportunity for patients with psycho-social problems. In an intention-to-treat analysis, the primary and secondary outcomes pertained to the patient, and a cost-effectiveness analysis was performed from a healthcare sector perspective. Patients and the assessment of outcomes were blinded. Practices and caregivers delivering the interventions were not blinded. Results Between January 2013 and July 2014, 60 practices were included, of which 54 practices (28 MuIS, 26 PaIS included 1101 patients (539 MuIS, 562 PaIS. Follow-up data for the primary outcome were available on 100 % of these patients. Twenty-seven patients (5.0 % in the MuIS group were referred to secondary care vs. 59 patients (10.5 % in the PaIS group. The adjusted odds ratio (AOR was 0.52 [95 % CI 0.30 to 0.90; p = 0.020]. The MuIS was cost

Comparison of expected treatment outcomes, obtained using risk models and international guidelines, with observed treatment outcomes in a Dutch cohort of patients with non-muscle-invasive bladder cancer treated with intravesical chemotherapy.

Science.gov (United States)

Lammers, Rianne J M; Palou, Joan; Witjes, Wim P J; Janzing-Pastors, Maria H D; Caris, Christien T M; Witjes, J Alfred

2014-08-01

To compare the risks according to the American Urological Association (AUA), EAU, European Organization for Research and Treatment of Cancer (EORTC) and Club Urológico Español de Tratamiento Oncologico (CUETO) classifications with real outcomes in a cohort of patients in the Netherlands, and to confirm that patients who were undertreated according to these risk models have worse outcomes than adequately treated patients. Patients treated with complete transurethral resection of bladder tumour and intravesical chemotherapy were included. Not all patients would have received intravesical chemotherapy had they been treated to current standards, and thus comparison of the observed outcomes in our Dutch cohort vs expected outcomes based on the EORTC risk tables and CUETO scoring model was possible. The cohort was reclassified according to the definitions of five index patients (IPs), as defined by the AUA guidelines, and three risk groups, defined according to the EAU guidelines, to compare the outcomes of undertreated patients with those of adequately treated patients. A total of 1001 patients were available for comparison with the AUA definitions and 728 patients were available for comparison with the EORTC and CUETO models. There was a large overlap between the observed outcomes and expected recurrence and progression probabilities when comparison was made using the EORTC risk tables. The observed recurrence outcomes were in general higher than the expected probabilities according to the CUETO risk classification, especially in the long term. No differences in progression were found when comparing these two models to the Dutch cohort. Patients who were undertreated according to the guidelines showed, in general, a higher risk of developing recurrence and progression. Limitations are i.a. its retrospective nature and the differences in grading system. Comparisons between the observed outcomes in our Dutch cohort and the expected outcomes based on EAU and CUETO risk

National and international guidelines for rectal cancer

DEFF Research Database (Denmark)

Nielsen, Liv Bjerre Juul; Wille-Jørgensen, P

2014-01-01

, this might not be the case between guidelines. No formal evaluation of the contrasting guidance has been reported. METHOD: A systematic search for national and international guidelines on rectal cancer was performed. Eleven guidelines were identified for further analysis. RESULTS: There was no consensus...... concerning the definition of rectal cancer. Ten of the 11 guidelines use the TNM staging system and there was general agreement regarding the recommendation of MRI and CT in rectal cancer. There was consensus concerning a multidisciplinary approach, preoperative chemoradiotherapy (CRT) and total mesorectal...

Record Keeping Guidelines

Science.gov (United States)

American Psychologist, 2007

2007-01-01

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

A national guideline for palliative sedation in the Netherlands

NARCIS (Netherlands)

Verkerk, Marian; van Wijlick, Eric; Legemaate, Johan; de Graeff, Alexander

2007-01-01

The first national guideline on palliative sedation in The Netherlands has been adopted by the General Board of the Royal Dutch Medical Association. By law, the physician is obliged to take this guideline into consideration. In this paper, we present the main principles of the guideline. Palliative

2004 Guidelines for Advancement and Promotion

CERN Multimedia

2004-01-01

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

2006 Guidelines for Advancement and Promotion

CERN Multimedia

HR Department

2006-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2006 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular 26 (Rev. 6). All decisions will be made by 1 July 2006. These now include career path changes for staff in Career Paths A to D. Departments are invited to comply strictly with the target date for the completion of the annual interviews which this year has been fixed at 15 March 2006. Group Leader evaluations are expected to be finalized by 13 April 2006. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. The annual appraisal report should be completed using the electronic version in the EDH system. 2. Budget guidelines Within the annual advancement budget, the guideline allocations have been defined by the Director-General on a departmental basis for staff in Career Paths A to E and on a CERN-wide basis for staff in Career Paths F and ...

2006 Guidelines for Advancement and Promotion

CERN Multimedia

HR Department

2006-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2006 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular 26 (Rev. 6). All decisions will be made by 1 July 2006. These now include career path changes for staff in Career Paths A to D. Departments are invited to comply strictly with the target date for the completion of the annual interviews which this year has been fixed at 15 March 2006. Group Leader evaluations are expected to be finalized by 13 April 2006. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. The annual appraisal report should be completed using the electronic version in the EDH system. 2. Budget guidelines Within the annual advancement budget, the guideline allocations have been defined by the Director-General on a departmental basis for staff in Career Paths A to E and on a CERN-wide basis for staff in Career Paths F and G...

44 CFR 12.18 - Uniform pay guidelines.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Uniform pay guidelines. 12.18 Section 12.18 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL ADVISORY COMMITTEES § 12.18 Uniform pay guidelines. (a) Members. Subject to the...

Incremental guideline formalization with tool support

NARCIS (Netherlands)

Serban, Radu; Puig-Centelles, Anna; ten Teije, Annette

2006-01-01

Guideline formalization is recognized as an important component in improving computerized guidelines, which in turn leads to better informedness, lower inter-practician variability and, ultimately, to higher quality healthcare. By means of a modeling exercise, we investigate the role of guideline

Guideline concordance of treatment for depressive disorders in Canada.

Science.gov (United States)

Duhoux, Arnaud; Fournier, Louise; Nguyen, Cat Tuong; Roberge, Pasquale; Beveridge, Rachelle

2009-05-01

Depression is one of the most prevalent mental health problems worldwide with considerable social and economic burdens. While practice guidelines exist, their adherence is inconsistent in clinical practice. To provide up-to-date national estimates of the adequacy of treatment received by Canadians having suffered a major depressive disorder (MDD) and examine factors associated with this adequacy. To evaluate the impact of different definitions of guideline-concordant treatment on the results. Data were drawn from the Canadian Community Health Survey, cycle 1.2: Mental Health and Well-Being (CCHS 1.2), a nationally representative survey conducted in 2002 and targetting persons aged 15 years or older living in private dwellings. In order to calculate the prevalence of treatment adequacy, we used a sample of 1,563 individuals meeting the criteria for MDD in the 12 months preceding the survey. A subset of 831 subjects who reported having used health services for mental health purposes at least once during that time served to identify the factors associated with treatment adequacy. Four definitions of minimally adequate treatment were considered and covariates were selected according to a well-known behavioral model. The analyses consisted of prevalence estimates and logistic regression models. Among selected subjects, 55% received guideline-concordant treatment according to the Canadian guidelines. Inadequacy was more prevalent in rural settings, for less complex cases, and in the general medical sector. Depending on the definition, prevalence of guideline-concordant treatment ranged between 48 and 71%, and factors associated with guideline-concordant treatment were mainly need factors and sector of care. A large proportion of people with a depressive disorder do not receive minimally adequate treatment. Improved access to and quality of treatment is required, especially in primary care settings.

A survey of psychiatrists' attitudes toward treatment guidelines.

Science.gov (United States)

Healy, Daniel J; Goldman, Mona; Florence, Timothy; Milner, Karen K

2004-04-01

We developed a survey to look at psychiatrists' attitudes toward psychotropic prescribing guidelines, specifically the Texas Medication Algorithm Project (TMAP) algorithms. The 22-page survey was distributed to 24 psychiatrists working in 4 CMHC's; 13 completed the survey. 90% agreed that guidelines should be general and flexible. The majority also agreed that guidelines should define how to measure response to a specific agent; fewer agreed guidelines should specify dosage, side effect management, or augmentation strategies. Psychiatrists were familiar with TMAP; none referred to it in their practice. In spite of this, psychiatrists' medication preferences were similar to those suggested by guidelines.

Generalized complex geometry, generalized branes and the Hitchin sigma model

International Nuclear Information System (INIS)

Zucchini, Roberto

2005-01-01

Hitchin's generalized complex geometry has been shown to be relevant in compactifications of superstring theory with fluxes and is expected to lead to a deeper understanding of mirror symmetry. Gualtieri's notion of generalized complex submanifold seems to be a natural candidate for the description of branes in this context. Recently, we introduced a Batalin-Vilkovisky field theoretic realization of generalized complex geometry, the Hitchin sigma model, extending the well known Poisson sigma model. In this paper, exploiting Gualtieri's formalism, we incorporate branes into the model. A detailed study of the boundary conditions obeyed by the world sheet fields is provided. Finally, it is found that, when branes are present, the classical Batalin-Vilkovisky cohomology contains an extra sector that is related non trivially to a novel cohomology associated with the branes as generalized complex submanifolds. (author)

Strategy Guideline: Demonstration Home

Energy Technology Data Exchange (ETDEWEB)

Savage, C.; Hunt, A.

2012-12-01

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

Strategy Guideline. Demonstration Home

Energy Technology Data Exchange (ETDEWEB)

Hunt, A.; Savage, C.

2012-12-01

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

Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

Science.gov (United States)

Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

2010-07-01

To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

Likelihood of cesarean delivery after applying leading active labor diagnostic guidelines.

Science.gov (United States)

Neal, Jeremy L; Lowe, Nancy K; Phillippi, Julia C; Ryan, Sharon L; Knupp, Amy M; Dietrich, Mary S; Thung, Stephen F

2017-06-01

Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons). Active labor diagnostic guidelines were retrospectively applied to cervical examination data from nulliparous women with spontaneous labor onset (n = 2573). Generalized linear models were used to determine outcome likelihoods within- and between-guideline groups. At admission, 15.7%, 48.3%, and 10.1% of nulliparous women were in active labor per Friedman, NICE, and ACOG/SMFM diagnostic guidelines, respectively. Cesarean delivery was more likely among women admitted before vs in active labor per the Friedman (AOR 1.75 [95% CI 1.08-2.82] or NICE guideline (AOR 2.55 [95% CI 1.84-3.53]). Between guidelines, cesarean delivery was less likely among women admitted in active labor per the NICE guideline, as compared with the ACOG/SMFM guideline (AOR 0.55 [95% CI 0.35-0.88]). Many nulliparous women are admitted to the hospital before active labor onset. These women are significantly more likely to have a cesarean delivery. Diagnosing active labor before admission or before intervention to speed labor may be one component of a multi-faceted approach to decreasing the primary cesarean rate in the United States. The NICE diagnostic guideline is more inclusive than Friedman or ACOG/SMFM guidelines and its use may be the most clinically useful for safely lowering cesarean rates. © 2017 Wiley Periodicals, Inc.

A general consumer-resource population model

Science.gov (United States)

Lafferty, Kevin D.; DeLeo, Giulio; Briggs, Cheryl J.; Dobson, Andrew P.; Gross, Thilo; Kuris, Armand M.

2015-01-01

Food-web dynamics arise from predator-prey, parasite-host, and herbivore-plant interactions. Models for such interactions include up to three consumer activity states (questing, attacking, consuming) and up to four resource response states (susceptible, exposed, ingested, resistant). Articulating these states into a general model allows for dissecting, comparing, and deriving consumer-resource models. We specify this general model for 11 generic consumer strategies that group mathematically into predators, parasites, and micropredators and then derive conditions for consumer success, including a universal saturating functional response. We further show how to use this framework to create simple models with a common mathematical lineage and transparent assumptions. Underlying assumptions, missing elements, and composite parameters are revealed when classic consumer-resource models are derived from the general model.

Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility

Directory of Open Access Journals (Sweden)

Kramer Lena

2011-11-01

Full Text Available Abstract Background Most guidelines concentrate on investigations, treatment, and monitoring instead of patient history and clinical examination. We developed a guideline that dealt with the different aetiologies of chest pain by emphasizing the patient's history and physical signs. The objective of this study was to evaluate the guideline's acceptance and feasibility in the context of a practice test. Methods The evaluation study was nested in a diagnostic cross-sectional study with 56 General Practitioners (GPs and 862 consecutively recruited patients with chest pain. The evaluation of the guideline was conducted in a mixed method design on a sub-sample of 17 GPs and 282 patients. Physicians' evaluation of the guideline was assessed via standardized questionnaires and case record forms. Additionally, practice nursing staff and selected patients were asked for their evaluation of specific guideline modules. Quantitative data was analyzed descriptively for frequencies, means, and standard deviations. In addition, two focus groups with a total of 10 GPs were held to gain further insights in the guideline implementation process. The data analysis and interpretation followed the standards of the qualitative content analysis. Results The overall evaluation of the GPs participating in the evaluation study regarding the recommendations made in the chest pain guideline was positive. A total of 14 GPs were convinced that there was a need for this kind of guideline and perceived the guideline recommendations as useful. While the long version was partially criticized for a perceived lack of clarity, the short version of the chest pain guideline and the heart score were especially appreciated by the GPs. However, change of clinical behaviour as consequence of the guideline was inconsistent. While on a concrete patient related level, GPs indicated to have behaved as the guideline recommended, the feedback on a more general level was heterogeneous. Several

Medical Malpractice Implications of Clinical Practice Guidelines.

Science.gov (United States)

Ruhl, Douglas S; Siegal, Gil

2017-08-01

Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.

Application of a conceptual framework for the modelling and execution of clinical guidelines as networks of concurrent processes

NARCIS (Netherlands)

Fung, L.S.N.; Fung, Nick Lik San; Widya, I.A.; Broens, T.H.F.; Larburu Rubio, Nekane; Bults, Richard G.A.; Shalom, Erez; Jones, Valerie M.; Hermens, Hermanus J.

2014-01-01

We present a conceptual framework for modelling clinical guidelines as networks of concurrent processes. This enables the guideline to be partitioned and distributed at run-time across a knowledge-based telemedicine system, which is distributed by definition but whose exact physical configuration

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

Directory of Open Access Journals (Sweden)

Johnson Lorraine

2010-06-01

Full Text Available Abstract Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA. Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.

Improved guideline adherence to pharmacotherapy of chronic systolic heart failure in general practice--results from a cluster-randomized controlled trial of implementation of a clinical practice guideline.

Science.gov (United States)

Peters-Klimm, Frank; Müller-Tasch, Thomas; Remppis, Andrew; Szecsenyi, Joachim; Schellberg, Dieter

2008-10-01

Clinical practice guidelines (CPG) reflect the evidence of effective pharmacotherapy of chronic (systolic) heart failure (CHF) which needs to be implemented. This study aimed to evaluate the effect of a new, multifaceted intervention (educational train-the-trainer course plus pharmacotherapy feedback = TTT) compared with standard education on guideline adherence (GA) in general practice. Thirty-seven participating general practitioners (GPs) were randomized (18 vs. 19) and included 168 patients with ascertained symptomatic CHF [New York Heart Association (NYHA) II-IV]. Groups received CPG, the TTT intervention consisted of four interactive educational meetings and a pharmacotherapy feedback, while the control group received a usual lecture (Standard). Outcome measure was GA assessed by prescription rates and target dosing of angiotensin converting enzyme (ACE) inhibitors (ACE-I) or angiotensin receptor blockers (ARB), beta-blockers (BB) and aldosterone antagonists (AA) at baseline and 7-month follow-up. Group comparisons at follow-up were adjusted to GA, sex, age and NYHA stage at baseline. Prescription rates at baseline (n = 168) were high (ACE-I/ARB 90, BB 79 and AA 29%) in both groups. At follow up (n = 146), TTT improved compared with Standard regarding AA (43% vs. 23%, P = 0.04) and the rates of reached target doses of ACE-I/ARB (28% vs. 15%, P = 0.04). TTT group achieved significantly higher mean percentages of daily target dose (52% vs. 42%, mean difference 10.3%, 95% CI 0.84-19.8, P = 0.03). Despite of pre-existing high GA in both groups and an active control group, the multifaceted intervention was effective in quality of care measured by GA. Further research is needed on the choice of interventions in different provider populations.

Investigation of the interactions between wind turbines and radio systems aimed at establishing co-siting guidelines. Phase 1: Introduction and modelling of wind turbine scatter, appendices E, F and G

International Nuclear Information System (INIS)

Dabis, H.S.; Chignell, R.J.

1997-01-01

The potential for wind turbines to interfere with radio systems can be a source of conflict between radio operators and the wind energy community. In this report, the problem of accurately predicting the effects of wind turbines on radio systems with the aim of establishing guidelines for their installation is investigated. Initially models for the scatter mechanisms that occur at the wind turbine are developed. These models predict the wind turbine radar cross section and the modulation effects due to the rotation of the blades. Initial validation of these models is established by comparing the predicted results with a set of measurements obtained from experiments performed on a 20:1 scale model wind turbine. It is shown that generally these results agree well. These results are then used in the guideline formulation to compute, for specific radio systems, regions where wind turbines cannot be installed. Examples using realistic parameters for various radio systems are presented. Further validation of the derived models is required. (author)

10 CFR 300.1 - General.

Science.gov (United States)

2010-01-01

... CLIMATE CHANGE VOLUNTARY GREENHOUSE GAS REPORTING PROGRAM: GENERAL GUIDELINES § 300.1 General. (a) Purpose... Policy Act of 1992 (42 U.S.C. 13385(b)). The purpose of the guidelines is to establish the procedures and... organizations, households and other private and public entities to submit annual reports of their greenhouse gas...

2002 GUIDELINES FOR ADVANCEMENT AND PROMOTION

CERN Document Server

Human Resources Division

2002-01-01

1. General Following the various Weekly Bulletin announcements concerning the new Merit Advancement and Promotion Scheme (MAPS), the Director-General has now fixed the guidelines and schedule for the 2002 annual advancement review as summarised below. The full details have been presented to the Management Board and to the Standing Concertation Committee. The guidelines correspond to the information given in the document 'An overview of the Merit Advancement and Promotion Scheme (MAPS) and implementation measures' dated 11 July 2001. The procedures will follow those given in the recently published Administrative Circular 26 (Rev. 3) except that the annual interview programme is extended to the completion date of 31 March 2002. As in previous years, decisions will be made, where possible, by 1 July 2002 except for career path changes for staff in Career Paths A to D which will be made by 31 October 2002 and applied retroactively to 1 July 2002. 2. Budget guidelines The budget allocation for the annual part of a...

Guidelines for developing and updating Bayesian belief networks applied to ecological modeling and conservation.

Science.gov (United States)

B.G. Marcot; J.D. Steventon; G.D. Sutherland; R.K. McCann

2006-01-01

We provide practical guidelines for developing, testing, and revising Bayesian belief networks (BBNs). Primary steps in this process include creating influence diagrams of the hypothesized "causal web" of key factors affecting a species or ecological outcome of interest; developing a first, alpha-level BBN model from the influence diagram; revising the model...

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

Science.gov (United States)

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

2015-01-01

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

Multivariate generalized linear mixed models using R

CERN Document Server

Berridge, Damon Mark

2011-01-01

Multivariate Generalized Linear Mixed Models Using R presents robust and methodologically sound models for analyzing large and complex data sets, enabling readers to answer increasingly complex research questions. The book applies the principles of modeling to longitudinal data from panel and related studies via the Sabre software package in R. A Unified Framework for a Broad Class of Models The authors first discuss members of the family of generalized linear models, gradually adding complexity to the modeling framework by incorporating random effects. After reviewing the generalized linear model notation, they illustrate a range of random effects models, including three-level, multivariate, endpoint, event history, and state dependence models. They estimate the multivariate generalized linear mixed models (MGLMMs) using either standard or adaptive Gaussian quadrature. The authors also compare two-level fixed and random effects linear models. The appendices contain additional information on quadrature, model...

[Vitamin D supplementation in the elderly: guidelines and practice].

Science.gov (United States)

Chel, V G M; Elders, P J M; Tuijp, M L M; van den Berg, H H; van Drongelen, K I; Siedenburg, R C; Ooms, M E; Lips, P T A

2013-01-01

In 2008, the Health Council of the Netherlands published an advice on vitamin D supplementation for the elderly. Nevertheless, suspicion arose at the Ministry of Health, Welfare and Sport and the Netherlands Nutrition Centre that vitamin D supplementation in the elderly is still insufficient. We aimed to determine the extent to which general practitioners and elderly care physicians actually followed the advice of the Health Council. Questionnaire study. Brief questionnaires were sent to all elderly care physicians in the Netherlands. Some questions were also posed to general practitioners at a network meeting of the Academic Network of GP Practices of the VU University Medical Center in Amsterdam. More than two-thirds of the respondents, both elderly care physicians and general practitioners, are familiar with the guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly, but about half do not prescribe vitamin D when the guideline advises to do so. When supplementation is prescribed, about half of the elderly care physicians and a fifth of the general practitioners uses an insufficient dose. The guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly are not sufficiently followed by elderly care physicians and general practitioners. Awareness of and support for the vitamin D supplementation guidelines among health care providers is still limited.

Guidelines for Posting Soil Contamination Areas

Energy Technology Data Exchange (ETDEWEB)

Mcnaughton, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Eisele, William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-02-01

All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.

Micro Data and General Equilibrium Models

DEFF Research Database (Denmark)

Browning, Martin; Hansen, Lars Peter; Heckman, James J.

1999-01-01

Dynamic general equilibrium models are required to evaluate policies applied at the national level. To use these models to make quantitative forecasts requires knowledge of an extensive array of parameter values for the economy at large. This essay describes the parameters required for different...... economic models, assesses the discordance between the macromodels used in policy evaluation and the microeconomic models used to generate the empirical evidence. For concreteness, we focus on two general equilibrium models: the stochastic growth model extended to include some forms of heterogeneity...

General fire protection guidelines for egyptian nuclear facilities. Vol. 4

Energy Technology Data Exchange (ETDEWEB)

Radhad, S; Hussien, A Z; Hammad, F H [National Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo (Egypt)

1996-03-01

The purpose of this paper is to establish the regulatory requirements of that will provide and ensure fire protection of egyptian nuclear facilities. Those facilities that use, handle and store low and/or medium radioactive substances are included. Two or more classes of occupancy are considered to occur in the same building or structure. Fir protection measures and systems were reviewed for three of the egyptian Nuclear facilities. These are egypt first nuclear reactor (ETRR-1) building and systems, hot laboratories buildings and facilities, and the building including the AECL type Is-6500 industrial cobalt-60 gamma irradiator {sup E}gypt`s mega gamma I{sup .} The study includes the outlines of the various aspects of fire protection with a view to define the relevant highlights and scope of egyptian guideline for nuclear installations. The study considers fire protection aspects including the following items: 1- Site selection. 2- General facility design. 3- Fire alarm, detection and suppression systems. (4- Protection for specific areas/control room, cable spreading room, computer room) 5- Fire emergency response planning. 6- Fire water supply. 7- Emergency lighting and communication. 8- Rescue and escape routes. 9- Explosion protection. 10-Manual fire fighting. 11- Security consideration in the interest of fire protection. 12- quality assurance programme. Therefore, first of all the design stage, then during the construction stage, and later during the operation stage, measures must be taken to forestall the risks associated with the outbreak of fire and to ensure that consequences of fire accidents remain limited.

General fire protection guidelines for egyptian nuclear facilities. Vol. 4

International Nuclear Information System (INIS)

Radhad, S.; Hussien, A.Z.; Hammad, F.H.

1996-01-01

The purpose of this paper is to establish the regulatory requirements of that will provide and ensure fire protection of egyptian nuclear facilities. Those facilities that use, handle and store low and/or medium radioactive substances are included. Two or more classes of occupancy are considered to occur in the same building or structure. Fir protection measures and systems were reviewed for three of the egyptian Nuclear facilities. These are egypt first nuclear reactor (ETRR-1) building and systems, hot laboratories buildings and facilities, and the building including the AECL type Is-6500 industrial cobalt-60 gamma irradiator E gypt's mega gamma I . The study includes the outlines of the various aspects of fire protection with a view to define the relevant highlights and scope of egyptian guideline for nuclear installations. The study considers fire protection aspects including the following items: 1- Site selection. 2- General facility design. 3- Fire alarm, detection and suppression systems. 4- Protection for specific areas/control room, cable spreading room, computer room) 5- Fire emergency response planning. 6- Fire water supply. 7- Emergency lighting and communication. 8- Rescue and escape routes. 9- Explosion protection. 10-Manual fire fighting. 11- Security consideration in the interest of fire protection. 12- quality assurance programme. Therefore, first of all the design stage, then during the construction stage, and later during the operation stage, measures must be taken to forestall the risks associated with the outbreak of fire and to ensure that consequences of fire accidents remain limited

Engineering design guidelines for nuclear criticality safety

International Nuclear Information System (INIS)

Waltz, W.R.

1988-08-01

This document provides general engineering design guidelines specific to nuclear criticality safety for a facility where the potential for a criticality accident exists. The guide is applicable to the design of new SRP/SRL facilities and to major modifications Of existing facilities. The document is intended an: A guide for persons actively engaged in the design process. A resource document for persons charged with design review for adequacy relative to criticality safety. A resource document for facility operating personnel. The guide defines six basic criticality safety design objectives and provides information to assist in accomplishing each objective. The guide in intended to supplement the design requirements relating to criticality safety contained in applicable Department of Energy (DOE) documents. The scope of the guide is limited to engineering design guidelines associated with criticality safety and does not include other areas of the design process, such as: criticality safety analytical methods and modeling, nor requirements for control of the design process

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

LENUS (Irish Health Repository)

Flynn, E

2012-03-01

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

Glauber model and its generalizations

International Nuclear Information System (INIS)

Bialkowski, G.

The physical aspects of the Glauber model problems are studied: potential model, profile function and Feynman diagrams approaches. Different generalizations of the Glauber model are discussed: particularly higher and lower energy processes and large angles [fr

Practical guidelines for modelling post-entry spread in invasion ecology

Directory of Open Access Journals (Sweden)

Hazel Parry

2013-09-01

Full Text Available In this article we review a variety of methods to enable understanding and modelling the spread of a pest or pathogen post-entry. Building upon our experience of multidisciplinary research in this area, we propose practical guidelines and a framework for model development, to help with the application of mathematical modelling in the field of invasion ecology for post-entry spread. We evaluate the pros and cons of a range of methods, including references to examples of the methods in practice. We also show how issues of data deficiency and uncertainty can be addressed. The aim is to provide guidance to the reader on the most suitable elements to include in a model of post-entry dispersal in a risk assessment, under differing circumstances. We identify both the strengths and weaknesses of different methods and their application as part of a holistic, multidisciplinary approach to biosecurity research.

Web Accessibility and Guidelines

Science.gov (United States)

Harper, Simon; Yesilada, Yeliz

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

The generalized circular model

NARCIS (Netherlands)

Webers, H.M.

1995-01-01

In this paper we present a generalization of the circular model. In this model there are two concentric circular markets, which enables us to study two types of markets simultaneously. There are switching costs involved for moving from one circle to the other circle, which can also be thought of as

Put in value of the Santa Teresa Park as a cultural landscape. Project and Ordinance of the Landscape in the General Guidelines of its Master Plan

Directory of Open Access Journals (Sweden)

Nair Rosana Sommaruga Montiel

2018-03-01

Full Text Available The paper is a summary of the landscape studies developed in the framework of 'Lineamientos generales para el Plan Director del Parque Santa Teresa' (General guidelines for Santa Teresa Park Master Plan, agreement made between the Ministry of Tourism, and the Faculty of Architecture, Design And Urbanism of the University of the Republic between August 2015 and July 2016. The purpose of the Convention is to position the Santa Teresa Park as a "model park" for Uruguay, putting in value its patrimonial, landscape and Environmental characteristics, thus contributing to its tourism and sociocultural promotion. The entire project includes and combines different disciplinary studies as well as external contributions. The Research program “Landscape and Public Space” from the Institute of Design in collaboration with VIDIALAB develops the Characterization and Landscape Assessment of the Park, through studies and proposals on its landscape structures, sociocultural perceptions and the qualification of the visual landscape.

Knowledge-based verification of clinical guidelines by detection of anomalies.

Science.gov (United States)

Duftschmid, G; Miksch, S

2001-04-01

As shown in numerous studies, a significant part of published clinical guidelines is tainted with different types of semantical errors that interfere with their practical application. The adaptation of generic guidelines, necessitated by circumstances such as resource limitations within the applying organization or unexpected events arising in the course of patient care, further promotes the introduction of defects. Still, most current approaches for the automation of clinical guidelines are lacking mechanisms, which check the overall correctness of their output. In the domain of software engineering in general and in the domain of knowledge-based systems (KBS) in particular, a common strategy to examine a system for potential defects consists in its verification. The focus of this work is to present an approach, which helps to ensure the semantical correctness of clinical guidelines in a three-step process. We use a particular guideline specification language called Asbru to demonstrate our verification mechanism. A scenario-based evaluation of our method is provided based on a guideline for the artificial ventilation of newborn infants. The described approach is kept sufficiently general in order to allow its application to several other guideline representation formats.

General safety guidelines for looking for a low mass activity-long life waste storage site

International Nuclear Information System (INIS)

2008-01-01

The objective of this document is to define general guidelines which must be followed during the stages of search for a site and stages of design of a storage facility for low activity-long life radioactive wastes, in order to ensure its safety after closure. After having specified the considered wastes, geological shapes, and situations, this document defines the fundamental objective and the associated criteria (protection against chemical risk, radioprotection). It presents the design aspects related to safety (safety principles and functions, waste packages, public works engineering, geological environment, storage concepts). The last part deals with the safety demonstration after site closure which includes the control of some components, the assessment of disturbances in the storage facility or due to its presence, the taking of uncertainty and sensitivity studies into account, the influence of natural events

Electronic Form of the 1999 WHO/ISH Hypertension Guidelines

Czech Academy of Sciences Publication Activity Database

Peleška, Jan; Anger, Z.; Tomečková, Marie; Veselý, Arnošt; Zvárová, Jana

21 Suppl. 4, - (2003), s. 181 ISSN 0263-6352. [European Meeting on Hypertension /13./. 13.06.2003-17.06.2003, Milan] R&D Projects: GA MŠk LN00B107 Keywords : hypertension * WHO/ISH guidelines * electronic guidelines Subject RIV: BA - General Mathematics

Guidelines on treatment of perinatal depression with antidepressants: An international review.

Science.gov (United States)

Molenaar, Nina M; Kamperman, Astrid M; Boyce, Philip; Bergink, Veerle

2018-04-01

Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged.

Safety guidelines for magnetic resonance diagnostic facilities (1991)

International Nuclear Information System (INIS)

1992-01-01

These guidelines provide information on levels and health effects of exposure to magnetic and radiofrequency electromagnetic fields associated with magnetic resonance (MR) devices, and on precautions to minimize effects on patients, staff, and the general public. The guidelines are for use by regulatory authorities, MR users and health professionals. 22 refs., 1 tab

The revised Canadian Guidelines for the Economic Evaluation of Pharmaceuticals.

Science.gov (United States)

Glennie, J L; Torrance, G W; Baladi, J F; Berka, C; Hubbard, E; Menon, D; Otten, N; Rivière, M

1999-05-01

The first edition of the Guidelines for Economic Evaluation of Pharmaceuticals: Canada was published in November 1994. At that time, the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) was assigned the task of maintaining and regularly updating the Canadian Guidelines. Since their introduction, a great deal of experience has been gained with the practical application of the guidelines. Their role has also evolved over time, from being a framework for pharmacoeconomic research to the point where a wide variety of decision-makers use economic evaluations based on the principles set out in the guidelines as a means of facilitating their formulary decisions. In addition, methodologies in certain areas (and the body of related research literature in general) have developed considerably over time. Given these changes in the science and the experience gained, CCOHTA convened a multi-disciplinary committee to address the need for revisions to the guidelines. The underlying principles of the review process were to keep the guidance nature of the document, to focus on the needs of 'doers' (so as to meet the information needs of 'users') and to provide information and advice in areas of controversy, with sound direction in areas of general agreement. The purpose of this review is three-fold: (i) to outline the process which lead to the revision of the Canadian Guidelines; (ii) to describe the major changes made to the second edition of this document; and (iii) to consider the 'next steps' as they relate to the impact of such guidelines and the measurement of outcomes related to economic assessments of pharmaceuticals in general.

2005 Guidelines for Advancement and Promotion

CERN Multimedia

Human Resources Department

2005-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2005 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular N° 6 (Rev. 5). Decisions will be made, where possible, by 1 July 2005 except for career path changes for staff in Career Paths A to D which will be made by 31 October 2005 and applied retroactively to 1 July 2005. Departments are invited to comply strictly with the target date for the completion of the annual interviews which this year has been fixed at 15 March 2005. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. As already announced in Weekly Bulletin 48/2004-22.11.2004 and further explained in Weekly Bulletin 3/2005-17.1.2005, the annual appraisal report should be completed using the electronic version in the EDH system. 2. Budget guidelines Within the annual advancement budget, the guideline allocations have been defi...

2003 Guidelines for Advancement and Promotion

CERN Multimedia

2003-01-01

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

Current European guidelines for management of cardiovascular disease

DEFF Research Database (Denmark)

Vinther, Johan L; Jacobsen, Rikke K; Jørgensen, Torben

2018-01-01

Background Health checks of the general population are widely used to prevent cardiovascular diseases, but are the current clinical guidelines from the European Society of Cardiology (ESC) suitable for screening the general population? Design A cross-sectional, population-based study of 978 men...... and women aged 40-65 years examined in 2010-2011 was used to estimate the proportion of the general Danish population fulfilling the criteria from the clinical guidelines from the ESC on medical treatment and lifestyle intervention to prevent cardiovascular disease. Methods The ESC criteria for medical...... treatment and lifestyle intervention were applied to a general population using information on previous cardiovascular diseases, known diabetes, urinalbumin, smoking, total cholesterol, systolic and diabolic blood pressure, low-density lipoprotein cholesterol and a multifactor risk score (SCORE). Results...

Guidelines for standard and biuretic renogram in children

International Nuclear Information System (INIS)

Gordon, I.; Piepsz, A.; Colarinha, P.; Hahn, K.; Fischer, S.; Porn, U.; Sixt, R.; Velzen, J. van

2000-01-01

The guidelines are intended to help nuclear medical teams in their daily routine. The information given relates to aspects such as data acquisition, evaluation and interpretation, and indications for pediatric renal functional scintigraphy. The guidelines have been elaborated in response to a request of EANM and the American Society of Nuclear Medicine, who expressed the need for guidelines on recommended procedures for most of the standard nuclear medical examinations. The guidelines express the opinion of the Paediatric Committee of the EANM, and should be seen in the context of generally accepted basic principles in nuclear medicine, as well as local and national regulatory standards in radiation protection. (orig./CB) [de

Testing the generalized partial credit model

NARCIS (Netherlands)

Glas, Cornelis A.W.

1996-01-01

The partial credit model (PCM) (G.N. Masters, 1982) can be viewed as a generalization of the Rasch model for dichotomous items to the case of polytomous items. In many cases, the PCM is too restrictive to fit the data. Several generalizations of the PCM have been proposed. In this paper, a

Tailoring Earned Value Management. General Guidelines

National Research Council Canada - National Science Library

2002-01-01

Partial Contents: General Principles, A Spectrum of Implementation, OMB Guidance, A Special Note about DOD, Risk Factors to Consider, How can EVMS be tailored, Tailor EVMS to Inherent Risk, Application Thresholds-DoD...

Fire protection guidelines for nuclear power plants

International Nuclear Information System (INIS)

1976-06-01

Guidelines acceptable to the NRC staff for implementing in the development of a fire protection program for nuclear power plants. The purpose of the fire protection program is to ensure the capability to shut down the reactor and maintain it in a safe shutdown condition and to minimize radioactive releases to the environment in the event of a fire. If designs or methods different from the guidelines presented herein are used, they must provide fire protection comparable to that recommended in the guidelines. Suitable bases and justification should be provided for alternative approaches to establish acceptable implementaion of General Design Criterion 3

Resuscitation outcomes comparing year 2000 with year 2005 ALS guidelines in a pig model of cardiac arrest.

Science.gov (United States)

Xanthos, Theodoros; Tsirikos-Karapanos, Nikolas; Papadimitriou, Dimitrios; Vlachos, Ioannis S; Tsiftsi, Katerina; Ekmektzoglou, Konstantinos A; Papadimitriou, Lila

2007-06-01

Ventricular fibrillation remains the leading cause of death in western societies. International organizations publish guidelines to follow in case of cardiac arrest. The aim of the present study is to assess whether the newly published guidelines record similar resuscitation success with the 2000 Advanced Life Support Guidelines on Resuscitation in a swine model of cardiac arrest. Nineteen landrace/large white pigs were used. Ventricular fibrillation was induced with the use of a transvenous pacing wire inserted into the right ventricle. The animals were randomized into two groups. In Group A, 10 animals were resuscitated using the 2000 guidelines, whereas in Group B, 9 animals were resuscitated using the 2005 guidelines. Both algorithms recorded similar successful resuscitation rates, as 60% of the animals in Group A and 44.5% in Group B were successfully resuscitated. However, animals in Group A restored a rhythm, compatible with a pulse, quicker than those in Group B (p=0.002). Coronary perfusion pressure (CPP) was not adversely affected by three defibrillation attempts in Group A. Both algorithms' resulted in comparable resuscitation success, however, guidelines 2000 resulted in faster resuscitation times. These preliminary results merit further investigation.

Generalizing Source Geometry of Site Contamination by Simulating and Analyzing Analytical Solution of Three-Dimensional Solute Transport Model

Directory of Open Access Journals (Sweden)

Xingwei Wang

2014-01-01

Full Text Available Due to the uneven distribution of pollutions and blur edge of pollutant area, there will exist uncertainty of source term shape in advective-diffusion equation model of contaminant transport. How to generalize those irregular source terms and deal with those uncertainties is very critical but rarely studied in previous research. In this study, the fate and transport of contaminant from rectangular and elliptic source geometry were simulated based on a three-dimensional analytical solute transport model, and the source geometry generalization guideline was developed by comparing the migration of contaminant. The result indicated that the variation of source area size had no effect on pollution plume migration when the plume migrated as far as five times of source side length. The migration of pollution plume became slower with the increase of aquifer thickness. The contaminant concentration was decreasing with scale factor rising, and the differences among various scale factors became smaller with the distance to field increasing.

Neuropathological assessment and validation of mouse models for Alzheimer's disease: applying NIA-AA guidelines

Directory of Open Access Journals (Sweden)

C. Dirk Keene

2016-06-01

Full Text Available Dozens of transgenic mouse models, generally based on mutations associated with familial Alzheimer's disease (AD, have been developed, in part, for preclinical testing of candidate AD therapies. However, none of these models has successfully predicted the clinical efficacy of drugs for treating AD patients. Therefore, development of more translationally relevant AD mouse models remains a critical unmet need in the field. A concept not previously implemented in AD preclinical drug testing is the use of mouse lines that have been validated for neuropathological features of human AD. Current thinking suggests that amyloid plaque and neurofibrillary tangle deposition is an essential component for accurate modeling of AD. Therefore, the AD translational paradigm would require pathologic Aβ and tau deposition, a disease-relevant distribution of plaques and tangles, and a pattern of disease progression of Aβ and tau isoforms similar to the neuropathological features found in the brains of AD patients. Additional parameters useful to evaluate parallels between AD and animal models would include 1 cerebrospinal fluid (CSF AD biomarker changes with reduced Aβ and increased phospho-tau/tau; 2 structural and functional neuroimaging patterns including MRI hippocampal atrophy, fluorodeoxyglucose (FDG, and amyloid/tau PET alterations in activity and/or patterns of pathologic peptide deposition and distribution; and 3 cognitive impairment with emphasis on spatial learning and memory to distinguish presymptomatic and symptomatic mice at specific ages. A validated AD mouse model for drug testing would likely show tau-related neurofibrillary degeneration following Aβ deposition and demonstrate changes in pathology, CSF analysis, and neuroimaging that mirror human AD. Development of the ideal model would revolutionize the ability to establish the translational value of AD mouse models and serve as a platform for discussions about national phenotyping guidelines

Generalized Nonlinear Yule Models

OpenAIRE

Lansky, Petr; Polito, Federico; Sacerdote, Laura

2016-01-01

With the aim of considering models with persistent memory we propose a fractional nonlinear modification of the classical Yule model often studied in the context of macrovolution. Here the model is analyzed and interpreted in the framework of the development of networks such as the World Wide Web. Nonlinearity is introduced by replacing the linear birth process governing the growth of the in-links of each specific webpage with a fractional nonlinear birth process with completely general birth...

A generalized additive regression model for survival times

DEFF Research Database (Denmark)

Scheike, Thomas H.

2001-01-01

Additive Aalen model; counting process; disability model; illness-death model; generalized additive models; multiple time-scales; non-parametric estimation; survival data; varying-coefficient models......Additive Aalen model; counting process; disability model; illness-death model; generalized additive models; multiple time-scales; non-parametric estimation; survival data; varying-coefficient models...

Exploiting Temporal Constraints of Clinical Guidelines by Applying OpenEHR Archetypes.

Science.gov (United States)

Cintho, Lilian Mie Mukai; Garcia, Diego; da Silva Santos, Bruno Henrique; Sacchi, Lucia; Quaglini, Silvana; Moro, Claudia Maria Cabral

2017-01-01

Studies describing Computer-Interpretable Clinical Guidelines (CIG) with temporal constrains (TC) generally have not addressed issues related to their integration into Electronic Health Record (EHR) systems. This study aimed to represent TCs contained in clinical guidelines by applying archetypes and Guideline Definition Language (GDL) to incorporate decision support into EHRs. An example of each TC class in the clinical guideline for management of Atrial Fibrillation was represented using archetypes and GDL.

Systematic review of guidelines on peripheral artery disease screening.

Science.gov (United States)

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

2012-02-01

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

Generalized Nonlinear Yule Models

Science.gov (United States)

Lansky, Petr; Polito, Federico; Sacerdote, Laura

2016-11-01

With the aim of considering models related to random graphs growth exhibiting persistent memory, we propose a fractional nonlinear modification of the classical Yule model often studied in the context of macroevolution. Here the model is analyzed and interpreted in the framework of the development of networks such as the World Wide Web. Nonlinearity is introduced by replacing the linear birth process governing the growth of the in-links of each specific webpage with a fractional nonlinear birth process with completely general birth rates. Among the main results we derive the explicit distribution of the number of in-links of a webpage chosen uniformly at random recognizing the contribution to the asymptotics and the finite time correction. The mean value of the latter distribution is also calculated explicitly in the most general case. Furthermore, in order to show the usefulness of our results, we particularize them in the case of specific birth rates giving rise to a saturating behaviour, a property that is often observed in nature. The further specialization to the non-fractional case allows us to extend the Yule model accounting for a nonlinear growth.

Climatology of the HOPE-G global ocean general circulation model - Sea ice general circulation model

Energy Technology Data Exchange (ETDEWEB)

Legutke, S. [Deutsches Klimarechenzentrum (DKRZ), Hamburg (Germany); Maier-Reimer, E. [Max-Planck-Institut fuer Meteorologie, Hamburg (Germany)

1999-12-01

The HOPE-G global ocean general circulation model (OGCM) climatology, obtained in a long-term forced integration is described. HOPE-G is a primitive-equation z-level ocean model which contains a dynamic-thermodynamic sea-ice model. It is formulated on a 2.8 grid with increased resolution in low latitudes in order to better resolve equatorial dynamics. The vertical resolution is 20 layers. The purpose of the integration was both to investigate the models ability to reproduce the observed general circulation of the world ocean and to obtain an initial state for coupled atmosphere - ocean - sea-ice climate simulations. The model was driven with daily mean data of a 15-year integration of the atmosphere general circulation model ECHAM4, the atmospheric component in later coupled runs. Thereby, a maximum of the flux variability that is expected to appear in coupled simulations is included already in the ocean spin-up experiment described here. The model was run for more than 2000 years until a quasi-steady state was achieved. It reproduces the major current systems and the main features of the so-called conveyor belt circulation. The observed distribution of water masses is reproduced reasonably well, although with a saline bias in the intermediate water masses and a warm bias in the deep and bottom water of the Atlantic and Indian Oceans. The model underestimates the meridional transport of heat in the Atlantic Ocean. The simulated heat transport in the other basins, though, is in good agreement with observations. (orig.)

The General Education Collaboration Model: A Model for Successful Mainstreaming.

Science.gov (United States)

Simpson, Richard L.; Myles, Brenda Smith

1990-01-01

The General Education Collaboration Model is designed to support general educators teaching mainstreamed disabled students, through collaboration with special educators. The model is based on flexible departmentalization, program ownership, identification and development of supportive attitudes, student assessment as a measure of program…

Adherence to guidelines for creatinine and potassium monitoring and discontinuation following renin-angiotensin system blockade: a UK general practice-based cohort study.

Science.gov (United States)

Schmidt, Morten; Mansfield, Kathryn E; Bhaskaran, Krishnan; Nitsch, Dorothea; Sørensen, Henrik Toft; Smeeth, Liam; Tomlinson, Laurie A

2017-01-09

To examine adherence to serum creatinine and potassium monitoring and discontinuation guidelines following initiation of treatment with ACE inhibitors (ACEI) or angiotensin receptor blockers (ARBs); and whether high-risk patients are monitored. A general practice-based cohort study using electronic health records from the UK Clinical Practice Research Datalink and Hospital Episode Statistics. UK primary care, 2004-2014. 223 814 new ACEI/ARB users. Proportion of patients with renal function monitoring before and after ACEI/ARB initiation; creatinine increase ≥30% or potassium levels >6 mmol/L at first follow-up monitoring; and treatment discontinuation after such changes. Using logistic regression models, we also examined patient characteristics associated with these biochemical changes, and with follow-up monitoring within the guideline recommendation of 2 weeks after treatment initiation. 10% of patients had neither baseline nor follow-up monitoring of creatinine within 12 months before and 2 months after initiation of an ACEI/ARB, 28% had monitoring only at baseline, 15% only at follow-up, and 47% both at baseline and follow-up. The median period between the most recent baseline monitoring and drug initiation was 40 days (IQR 12-125 days). 34% of patients had baseline creatinine monitoring within 1 month before initiating therapy, but creatinine increase ≥30% (n=567, 1.2%) or potassium level >6 mmol/L (n=191, 0.4%), 80% continued treatment. Although patients with prior myocardial infarction, hypertension or baseline potassium >5 mmol/L were at high risk of ≥30% increase in creatinine after ACEI/ARB initiation, there was no evidence that they were more frequently monitored. Only one-tenth of patients initiating ACEI/ARB therapy receive the guideline-recommended creatinine monitoring. Moreover, the vast majority of the patients fulfilling postinitiation discontinuation criteria for creatinine and potassium increases continue on treatment

Adherence to guidelines for creatinine and potassium monitoring and discontinuation following renin–angiotensin system blockade: a UK general practice-based cohort study

Science.gov (United States)

Schmidt, Morten; Bhaskaran, Krishnan; Nitsch, Dorothea; Sørensen, Henrik Toft; Smeeth, Liam; Tomlinson, Laurie A

2017-01-01

Objectives To examine adherence to serum creatinine and potassium monitoring and discontinuation guidelines following initiation of treatment with ACE inhibitors (ACEI) or angiotensin receptor blockers (ARBs); and whether high-risk patients are monitored. Design A general practice-based cohort study using electronic health records from the UK Clinical Practice Research Datalink and Hospital Episode Statistics. Setting UK primary care, 2004–2014. Subjects 223 814 new ACEI/ARB users. Main outcome measures Proportion of patients with renal function monitoring before and after ACEI/ARB initiation; creatinine increase ≥30% or potassium levels >6 mmol/L at first follow-up monitoring; and treatment discontinuation after such changes. Using logistic regression models, we also examined patient characteristics associated with these biochemical changes, and with follow-up monitoring within the guideline recommendation of 2 weeks after treatment initiation. Results 10% of patients had neither baseline nor follow-up monitoring of creatinine within 12 months before and 2 months after initiation of an ACEI/ARB, 28% had monitoring only at baseline, 15% only at follow-up, and 47% both at baseline and follow-up. The median period between the most recent baseline monitoring and drug initiation was 40 days (IQR 12–125 days). 34% of patients had baseline creatinine monitoring within 1 month before initiating therapy, but creatinine increase ≥30% (n=567, 1.2%) or potassium level >6 mmol/L (n=191, 0.4%), 80% continued treatment. Although patients with prior myocardial infarction, hypertension or baseline potassium >5 mmol/L were at high risk of ≥30% increase in creatinine after ACEI/ARB initiation, there was no evidence that they were more frequently monitored. Conclusions Only one-tenth of patients initiating ACEI/ARB therapy receive the guideline-recommended creatinine monitoring. Moreover, the vast majority of the patients fulfilling postinitiation

Overview and status of Department of Energy siting guidelines

International Nuclear Information System (INIS)

Hanlon, C.

1984-01-01

One of the initial requirements of the Nuclear Waste Policy Act of 1982 was the development of siting guidelines for use in the selection of repository sites. The key issues raised during the consultation process are summarized as follows: the use of NRC and EPA regulations; the application of the guidelines in the siting process; the structure and specificity of the guidelines; the relationship between system and technical guidelines; the use of the systems approach in evaluating the overall performance of the repository system; the relative importance of individual guidelines; the degree of reliance placed on engineered barriers; impacts on the local population; impacts on the environment; protection of ground-water resources; and transportation. All of these issues were considered in revising the guidelines, and the responses to them are summarized in general terms

A new General Lorentz Transformation model

International Nuclear Information System (INIS)

Novakovic, Branko; Novakovic, Alen; Novakovic, Dario

2000-01-01

A new general structure of Lorentz Transformations, in the form of General Lorentz Transformation model (GLT-model), has been derived. This structure includes both Lorentz-Einstein and Galilean Transformations as its particular (special) realizations. Since the free parameters of GLT-model have been identified in a gravitational field, GLT-model can be employed both in Special and General Relativity. Consequently, the possibilities of an unification of Einstein's Special and General Theories of Relativity, as well as an unification of electromagnetic and gravitational fields are opened. If GLT-model is correct then there exist four new observation phenomena (a length and time neutrality, and a length dilation and a time contraction). Besides, the well-known phenomena (a length contraction, and a time dilation) are also the constituents of GLT-model. It means that there is a symmetry in GLT-model, where the center of this symmetry is represented by a length and a time neutrality. A time and a length neutrality in a gravitational field can be realized if the velocity of a moving system is equal to the free fall velocity. A time and a length neutrality include an observation of a particle mass neutrality. A special consideration has been devoted to a correlation between GLT-model and a limitation on particle velocities in order to investigate the possibility of a travel time reduction. It is found out that an observation of a particle speed faster then c=299 792 458 m/s, is possible in a gravitational field, if certain conditions are fulfilled

Guidelines for the responsible management of plutonium

International Nuclear Information System (INIS)

Agrell, P.H.

1997-01-01

Since 1994 an informal group of representatives of States party to the NPT has been trying to develop agreed international guidelines for the responsible management of non-military plutonium. This paper gives a brief description of the outcome. Since the results are still subject to decision by Governments, the description must be in general terms only. The paper describes the background to, and genesis of, the discussions and the general approach taken, which was based on commitment to the NPT, national responsibility for the management of nuclear materials and the fuel cycle, upholding of the IAEA's safeguards system, and a focus on civil material. An indication is given of the development of the Group's thinking, especially the decisions that any guidelines must be capable of accommodating surplus military plutonium, as well as civil, and that the main focus should be on measures to increase transparency. The resulting guidelines are described. Their main features are a re-statement of commitments and standards for the management of non-military plutonium with regard to non-proliferation, safety, and other fields, a commitment to the management of such plutonium according to a consistent national strategy, and a commitment to the publication of information on that strategy, and of annual statistics for holdings of plutonium in a consistent format. Other aspects of the guidelines are also explained. Finally, an attempt is made to assess the possible practical effects of the guidelines if adopted by governments. (author)

Guidelines for personal exposure monitoring of chemicals: Part III.

Science.gov (United States)

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

2018-01-25

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

Guidelines for personal exposure monitoring of chemicals: Part IV.

Science.gov (United States)

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

2018-03-27

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

Guidelines for personal exposure monitoring of chemicals: Part II.

Science.gov (United States)

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

2017-11-25

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

Guidelines for personal exposure monitoring of chemicals: Part I.

Science.gov (United States)

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

2017-09-28

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

Guidelines for personal exposure monitoring of chemicals: Part V.

Science.gov (United States)

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

2018-05-25

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

Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel

Science.gov (United States)

Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G.; Ruggeri, Kai

2016-01-01

Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed. PMID:27252672

Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel.

Science.gov (United States)

Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G; Ruggeri, Kai

2016-01-01

Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed.

A new independent authority is needed to issue National Health Care guidelines.

Science.gov (United States)

Keyhani, Salomeh; Kim, Azalea; Mann, Micah; Korenstein, Deborah

2011-02-01

Health experts emphasize that getting doctors to follow clinical guidelines can save both lives and money. Less attention has been paid to how the guidelines are developed and the variability in the recommendations they include. We examined the quality and content of screening guidelines as a proxy for guidelines in general and found that the source of the guidelines affects their quality. Guidelines with inconsistent recommendations are unlikely to serve patients or physicians well. The creation of an independent organization that would work with multiple stakeholders to develop guidelines holds the potential to improve their quality.

40 CFR 420.07 - Effluent limitations guidelines and standards for pH.

Science.gov (United States)

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS IRON AND STEEL MANUFACTURING POINT SOURCE CATEGORY General Provisions § 420.07 Effluent limitations guidelines and standards for pH. (a) The pH level in process wastewaters... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Effluent limitations guidelines and...

“If you drink alcohol, drink sensibly.” Is this guideline still appropriate?

African Journals Online (AJOL)

Food-Based Dietary Guidelines for South Africa: “If you drink alcohol, drink sensibly.” - Is this guideline ... alcohol-consumption guideline to be adopted by the general public: “If .... Survey of 20038 and the Youth Risk Behaviour Study of 20029.

Guidelines for use of fishes in research

Science.gov (United States)

Use of Fishes in Research Committee (joint committee of the American Fisheries Society, the American Institute of Fishery Research Biologists

2014-01-01

The 2004 and 2014 Guidelines were developed to provide a structure that advances appropriate attention toward valid experimental designs and procedures with aquatic animals while ensuring humane treatment of the experimental subjects. At a practical level, the Guidelines are intended to provide general recommendations on field and laboratory endeavors, such as sampling, holding, and handling fishes; to offer information on administrative matters, including regulations and permits; and to address typical ethical concerns, such as perceptions of pain or discomfort experienced by experimental subjects. These Guidelines must be recognized as guidelines. They are not intended to provide detailed instructions but rather to alert investigators to a broad array of topics and concerns to consider prior to initiating study. At a comprehensive level, the principles upon which these Guidelines are based are broadly applicable, and many of the described practices and approaches can be adapted to situations involving other aquatic animal species and conditions. Understanding the differences between fishes and other vertebrates, especially mammals, is critically important to conducting scientifically sound research with fishes. Disparities in life histories and mortality rates in fishes versus other vertebrates are critical in designing sustainable sampling levels in fish populations. The UFR Committee points out that (1) compared to mammalian populations, adult populations of many fish species persist despite very high natural mortality rates in juvenile stages by virtue of the fact that most species lay thousands or tens of thousands of eggs; (2) because of these mortality patterns, research on fishes, especially field research or research on early life stages, can involve, and often requires, much larger numbers of research subjects than does research on mammals; and (3) the animal handling and husbandry requirements for fishes are fundamentally different from those for

The General Aggression Model

NARCIS (Netherlands)

Allen, Johnie J.; Anderson, Craig A.; Bushman, Brad J.

The General Aggression Model (GAM) is a comprehensive, integrative, framework for understanding aggression. It considers the role of social, cognitive, personality, developmental, and biological factors on aggression. Proximate processes of GAM detail how person and situation factors influence

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

NARCIS (Netherlands)

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

2012-01-01

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

Enhancing health care professionals' and trainees' knowledge of physical activity guidelines for adults with and without SCI.

Science.gov (United States)

Shirazipour, Celina H; Tomasone, Jennifer R; Martin Ginis, Kathleen A

2018-01-11

Health care providers (HCPs) are preferred sources of physical activity (PA) information; however, minimal research has explored HCPs' knowledge of spinal cord injury (SCI) PA guidelines, and no research has examined HCP trainees' PA guideline knowledge. The current study explored HCPs' and trainees' initial knowledge of PA guidelines for both adults with SCI and the general population, and the utility of an event-based intervention for improving this knowledge. Participants (HCPs n = 129; trainees n = 573) reported guideline knowledge for both sets of guidelines (SCI and general population) immediately after, one-month, and six-months following the intervention. Frequencies determined guideline knowledge at each timepoint, while chi-squared tests examined differences in knowledge of both guidelines, as well as knowledge differences in the short- and long-term. Results demonstrated that HCPs and trainees lack knowledge of PA guidelines, particularly guidelines for adults with SCI. The results further suggest that a single event-based intervention is not effective for improving long-term guideline knowledge. Suggestions are made for future research with the aim of improving interventions that target HCP and HCP trainees' long-term guideline knowledge for adults with SCI and the general population.

Guidelines for indoor air hygiene in school buildings

Energy Technology Data Exchange (ETDEWEB)

Moriske, Heinz-Joern; Szewzyk, Regine (eds.)

2008-08-15

The new guidelines for indoor air hygiene in school buildings are intended as a response to current requirements in school practice. The recommendations aim to help to avoid mistakes in modernising school buildings and to provide hygiene-specific support in planning of new school buildings. The guidelines are laid out as follows: (a) In the general section the targets of the guidelines and the target groups are addressed. The current indoor hygiene situation in German schools is described, followed by the parameters with regard to peripheral issues which will not be dealt with further; (b) Part A deals with the hygiene requirements in the practical running of schools. Besides general requirements for maintenance and operation the important issues of cleaning and ventilation are considered, as well as minor building works; (c) Part B provides an overview of important chemical and biological contaminants in schools; (d) Part C looks at building and air conditioning requirements. The important issues of acoustic requirements is also addressed; (e) Part D shows how to deal practically with problem cases and list case studies with 'typical' procedures; (f) Part E provides a brief overview of existing renovation guidelines.

Guidelines for indoor air hygiene in school buildings

Energy Technology Data Exchange (ETDEWEB)

Moriske, Heinz-Joern; Szewzyk, Regine [eds.

2008-08-15

The new guidelines for indoor air hygiene in school buildings are intended as a response to current requirements in school practice. The recommendations aim to help to avoid mistakes in modernising school buildings and to provide hygiene-specific support in planning of new school buildings. The guidelines are laid out as follows: (a) In the general section the targets of the guidelines and the target groups are addressed. The current indoor hygiene situation in German schools is described, followed by the parameters with regard to peripheral issues which will not be dealt with further; (b) Part A deals with the hygiene requirements in the practical running of schools. Besides general requirements for maintenance and operation the important issues of cleaning and ventilation are considered, as well as minor building works; (c) Part B provides an overview of important chemical and biological contaminants in schools; (d) Part C looks at building and air conditioning requirements. The important issues of acoustic requirements is also addressed; (e) Part D shows how to deal practically with problem cases and list case studies with 'typical' procedures; (f) Part E provides a brief overview of existing renovation guidelines.

Generalized bi-additive modelling for categorical data

NARCIS (Netherlands)

P.J.F. Groenen (Patrick); A.J. Koning (Alex)

2004-01-01

textabstractGeneralized linear modelling (GLM) is a versatile technique, which may be viewed as a generalization of well-known techniques such as least squares regression, analysis of variance, loglinear modelling, and logistic regression. In may applications, low-order interaction (such as

Generalized latent variable modeling multilevel, longitudinal, and structural equation models

CERN Document Server

Skrondal, Anders; Rabe-Hesketh, Sophia

2004-01-01

This book unifies and extends latent variable models, including multilevel or generalized linear mixed models, longitudinal or panel models, item response or factor models, latent class or finite mixture models, and structural equation models.

Designing Instructional Materials: Some Guidelines.

Science.gov (United States)

Burbank, Lucille; Pett, Dennis

Guidelines for the design of instructional materials are outlined in this paper. The principles of design are presented in five major categories: (1) general design (structural appeal and personal appeal); (2) instructional design (attention, memory, concept learning, and attitude change); (3) visual design (media considerations, pictures, graphs…

On the Use of Generalized Volume Scattering Models for the Improvement of General Polarimetric Model-Based Decomposition

Directory of Open Access Journals (Sweden)

Qinghua Xie

2017-01-01

Full Text Available Recently, a general polarimetric model-based decomposition framework was proposed by Chen et al., which addresses several well-known limitations in previous decomposition methods and implements a simultaneous full-parameter inversion by using complete polarimetric information. However, it only employs four typical models to characterize the volume scattering component, which limits the parameter inversion performance. To overcome this issue, this paper presents two general polarimetric model-based decomposition methods by incorporating the generalized volume scattering model (GVSM or simplified adaptive volume scattering model, (SAVSM proposed by Antropov et al. and Huang et al., respectively, into the general decomposition framework proposed by Chen et al. By doing so, the final volume coherency matrix structure is selected from a wide range of volume scattering models within a continuous interval according to the data itself without adding unknowns. Moreover, the new approaches rely on one nonlinear optimization stage instead of four as in the previous method proposed by Chen et al. In addition, the parameter inversion procedure adopts the modified algorithm proposed by Xie et al. which leads to higher accuracy and more physically reliable output parameters. A number of Monte Carlo simulations of polarimetric synthetic aperture radar (PolSAR data are carried out and show that the proposed method with GVSM yields an overall improvement in the final accuracy of estimated parameters and outperforms both the version using SAVSM and the original approach. In addition, C-band Radarsat-2 and L-band AIRSAR fully polarimetric images over the San Francisco region are also used for testing purposes. A detailed comparison and analysis of decomposition results over different land-cover types are conducted. According to this study, the use of general decomposition models leads to a more accurate quantitative retrieval of target parameters. However, there

Development of clinical practice guidelines.

Science.gov (United States)

Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

2014-01-01

Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

Adherence to management guidelines for childhood asthma in Australia.

Science.gov (United States)

Bereznicki, Bonnie J; Beggs, Sean; Duff, Caitlin; Bereznicki, Luke

2015-12-01

Little is known about doctors' treatment preferences for childhood asthma. The aim of this study was to investigate adherence to management guidelines for childhood asthma. One thousand general practitioners (GPs) and paediatric specialists in Australia were invited to take part in a survey, which collected demographic details and explored their familiarity with and adherence to childhood asthma management guidelines. Two hundred doctors (20% response rate) responded and were eligible for inclusion in the survey. Approximately half (54.5%) of the respondents were very familiar with at least one of the childhood asthma management guidelines. The majority of respondents (86.8%) followed guideline recommendations when prescribing initial maintenance therapy for childhood asthma, while 89.2% and 68.0% followed guideline recommendations regarding step-up and step-down therapy respectively. Overall familiarity with childhood asthma management guidelines could be improved. There is scope for improvement in the adherence to these guidelines when prescribing medication in childhood asthma, particularly for step-down therapy.

Simple implementation of general dark energy models

International Nuclear Information System (INIS)

Bloomfield, Jolyon K.; Pearson, Jonathan A.

2014-01-01

We present a formalism for the numerical implementation of general theories of dark energy, combining the computational simplicity of the equation of state for perturbations approach with the generality of the effective field theory approach. An effective fluid description is employed, based on a general action describing single-scalar field models. The formalism is developed from first principles, and constructed keeping the goal of a simple implementation into CAMB in mind. Benefits of this approach include its straightforward implementation, the generality of the underlying theory, the fact that the evolved variables are physical quantities, and that model-independent phenomenological descriptions may be straightforwardly investigated. We hope this formulation will provide a powerful tool for the comparison of theoretical models of dark energy with observational data

A generalized methodology for identification of threshold for HRU delineation in SWAT model

Science.gov (United States)

M, J.; Sudheer, K.; Chaubey, I.; Raj, C.

2016-12-01

The distributed hydrological model, Soil and Water Assessment Tool (SWAT) is a comprehensive hydrologic model widely used for making various decisions. The simulation accuracy of the distributed hydrological model differs due to the mechanism involved in the subdivision of the watershed. Soil and Water Assessment Tool (SWAT) considers sub-dividing the watershed and the sub-basins into small computing units known as 'hydrologic response units (HRU). The delineation of HRU is done based on unique combinations of land use, soil types, and slope within the sub-watersheds, which are not spatially defined. The computations in SWAT are done at HRU level and are then aggregated up to the sub-basin outlet, which is routed through the stream system. Generally, the HRUs are delineated by considering a threshold percentage of land use, soil and slope are to be given by the modeler to decrease the computation time of the model. The thresholds constrain the minimum area for constructing an HRU. In the current HRU delineation practice in SWAT, the land use, soil and slope of the watershed within a sub-basin, which is less than the predefined threshold, will be surpassed by the dominating land use, soil and slope, and introduce some level of ambiguity in the process simulations in terms of inappropriate representation of the area. But the loss of information due to variation in the threshold values depends highly on the purpose of the study. Therefore this research studies the effects of threshold values of HRU delineation on the hydrological modeling of SWAT on sediment simulations and suggests guidelines for selecting the appropriate threshold values considering the sediment simulation accuracy. The preliminary study was done on Illinois watershed by assigning different thresholds for land use and soil. A general methodology was proposed for identifying an appropriate threshold for HRU delineation in SWAT model that considered computational time and accuracy of the simulation

The 2015 Dutch food-based dietary guidelines.

Science.gov (United States)

Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M

2016-08-01

The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.

How do SAGES members rate its guidelines?

Science.gov (United States)

Hope, William W; Richardson, William; Fanelli, Robert; Stefanidis, Dimitrios

2014-04-01

The development of practice guidelines should take into consideration the opinions of end users. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has implemented several changes in its guideline development and dissemination process based on previous end-user input. An anonymous electronic survey was conducted via e-mail solicitation in September 2011. Respondents were asked to submit their feedback on the 26 guidelines produced by our society using a 32-item questionnaire and to suggest topics for new guideline development and areas of improvement. Responses from the survey were received by 494 people, of whom 474 (96 %) were clinicians; 373 (75 %) were general, laparoscopic, or bariatric surgeons; and 324 (65 %) held leadership roles within their institution. Most respondents were 35-44 years old (36 %), male (83 %), and had been in practice for over 10 years (54 %). A total of 383 (81 %) had used our guidelines, and, of those, 96 % agreed with their content. Guideline quality was rated 4.34; value 4.27; and ease of access 3.97 on a five-point Likert scale. The most commonly referenced guideline in the survey regarded surgical treatment of reflux (67 %), followed by laparoscopy during pregnancy (51 %). The three most common reasons guidelines were accessed were to update knowledge (68 %), to maximize patient care through evidence-based treatment (51 %), and to obtain a critical literature review. The majority of respondents indicated they greatly value and agree with our guidelines. These results indicate that recent efforts to improve our guidelines have succeeded.

K-Basins design guidelines

International Nuclear Information System (INIS)

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

1995-06-01

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

Guidelines - let's take a break and then move forward together!

DEFF Research Database (Denmark)

Bro, Flemming; Waldorff, Frans Boch

2004-01-01

With our limited resources, the national colleges of general practice in the Nordic countries should select only a few important topics and only get involved in guideline preparations if they have a primary care perspective. We need not develop our own guidelines from scratch, but should take...

Moderation in the Certificates of General Education for Adults. Guidelines for Providers.

Science.gov (United States)

Council of Adult Education, Melbourne (Australia).

This document provides guidelines for the process of moderation and verification of assessments for educators involved in adult education. As used in the education establishment in Australia, "moderation" is the process of ensuring the standardization of assessment. Through the moderation process, assessment procedures conducted in a…

Guidelines for District Heating Substations

Energy Technology Data Exchange (ETDEWEB)

2009-07-15

The present guidelines contain a set of recommendations focusing on planning, installation, use and maintenance of district heating (DH) substations within district heating systems throughout Europe. The recommendations were developed in order to enable readers to develop well-functioning substations and an effective heat and domestic warm water delivery. These guidelines are intended to give the most effective overall solutions for various parts of the customer installation. The guidelines are not meant to specify the different components of the substation such as meters or heat exchangers. The guidelines deal with a wide variety of issues concerning both present systems of today and district heating systems of the future. Specific handling and maintenance recommendations are mainly focused on present modern systems but are also intended to cover the future situation as much as is feasible. For this reason, certain existing systems are not dealt with in these guidelines. For instance, these guidelines do not cover steam systems, systems with temperatures exceeding 110 deg C and pressure levels above 1.6 MPa. The guidelines include a chapter on the heat meter, as the meter and especially the meter installation is always installed simultaneously with the rest of the substation. These guidelines aim to provide best-practice and easy-to-handle recommendations for: - those who are responsible for relations between district heating utilities and customers; - those who own or maintain a building connected to the district heating network; - those who manufacture, plan, purchase, test and install substations. These guidelines do not deal with investment or cost aspects, but in general, Euroheat and Power recommends looking at the lifetime cost of all components of the substation, instead of investment costs alone. An example of this is provided in Chapter 7.8. The Guidelines were developed based on the most optimal operating principles of substations and meters

10 CFR 436.102 - General operations plan format and content.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false General operations plan format and content. 436.102... PROGRAMS Guidelines for General Operations Plans § 436.102 General operations plan format and content. (a... effective date of these guidelines, a general operations 10-year plan which shall consist of two parts, an...

[Use of multiple regression models in observational studies (1970-2013) and requirements of the STROBE guidelines in Spanish scientific journals].

Science.gov (United States)

Real, J; Cleries, R; Forné, C; Roso-Llorach, A; Martínez-Sánchez, J M

In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed. A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science. Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline. A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Guidelines - let's take a break and then move forward together!

DEFF Research Database (Denmark)

Bro, Flemming; Waldorff, Frans Boch

2004-01-01

With our limited resources, the national colleges of general practice in the Nordic countries should select only a few important topics and only get involved in guideline preparations if they have a primary care perspective. We need not develop our own guidelines from scratch, but should take exi...

Actuarial statistics with generalized linear mixed models

NARCIS (Netherlands)

Antonio, K.; Beirlant, J.

2007-01-01

Over the last decade the use of generalized linear models (GLMs) in actuarial statistics has received a lot of attention, starting from the actuarial illustrations in the standard text by McCullagh and Nelder [McCullagh, P., Nelder, J.A., 1989. Generalized linear models. In: Monographs on Statistics

Medical guidelines presentation and comparing with Electronic Health Record.

Science.gov (United States)

Veselý, Arnost; Zvárová, Jana; Peleska, Jan; Buchtela, David; Anger, Zdenek

2006-01-01

Electronic Health Record (EHR) systems are now being developed in many places. More advanced systems provide also reminder facilities, usually based on if-then rules. In this paper we propose a method how to build the reminder facility directly upon the guideline interchange format (GLIF) model of medical guidelines. The method compares data items on the input of EHR system with medical guidelines GLIF model and is able to reveal if the input data item, that represents patient diagnosis or proposed patient treatment, contradicts with medical guidelines or not. The reminder facility can be part of EHR system itself or it can be realized by a stand-alone reminder system (SRS). The possible architecture of stand-alone reminder system is described in this paper and the advantages of stand-alone solution are discussed. The part of the EHR system could be also a browser that would present graphical GLIF model in easy to understand manner on the user screen. This browser can be data driven and focus attention of user to the relevant part of medical guidelines GLIF model.

Guidelines on acute gastroenteritis in children: a critical appraisal of their quality and applicability in primary care

Directory of Open Access Journals (Sweden)

van den Berg José

2011-12-01

Full Text Available Abstract Background Reasons for poor guideline adherence in acute gastroenteritis (AGE in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice. The aim of this study was to assess the quality of international guidelines on AGE in children and investigate the generalizability of the recommendations to general practice. Methods Guidelines were retrieved from websites of professional medical organisations and websites of institutes involved in guideline development. In addition, a systematic search of the literature was performed. Articles were selected if they were a guideline, consensus statement or care protocol. Results Eight guidelines met the inclusion criteria, the quality of the guidelines varied. 242 recommendations on diagnosis and management were found, of which 138 (57% were based on evidence. There is a large variety in the classification of symptoms to different categories of dehydration. No signs are generalizable to general practice. It is consistently recommended to use hypo-osmolar ORS, however, the recommendations on ORS-dosage are not evidence based and are inconsistent. One of 14 evidence based recommendations on therapy of AGE is based on outpatient research and is therefore generalizable to general practice. Conclusions The present study shows considerable variation in the quality of guidelines on AGE in children, as well as inconsistencies between the recommendations. It remains unclear how to asses the extent of dehydration and determine the preferred treatment or referral of a young child with AGE presenting in general practice.

Correlates of Achieving the Guidelines of Four Forms of Physical Activity, and the Relationship between Guidelines Achievement and Academic Performance: Undergraduate Students in Finland.

Science.gov (United States)

El Ansari, Walid; Suominen, Sakari; Draper, Steve

2017-06-01

We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles. Copyright© by the

Modelling guidelines for core exit temperature simulations with system codes

Energy Technology Data Exchange (ETDEWEB)

Freixa, J., E-mail: jordi.freixa-terradas@upc.edu [Department of Physics and Nuclear Engineering, Technical University of Catalonia (UPC) (Spain); Paul Scherrer Institut (PSI), 5232 Villigen (Switzerland); Martínez-Quiroga, V., E-mail: victor.martinez@nortuen.com [Department of Physics and Nuclear Engineering, Technical University of Catalonia (UPC) (Spain); Zerkak, O., E-mail: omar.zerkak@psi.ch [Paul Scherrer Institut (PSI), 5232 Villigen (Switzerland); Reventós, F., E-mail: francesc.reventos@upc.edu [Department of Physics and Nuclear Engineering, Technical University of Catalonia (UPC) (Spain)

2015-05-15

Highlights: • Core exit temperature is used in PWRs as an indication of core heat up. • Modelling guidelines of CET response with system codes. • Modelling of heat transfer processes in the core and UP regions. - Abstract: Core exit temperature (CET) measurements play an important role in the sequence of actions under accidental conditions in pressurized water reactors (PWR). Given the difficulties in placing measurements in the core region, CET readings are used as criterion for the initiation of accident management (AM) procedures because they can indicate a core heat up scenario. However, the CET responses have some limitation in detecting inadequate core cooling and core uncovery simply because the measurement is not placed inside the core. Therefore, it is of main importance in the field of nuclear safety for PWR power plants to assess the capabilities of system codes for simulating the relation between the CET and the peak cladding temperature (PCT). The work presented in this paper intends to address this open question by making use of experimental work at integral test facilities (ITF) where experiments related to the evolution of the CET and the PCT during transient conditions have been carried out. In particular, simulations of two experiments performed at the ROSA/LSTF and PKL facilities are presented. The two experiments are part of a counterpart exercise between the OECD/NEA ROSA-2 and OECD/NEA PKL-2 projects. The simulations are used to derive guidelines in how to correctly reproduce the CET response during a core heat up scenario. Three aspects have been identified to be of main importance: (1) the need for a 3-dimensional representation of the core and Upper Plenum (UP) regions in order to model the heterogeneity of the power zones and axial areas, (2) the detailed representation of the active and passive heat structures, and (3) the use of simulated thermocouples instead of steam temperatures to represent the CET readings.

EFOM 12C software: general overview. Final report

Energy Technology Data Exchange (ETDEWEB)

Jadot, P; Fuchsova, J; Vankelecom, E; Van der Voort, E; Thonet, C

1981-01-01

A logic manual defining the general philosophy of the EC-12C software is presented. The guidelines used to develop the Energy Data Base and the programs of the energy flow models are: within the frame of some basic conventions, the data base structure and software should be as independent as possible from the energy system representation; utilization of the models should be user-friendly; as data has to be collected and manipulated by various national expert teams, extensive data consistency checks and appropriate error messages should be included in the software to support the data validation process; the various energy flow models should be integrated; the outputs of the programs should be user-controlled; and the scope of the study is under user's control. As a result of those guidelines, an integrated set of software composed of DAMOCLES (Data Base Management System); SIML (simulation program suitable for data analysis and description study); and ORESTE EDISON (LP matrix generator and report writer) was developed. These are described.

Clinical guideline implementation strategies for common mental health disorders.

Science.gov (United States)

Moreno, Eliana María; Moriana, Juan Antonio

2016-01-01

There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide. A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope. A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%). Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments. Copyright © 2015. Published by Elsevier España.

Guidelines for reporting evaluations based on observational methodology.

Science.gov (United States)

Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

2015-01-01

Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.

Implementation of a next-generation electronic nursing records system based on detailed clinical models and integration of clinical practice guidelines.

Science.gov (United States)

Min, Yul Ha; Park, Hyeoun-Ae; Chung, Eunja; Lee, Hyunsook

2013-12-01

The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

Time to detoxify medical literature from guideline overdose

Institute of Scientific and Technical Information of China (English)

Dinesh Vyas; Arpita K Vyas

2012-01-01

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product (GDP)in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Executive summary

International Nuclear Information System (INIS)

Simmons, C.S.; Cole, C.R.

1985-05-01

This document was written to provide guidance to managers and site operators on how ground-water transport codes should be selected for assessing burial site performance. There is a need for a formal approach to selecting appropriate codes from the multitude of potentially useful ground-water transport codes that are currently available. Code selection is a problem that requires more than merely considering mathematical equation-solving methods. These guidelines are very general and flexible and are also meant for developing systems simulation models to be used to assess the environmental safety of low-level waste burial facilities. Code selection is only a single aspect of the overall objective of developing a systems simulation model for a burial site. The guidance given here is mainly directed toward applications-oriented users, but managers and site operators need to be familiar with this information to direct the development of scientifically credible and defensible transport assessment models. Some specific advice for managers and site operators on how to direct a modeling exercise is based on the following five steps: identify specific questions and study objectives; establish costs and schedules for achieving answers; enlist the aid of professional model applications group; decide on approach with applications group and guide code selection; and facilitate the availability of site-specific data. These five steps for managers/site operators are discussed in detail following an explanation of the nine systems model development steps, which are presented first to clarify what code selection entails

Systematic evaluation of clinical practice guidelines for pharmacogenomics.

Science.gov (United States)

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

2018-06-01

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

Systematic review of recent dementia practice guidelines.

Science.gov (United States)

Ngo, Jennifer; Holroyd-Leduc, Jayna M

2015-01-01

dementia is a highly prevalent acquired cognitive disorder that interferes with activities of daily living, relationships and quality of life. Recognition and effective management strategies are necessary to provide comprehensive care for these patients and their families. High-quality clinical practice guidelines can improve the quality and consistency of care in all aspects of dementia diagnosis and management by clarifying interventions supported by sound evidence and by alerting clinicians to interventions without proven benefit. we aimed to offer a synthesis of existing practice recommendations for the diagnosis and management of dementia, based upon moderate-to-high quality dementia guidelines. we performed a systematic search in EMBASE and MEDLINE as well as the grey literature for guidelines produced between 2008 and 2013. thirty-nine retrieved practice guidelines were included for quality appraisal by the Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool, performed by two independent reviewers. From the 12 moderate-to-high quality guidelines included, specific practice recommendations for the diagnosis and/or management of any aspect of dementia were extracted for comparison based upon the level of evidence and strength of recommendation. there was a general agreement between guidelines for many practice recommendations. However, direct comparisons between guidelines were challenging due to variations in grading schemes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Generalized QMRA Beta-Poisson Dose-Response Model.

Science.gov (United States)

Xie, Gang; Roiko, Anne; Stratton, Helen; Lemckert, Charles; Dunn, Peter K; Mengersen, Kerrie

2016-10-01

Quantitative microbial risk assessment (QMRA) is widely accepted for characterizing the microbial risks associated with food, water, and wastewater. Single-hit dose-response models are the most commonly used dose-response models in QMRA. Denoting PI(d) as the probability of infection at a given mean dose d, a three-parameter generalized QMRA beta-Poisson dose-response model, PI(d|α,β,r*), is proposed in which the minimum number of organisms required for causing infection, K min , is not fixed, but a random variable following a geometric distribution with parameter 0Poisson model, PI(d|α,β), is a special case of the generalized model with K min = 1 (which implies r*=1). The generalized beta-Poisson model is based on a conceptual model with greater detail in the dose-response mechanism. Since a maximum likelihood solution is not easily available, a likelihood-free approximate Bayesian computation (ABC) algorithm is employed for parameter estimation. By fitting the generalized model to four experimental data sets from the literature, this study reveals that the posterior median r* estimates produced fall short of meeting the required condition of r* = 1 for single-hit assumption. However, three out of four data sets fitted by the generalized models could not achieve an improvement in goodness of fit. These combined results imply that, at least in some cases, a single-hit assumption for characterizing the dose-response process may not be appropriate, but that the more complex models may be difficult to support especially if the sample size is small. The three-parameter generalized model provides a possibility to investigate the mechanism of a dose-response process in greater detail than is possible under a single-hit model. © 2016 Society for Risk Analysis.

The changing Chinese SEA indicator guidelines

DEFF Research Database (Denmark)

Gao, Jingjing; Christensen, Per; Kørnøv, Lone

2014-01-01

general trends in the development of SEA and other environmental policies in a recent, Chinese context. Beside a more top-down, intentional approach specifying indicators for different sectors based on Chinese experiences from the preceding years, another significant change, following the new guidelines...

Bayesian Subset Modeling for High-Dimensional Generalized Linear Models

KAUST Repository

Liang, Faming

2013-06-01

This article presents a new prior setting for high-dimensional generalized linear models, which leads to a Bayesian subset regression (BSR) with the maximum a posteriori model approximately equivalent to the minimum extended Bayesian information criterion model. The consistency of the resulting posterior is established under mild conditions. Further, a variable screening procedure is proposed based on the marginal inclusion probability, which shares the same properties of sure screening and consistency with the existing sure independence screening (SIS) and iterative sure independence screening (ISIS) procedures. However, since the proposed procedure makes use of joint information from all predictors, it generally outperforms SIS and ISIS in real applications. This article also makes extensive comparisons of BSR with the popular penalized likelihood methods, including Lasso, elastic net, SIS, and ISIS. The numerical results indicate that BSR can generally outperform the penalized likelihood methods. The models selected by BSR tend to be sparser and, more importantly, of higher prediction ability. In addition, the performance of the penalized likelihood methods tends to deteriorate as the number of predictors increases, while this is not significant for BSR. Supplementary materials for this article are available online. © 2013 American Statistical Association.

Isolated systems with wind power. An implementation guideline

Energy Technology Data Exchange (ETDEWEB)

Clausen, N.E.; Bindner, H.; Frandsen, S.; Hansen, J.C.; Hansen, L.H.; Lundsager, P.

2001-06-01

The overall objective of this research project is to study the development of methods and guidelines rather than 'universal solutions' for the use of wind energy in isolated communities. So far most studies of isolated systems with wind power have been case-oriented and it has proven difficult to extend results from one project to another, not least due to the strong individuality that has characterised such systems in design and implementation. In the present report a unified and generally applicable approach is attempted in order to support a fair assessment of the technical and economical feasibility of isolated power supply systems with wind energy. General guidelines and checklists on which facts and data are needed to carry out a project feasibility analysis are presented as well as guidelines how to carry out the project feasibility study and the environmental analysis. The report outlines the results of the project as a set of proposed guidelines to be applied when developing a project containing an application of wind in an isolated power system. It is the author's hope that this will facilitate the development of projects and enhance electrification of small rural communities in developing countries. (au)

Sector-specific issues and reporting methodologies supporting the General Guidelines for the voluntary reporting of greenhouse gases under Section 1605(b) of the Energy Policy Act of 1992. Volume 2: Part 4, Transportation sector; Part 5, Forestry sector; Part 6, Agricultural sector

International Nuclear Information System (INIS)

1994-10-01

This volume, the second of two such volumes, contains sector-specific guidance in support of the General Guidelines for the voluntary reporting of greenhouse gas emissions and carbon sequestration. This voluntary reporting program was authorized by Congress in Section 1605(b) of the Energy Policy Act of 1992. The General Guidelines, bound separately from this volume, provide the overall rationale for the program, discuss in general how to analyze emissions and emission reduction/carbon sequestration projects, and address programmatic issues such as minimum reporting requirements, time parameters, international projects, confidentiality, and certification. Together, the General Guidelines and the guidance in these supporting documents will provide concepts and approaches needed to prepare the reporting forms. This second volume of sector-specific guidance covers the transportation sector, the forestry sector, and the agricultural sector

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

Science.gov (United States)

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

2017-10-01

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

Cryogenic Safety Rules and Guidelines at CERN

CERN Multimedia

CERN. Geneva

2016-01-01

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

Guidelines for Sandia ASCI Verification and Validation Plans - Content and Format: Version 1.0

Energy Technology Data Exchange (ETDEWEB)

TRUCANO,TIMOTHY G.; MOYA,JAIME L.

1999-12-01

This report summarizes general guidelines for the development of Verification and Validation (V and V) plans for ASCI code projects at Sandia National Laboratories. The main content categories recommended by these guidelines for explicit treatment in Sandia V and V plans are (1) stockpile drivers influencing the code development project (2) the key phenomena to be modeled by the individual code; (3) software verification strategy and test plan; and (4) code validation strategy and test plans. The authors of this document anticipate that the needed content of the V and V plans for the Sandia ASCI codes will evolve as time passes. These needs will be reflected by future versions of this document.

Curriculum Guidelines for a Distance Education Course in Urban Agriculture Based on an Eclectic Model.

Science.gov (United States)

Gaum, Wilma G.; van Rooyen, Hugo G.

1997-01-01

Describes research to develop curriculum guidelines for a distance education course in urban agriculture. The course, designed to train the teacher, is based on an eclectic curriculum design model. The course is aimed at the socioeconomic empowerment of urban farmers and is based on sustainable ecological-agricultural principles, an…

EAACI Guidelines on Allergen Immunotherapy

DEFF Research Database (Denmark)

Sturm, Gunter J; Varga, Eva-Maria; Roberts, Graham

2018-01-01

and adults to prevent further moderate to severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline auto-injector. This guideline aims to give...... practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence-based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence. This article...

A Generalized Deduction of the Ideal-Solution Model

Science.gov (United States)

Leo, Teresa J.; Perez-del-Notario, Pedro; Raso, Miguel A.

2006-01-01

A new general procedure for deriving the Gibbs energy of mixing is developed through general thermodynamic considerations, and the ideal-solution model is obtained as a special particular case of the general one. The deduction of the Gibbs energy of mixing for the ideal-solution model is a rational one and viewed suitable for advanced students who…

Predictive analytics in mental health: applications, guidelines, challenges and perspectives.

Science.gov (United States)

Hahn, T; Nierenberg, A A; Whitfield-Gabrieli, S

2017-01-01

The emerging field of 'predictive analytics in mental health' has recently generated tremendous interest with the bold promise to revolutionize clinical practice in psychiatry paralleling similar developments in personalized and precision medicine. Here, we provide an overview of the key questions and challenges in the field, aiming to (1) propose general guidelines for predictive analytics projects in psychiatry, (2) provide a conceptual introduction to core aspects of predictive modeling technology, and (3) foster a broad and informed discussion involving all stakeholders including researchers, clinicians, patients, funding bodies and policymakers.

Revised dietary guidelines for Koreans.

Science.gov (United States)

Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

2008-01-01

With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

Guideline adherence for pharmacotherapy of chronic systolic heart failure in general practice: a closer look on evidence-based therapy.

Science.gov (United States)

Peters-Klimm, F; Müller-Tasch, T; Schellberg, D; Remppis, A; Barth, A; Holzapfel, N; Jünger, J; Herzog, W; Szecsenyi, J

2008-04-01

There is robust evidence for effective pharmacotherapy of chronic (systolic) heart failure (CHF) which has led to the creation of guidelines, but many surveys evaluating CHF treatment show an under-utilisation of relevant drugs, while setting and patient population appear to be crucial for adequate appraisal of treatment patterns. To evaluate the guideline adherence (GA) of general practitioners (GPs) in a well-defined patient population with CHF in primary care (PC). A cross-sectional analysis was performed with the data of 167 patients enrolled in 37 GP practices (Germany) with documented left ventricular systolic dysfunction (LVEF: 33.3 +/- 6.9%). GA was assessed as usual (prescribing "yes" or "no"), through evaluation of target dosing, while adjusting for potential clinical contraindications, and through a modified Guideline Adherence Indicator-3 (mGAI-3), which assesses three relevant groups of substances according to New York Heart Association (NYHA) functional class: ACE-Inhibitors (ACE-I) or angiotensin receptor blockers (ARB), beta-blockers (BB) and aldosterone-antagonists (AA). Prescription rates for ACE-I/ARB, BB or both were 80%, 75% and 62%, respectively. The proportion of target doses reached for ACE-I was 16%, for BB only 8%. When adjusted for potential (mainly relative) contraindications (COPD, heart rate <60/min, hypotension, hyperkalaemia and renal dysfunction), the percentage of target doses reached increased to 49% for ACE-I/ARBs and 46% for BB. Application of the mGAI-3 showed moderate to perfect GA for usual assessment, proportion of target dose reached and adjusted in 83%, 16% and 55% of the patients, respectively. In the context of this patient and doctor setting, life-saving treatment was provided above average when assessed by usual criteria. The application of additional criteria showed further room for improvement. Future interventions aiming at optimisation should be tailored to the needs of doctors and patients likewise.

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

DEFF Research Database (Denmark)

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

2012-01-01

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

Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

Science.gov (United States)

Jauch, Edward C; Saver, Jeffrey L; Adams, Harold P; Bruno, Askiel; Connors, J J Buddy; Demaerschalk, Bart M; Khatri, Pooja; McMullan, Paul W; Qureshi, Adnan I; Rosenfield, Kenneth; Scott, Phillip A; Summers, Debbie R; Wang, David Z; Wintermark, Max; Yonas, Howard

2013-03-01

The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. Because many of the recommendations are based on limited data, additional research on treatment of acute ischemic stroke remains urgently needed.

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

Science.gov (United States)

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

2017-01-01

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

40 CFR 401.12 - Law authorizing establishment of effluent limitations guidelines for existing sources, standards...

Science.gov (United States)

2010-07-01

... effluent limitations guidelines for existing sources, standards of performance for new sources and... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.12 Law authorizing establishment of effluent limitations guidelines for existing sources, standards of performance...

Isolated systems with wind power. An implementation guideline

DEFF Research Database (Denmark)

Clausen, Niels-Erik; Bindner, Henrik W.; Frandsen, Sten Tronæs

2001-01-01

The overall objective of this research project is to study the development of methods and guidelines rather than "universal solutions" for the use of wind energy in isolated communities. So far most studies of isolated systems with wind power have beencase-oriented and it has proven difficult...... feasibility of isolated power supply systems with wind energy. General guidelines and checklists on which facts and data are needed to carry out a projectfeasibility analysis are presented as well as guidelines how to carry out the project feasibility study and the environmental analysis. The report outlines...... the results of the project as a set of proposed guidelines to be applied when developing a projectcontaining an application of wind in an isolated power system. It is the author's hope that this will facilitate the development of projects and enhance electrification of small rural communities in developing...

Validation of the 2014 European Society of Cardiology guidelines risk prediction model for the primary prevention of sudden cardiac death in hypertrophic cardiomyopathy.

Science.gov (United States)

Vriesendorp, Pieter A; Schinkel, Arend F L; Liebregts, Max; Theuns, Dominic A M J; van Cleemput, Johan; Ten Cate, Folkert J; Willems, Rik; Michels, Michelle

2015-08-01

The recently released 2014 European Society of Cardiology guidelines of hypertrophic cardiomyopathy (HCM) use a new clinical risk prediction model for sudden cardiac death (SCD), based on the HCM Risk-SCD study. Our study is the first external and independent validation of this new risk prediction model. The study population consisted of a consecutive cohort of 706 patients with HCM without prior SCD event, from 2 tertiary referral centers. The primary end point was a composite of SCD and appropriate implantable cardioverter-defibrillator therapy, identical to the HCM Risk-SCD end point. The 5-year SCD risk was calculated using the HCM Risk-SCD formula. Receiver operating characteristic curves and C-statistics were calculated for the 2014 European Society of Cardiology guidelines, and risk stratification methods of the 2003 American College of Cardiology/European Society of Cardiology guidelines and 2011 American College of Cardiology Foundation/American Heart Association guidelines. During follow-up of 7.7±5.3 years, SCD occurred in 42 (5.9%) of 706 patients (ages 49±16 years; 34% women). The C-statistic of the new model was 0.69 (95% CI, 0.57-0.82; P=0.008), which performed significantly better than the conventional risk factor models based on the 2003 guidelines (C-statistic of 0.55: 95% CI, 0.47-0.63; P=0.3), and 2011 guidelines (C-statistic of 0.60: 95% CI, 0.50-0.70; P=0.07). The HCM Risk-SCD model improves the risk stratification of patients with HCM for primary prevention of SCD, and calculating an individual risk estimate contributes to the clinical decision-making process. Improved risk stratification is important for the decision making before implantable cardioverter-defibrillator implantation for the primary prevention of SCD. © 2015 American Heart Association, Inc.

Topics in the generalized vector dominance model

International Nuclear Information System (INIS)

Chavin, S.

1976-01-01

Two topics are covered in the generalized vector dominance model. In the first topic a model is constructed for dilepton production in hadron-hadron interactions based on the idea of generalized vector-dominance. It is argued that in the high mass region the generalized vector-dominance model and the Drell-Yan parton model are alternative descriptions of the same underlying physics. In the low mass regions the models differ; the vector-dominance approach predicts a greater production of dileptons. It is found that the high mass vector mesons which are the hallmark of the generalized vector-dominance model make little contribution to the large yield of leptons observed in the transverse-momentum range 1 less than p/sub perpendicular/ less than 6 GeV. The recently measured hadronic parameters lead one to believe that detailed fits to the data are possible under the model. The possibility was expected, and illustrated with a simple model the extreme sensitivity of the large-p/sub perpendicular/ lepton yield to the large-transverse-momentum tail of vector-meson production. The second topic is an attempt to explain the mysterious phenomenon of photon shadowing in nuclei utilizing the contribution of the longitudinally polarized photon. It is argued that if the scalar photon anti-shadows, it could compensate for the transverse photon, which is presumed to shadow. It is found in a very simple model that the scalar photon could indeed anti-shadow. The principal feature of the model is a cancellation of amplitudes. The scheme is consistent with scalar photon-nucleon data as well. The idea is tested with two simple GVDM models and finds that the anti-shadowing contribution of the scalar photon is not sufficient to compensate for the contribution of the transverse photon. It is found doubtful that the scalar photon makes a significant contribution to the total photon-nuclear cross section

A Generalized Random Regret Minimization Model

NARCIS (Netherlands)

Chorus, C.G.

2013-01-01

This paper presents, discusses and tests a generalized Random Regret Minimization (G-RRM) model. The G-RRM model is created by replacing a fixed constant in the attribute-specific regret functions of the RRM model, by a regret-weight variable. Depending on the value of the regret-weights, the G-RRM

Smartphone Application of Primary Care Guidelines used in Education of Medical Students

Science.gov (United States)

Waldmann, Uta-Maria; Weckbecker, Klaus

2013-01-01

Background and Objective: The guidelines of the German College of General Practitioners and Family Physicians (DEGAM) on frequent and important reasons for encounter in Primary Care play a central role in the teaching of Family Medicine. They were edited by the authors into an app for mobile phones, making them available at all times to General Practitioners and medical students. This study examines the issue: how useful do students consider this application within their learning process in Family Medicine? Method: The short versions of the 15 DEGAM guidelines were processed as a web app (for all smartphone software systems) including offline utilisation, and offered to students in the Family Medicine course, during clinical attachments in General Practice, on elective compulsory courses or for their final year rotation in General Practice. The evaluation was made with a structured survey using the feedback function of the Moodle learning management system [http://www.elearning-allgemeinmedizin.de] with Likert scales and free-text comments. Results: Feedback for evaluation came from 14 (25%) of the student testers from the Family Medicine course (9), the clinical attachment in General Practice (1), the final year rotation in General Practice (1) and elective compulsory courses (4). Students rated the app as an additional benefit to the printed/pdf-form. They use it frequently and successfully during waiting periods and before, during, or after lectures. In addition to general interest and a desire to become acquainted with the guidelines and to learn, the app is consulted with regard to general (theoretical) questions, rather than in connection with contact with patients. Interest in and knowledge of the guidelines is stimulated by the app, and on the whole the application can be said to be well suited to the needs of this user group. Discussion: The students evaluated the guidelines app positively: as a modern way of familiarising them with the guidelines and

The DINA model as a constrained general diagnostic model: Two variants of a model equivalency.

Science.gov (United States)

von Davier, Matthias

2014-02-01

The 'deterministic-input noisy-AND' (DINA) model is one of the more frequently applied diagnostic classification models for binary observed responses and binary latent variables. The purpose of this paper is to show that the model is equivalent to a special case of a more general compensatory family of diagnostic models. Two equivalencies are presented. Both project the original DINA skill space and design Q-matrix using mappings into a transformed skill space as well as a transformed Q-matrix space. Both variants of the equivalency produce a compensatory model that is mathematically equivalent to the (conjunctive) DINA model. This equivalency holds for all DINA models with any type of Q-matrix, not only for trivial (simple-structure) cases. The two versions of the equivalency presented in this paper are not implied by the recently suggested log-linear cognitive diagnosis model or the generalized DINA approach. The equivalencies presented here exist independent of these recently derived models since they solely require a linear - compensatory - general diagnostic model without any skill interaction terms. Whenever it can be shown that one model can be viewed as a special case of another more general one, conclusions derived from any particular model-based estimates are drawn into question. It is widely known that multidimensional models can often be specified in multiple ways while the model-based probabilities of observed variables stay the same. This paper goes beyond this type of equivalency by showing that a conjunctive diagnostic classification model can be expressed as a constrained special case of a general compensatory diagnostic modelling framework. © 2013 The British Psychological Society.

Log-normal frailty models fitted as Poisson generalized linear mixed models.

Science.gov (United States)

Hirsch, Katharina; Wienke, Andreas; Kuss, Oliver

2016-12-01

The equivalence of a survival model with a piecewise constant baseline hazard function and a Poisson regression model has been known since decades. As shown in recent studies, this equivalence carries over to clustered survival data: A frailty model with a log-normal frailty term can be interpreted and estimated as a generalized linear mixed model with a binary response, a Poisson likelihood, and a specific offset. Proceeding this way, statistical theory and software for generalized linear mixed models are readily available for fitting frailty models. This gain in flexibility comes at the small price of (1) having to fix the number of pieces for the baseline hazard in advance and (2) having to "explode" the data set by the number of pieces. In this paper we extend the simulations of former studies by using a more realistic baseline hazard (Gompertz) and by comparing the model under consideration with competing models. Furthermore, the SAS macro %PCFrailty is introduced to apply the Poisson generalized linear mixed approach to frailty models. The simulations show good results for the shared frailty model. Our new %PCFrailty macro provides proper estimates, especially in case of 4 events per piece. The suggested Poisson generalized linear mixed approach for log-normal frailty models based on the %PCFrailty macro provides several advantages in the analysis of clustered survival data with respect to more flexible modelling of fixed and random effects, exact (in the sense of non-approximate) maximum likelihood estimation, and standard errors and different types of confidence intervals for all variance parameters. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Fire protection guidelines for nuclear power plants, June 1976

International Nuclear Information System (INIS)

Anon.

1977-01-01

Guidelines acceptable to the NRC staff for implementing in the development of a fire protection program for nuclear power plants. The purpose of the fire protection program is to ensure the capability to shut down the reactor and maintain it in a safe shutdown condition and to minimize radioactive releases to the environment in the event of a fire. If designs or methods different from the guidelines presented herein are used, they must provide fire protection comparable to that recommended in the guidelines. Suitable bases and justification should be provided for alternative approaches to establish acceptable implementation of General Design Criterion 3

Guidelines for authorities and operators from the EURATOM regulation according to nuclear safety

International Nuclear Information System (INIS)

Karpenstein, Ulrich

2010-01-01

At 22nd July, 2009 the guideline 2009/71/EURATOM on a community framework for the nuclear security of nuclear installations comes into effect. A lot of regulations of this guideline intervene very deeply in the competencies of the member states. In acknowledgment of the national responsibility for nuclear security, the guideline grants large free space to the member states. Thereby, the guideline aims at a general legal framework and a mutual learning process off.

A Note on the Identifiability of Generalized Linear Mixed Models

DEFF Research Database (Denmark)

Labouriau, Rodrigo

2014-01-01

I present here a simple proof that, under general regularity conditions, the standard parametrization of generalized linear mixed model is identifiable. The proof is based on the assumptions of generalized linear mixed models on the first and second order moments and some general mild regularity...... conditions, and, therefore, is extensible to quasi-likelihood based generalized linear models. In particular, binomial and Poisson mixed models with dispersion parameter are identifiable when equipped with the standard parametrization...

Guidelines for emergency laparoscopy

Directory of Open Access Journals (Sweden)

Sauerland Stefan

2006-10-01

Full Text Available Abstract Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain.

Guidelines for Urban Labs

DEFF Research Database (Denmark)

Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

2017-01-01

These guidelines are intended for team members and managers of urban labs and, more generally, for civil servants and facilitators in cities working with experimental processes to tackle complex challenges. They aim to support the everyday practice of collaboratively experimenting and learning ho...... the result is inspiring and instructive for all those who want to wrap their minds around experimental co-creative approaches to urban governance and city development....

Multiple phase transitions in the generalized Curie-Weiss model

International Nuclear Information System (INIS)

Eisele, T.; Ellis, R.S.

1988-01-01

The generalized Curie-Weiss model is an extension of the classical Curie-Weiss model in which the quadratic interaction function of the mean spin value is replaced by a more general interaction function. It is shown that the generalized Curie-Weiss model can have a sequence of phase transitions at different critical temperatures. Both first-order and second-order phase transitions can occur, and explicit criteria for the two types are given. Three examples of generalized Curie-Weiss models are worked out in detail, including one example with infinitely many phase transitions. A number of results are derived using large-deviation techniques

Guidelines on the prevention of built-in moisture

DEFF Research Database (Denmark)

Hansen, Ernst Jan de Place; Møller, Eva B.

2014-01-01

As a result of built-in-moisture, a number of buildings in Denmark were attacked by moulds even before the users moved in. Therefore, the Danish Building Regulations have since 2008 stipulated that building structures and materials must not, on moving in, have a moisture content that is liable...... the execution phase and the building’s capacity to withstand moisture. It also specifies how moisture should be dealt with in the general quality assurance system of the building industry. The Danish guideline is compared with similar guidelines and tools in other Nordic countries. The education of moisture...... specialists is emphasised and it is questioned whether a voluntary guideline will have the desired effect....

Guidelines for the editing of dissertations and theses: A survey of ...

African Journals Online (AJOL)

The general lack of explicit policy guidelines for the editing of dissertations and theses in South Africa, and the variation among sets of guidelines that do exist, create a possible ethical dilemma, with potential ramifications for the editor, the postgraduate student and the highereducation institution from which the qualification ...

Generalization of the quark rearrangement model

International Nuclear Information System (INIS)

Fields, T.; Chen, C.K.

1976-01-01

An extension and generalization of the quark rearrangement model of baryon annihilation is described which can be applied to all annihilation reactions and which incorporates some of the features of the highly successful quark parton model. Some p anti-p interactions are discussed

Guidelines for rating Global Assessment of Functioning (GAF

Directory of Open Access Journals (Sweden)

Aas IH Monrad

2011-01-01

Full Text Available Abstract Background Global Assessment of Functioning (GAF is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines. Methods A thorough literature search was conducted. Results Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1 general points about guidelines for rating GAF; (2 introduction to guidelines, with ground rules; (3 starting scoring at the top, middle or bottom level of the scale; (4 scoring for different time periods and of different values (highest, lowest or average; (5 the finer grading of the scale; (6 different guidelines for different conditions; and (7 different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding. Conclusions Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and

Nigerian Journal of General Practice: Submissions

African Journals Online (AJOL)

Author Guidelines. The Nigerian Journal of General Practice is the Official Publication of the Association of General and Private Medical Practitioners of Nigeria [AGPMPN] and a forum for family private/general practice medicine education and research. The Nigerian Journal of General Practice invites scholarly manuscripts ...

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

Science.gov (United States)

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

2011-01-01

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

A generalized logarithmic image processing model based on the gigavision sensor model.

Science.gov (United States)

Deng, Guang

2012-03-01

The logarithmic image processing (LIP) model is a mathematical theory providing generalized linear operations for image processing. The gigavision sensor (GVS) is a new imaging device that can be described by a statistical model. In this paper, by studying these two seemingly unrelated models, we develop a generalized LIP (GLIP) model. With the LIP model being its special case, the GLIP model not only provides new insights into the LIP model but also defines new image representations and operations for solving general image processing problems that are not necessarily related to the GVS. A new parametric LIP model is also developed. To illustrate the application of the new scalar multiplication operation, we propose an energy-preserving algorithm for tone mapping, which is a necessary step in image dehazing. By comparing with results using two state-of-the-art algorithms, we show that the new scalar multiplication operation is an effective tool for tone mapping.

Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Volume 1. Guideline approach

Energy Technology Data Exchange (ETDEWEB)

Simmons, C.S.; Cole, C.R.

1985-05-01

This document was written for the National Low-Level Waste Management Program to provide guidance for managers and site operators who need to select ground-water transport codes for assessing shallow-land burial site performance. The guidance given in this report also serves the needs of applications-oriented users who work under the direction of a manager or site operator. The guidelines are published in two volumes designed to support the needs of users having different technical backgrounds. An executive summary, published separately, gives managers and site operators an overview of the main guideline report. This volume includes specific recommendations for decision-making managers and site operators on how to use these guidelines. The more detailed discussions about the code selection approach are provided. 242 refs., 6 figs.

Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Volume 1. Guideline approach

International Nuclear Information System (INIS)

Simmons, C.S.; Cole, C.R.

1985-05-01

This document was written for the National Low-Level Waste Management Program to provide guidance for managers and site operators who need to select ground-water transport codes for assessing shallow-land burial site performance. The guidance given in this report also serves the needs of applications-oriented users who work under the direction of a manager or site operator. The guidelines are published in two volumes designed to support the needs of users having different technical backgrounds. An executive summary, published separately, gives managers and site operators an overview of the main guideline report. This volume includes specific recommendations for decision-making managers and site operators on how to use these guidelines. The more detailed discussions about the code selection approach are provided. 242 refs., 6 figs

The impacts of the 1995 financial institution environmental guidelines on power projects

International Nuclear Information System (INIS)

Weaver, K.L.; Schott, G.A.

1996-01-01

In 1995, two of the most influential international financial institutions, The World Bank and The US Export-Import Bank (Ex-Im Bank) issued new environmental guidelines. These guidelines, particularly the World Bank guidelines, are used as a benchmark for evaluating the environmental acceptability of a project by many financial institutions, project developers, private investors, the public, and many developing countries. The impact of these guidelines must be well understood by developers of power projects in order to obtain the necessary financing, in addition to attracting investors, and obtaining national approvals and general public acceptance

Sedation in a radiology department--do radiologists follow their own guidelines?

Science.gov (United States)

Eason, D; Chakraverty, S; Wildsmith, J A W

2011-05-01

The Royal College of Radiologists (RCR) published guidelines in 2003 which aimed to standardise and improve the safety of sedation in the modern Radiology department. As sedation requirements increase, we decided to audit our own departments understandings and practice with respect to sedation. A repeat audit cycle was performed following a re-educational lecture, one year later. Three common sedation case scenarios were incorporated into a questionnaire which detailed questioning on requirements for fasting, monitoring and the order and use of sedation drugs alongside analgesics. These were compared to the 2003 RCR guidelines. The audit was recycled at one year. Despite the RCR guidelines, freely available on the RCR website, there was a persisting variation in practice which revealed a lack of awareness of the requirements for adequate fasting and the importance of giving the opiate before the benzodiazepine (sedative) agent in cases where a combination are chosen. The audit did show a trend towards using shorter acting benzodiazepines, which is in keeping with the guidelines. Monitoring of vital signs was generally, well carried out. General awareness of the RCR guidelines for safe sedation in the Radiology department was initially low and practice found to be variable. Re-education saw some improvements but also, some persisting habitual deviations from the guidelines, particularly with respect to the order in which the opiate and sedative benzodiazepine were given.

Comparison of evaluation guidelines for life-safety seismic hazards

International Nuclear Information System (INIS)

Wyllie, L.A.; Love, R.J.

1989-01-01

The guidelines presented in Design Evaluation guidelines for Department of Energy Facilities Subjected to natural Phenomena Hazards (UCRL 15910 Draft; May 1989) include evaluation criteria for existing Department of Energy buildings subjected to earthquakes. These criteria were developed at the Lawrence Livermore National Laboratory for use in both the seismic design of new structures and the evaluation of existing structures. ATC-14: Evaluating The Seismic Resistance of Existing Buildings developed by the Applied Technology Council, consists of guidelines and criteria for identifying the buildings or building components that present unacceptable risk to human lives. This paper compares and contrasts the two evaluation guidelines for existing buildings using a prototype building as an example. The prototype building is a seven story, concrete shear wall building assuming a General Use Occupancy

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest.

Science.gov (United States)

Eccles, Martin P; Grimshaw, Jeremy M; Shekelle, Paul; Schünemann, Holger J; Woolf, Steven

2012-07-04

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development.

Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World

Science.gov (United States)

Evenson, Kelly R.; Barakat, Ruben; Brown, Wendy J.; Dargent-Molina, Patricia; Haruna, Megumi; Mikkelsen, Ellen M.; Mottola, Michelle F.; Owe, Katrine M.; Rousham, Emily K.; Yeo, SeonAe

2013-01-01

Introduction Women attain numerous benefits from physical activity during pregnancy. However, due to physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. Methods We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. Results In total, 11 guidelines were identified from nine countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United States). Most guidelines supported moderate intensity physical activity during pregnancy (10/11) and indicated specific frequency (9/11) and duration/time (9/11) recommendations. Most guidelines provided advice on initiating an exercise program during pregnancy (10/11). Six guidelines included absolute and relative contraindications to exercise. All guidelines generally ruled-out sports with risks of falls, trauma, or collisions. Six guidelines included indications for stopping exercise during pregnancy. Conclusion This review contrasted pregnancy-related physical activity guidelines from around the world, and can help to inform new guidelines as they are created or updated, and facilitate the development of a worldwide guideline. PMID:25346651

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

Linder, Brian J; Bass, Edward J; Mostafid, Hugh; Boorjian, Stephen A

2018-02-01

The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

The DART general equilibrium model: A technical description

OpenAIRE

Springer, Katrin

1998-01-01

This paper provides a technical description of the Dynamic Applied Regional Trade (DART) General Equilibrium Model. The DART model is a recursive dynamic, multi-region, multi-sector computable general equilibrium model. All regions are fully specified and linked by bilateral trade flows. The DART model can be used to project economic activities, energy use and trade flows for each of the specified regions to simulate various trade policy as well as environmental policy scenarios, and to analy...

A comparative review of the pharmacoeconomic guidelines in South Africa.

Science.gov (United States)

Carapinha, João L

2017-01-01

To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries. A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated. Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary. Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.

The changing Chinese SEA indicator guidelines: Top-down or bottom-up?

International Nuclear Information System (INIS)

Gao, Jingjing; Christensen, Per; Kørnøv, Lone

2014-01-01

In the last decades, China has introduced a set of indicators to guide the Strategic Environmental Assessment (SEA) practice. The most recent indicator system proposed in 2009 is based on sector-specific guidelines and it found its justification in past negative experiences with more general guidelines (from 2003), which were mostly inspired by, or copied from, international experiences. Based on interviews with practitioners, researchers and administrators, we map and analyse the change in the national guidelines. This analysis is based on a description of the indicators that makes it possible to discern different aggregation levels of indicators and then trace the changes occurring under two sets of guidelines. The analysis also reveals the reasons and rationales behind the changes found in the guidelines. This analysis is inspired by implementation theory and a description of some of the more general trends in the development of SEA and other environmental policies in a recent Chinese context. Beside a more top-down, intentional approach specifying indicators for different sectors based on Chinese experiences from the preceding years, another significant change, following the new guidelines, is a more bottom-up approach which gives more discretion to practitioners. This entails a call for practitioners to make decisions on indicators, which involves an interpretation of the ones present in sector guidance. Highlights: • Focusing on the new Chinese national SEA guidelines proposed in 2009 • Mapping and analysing the most recent change in the indicator system • Revealing the reasons and rationales behind the changes found in the new guidelines • A top-down intention specifying indicators for different sectors • A bottom-up effect in giving discretion and interpretation of using indicators

The changing Chinese SEA indicator guidelines: Top-down or bottom-up?

Energy Technology Data Exchange (ETDEWEB)

Gao, Jingjing, E-mail: Jingjing@plan.aau.dk; Christensen, Per; Kørnøv, Lone

2014-01-15

In the last decades, China has introduced a set of indicators to guide the Strategic Environmental Assessment (SEA) practice. The most recent indicator system proposed in 2009 is based on sector-specific guidelines and it found its justification in past negative experiences with more general guidelines (from 2003), which were mostly inspired by, or copied from, international experiences. Based on interviews with practitioners, researchers and administrators, we map and analyse the change in the national guidelines. This analysis is based on a description of the indicators that makes it possible to discern different aggregation levels of indicators and then trace the changes occurring under two sets of guidelines. The analysis also reveals the reasons and rationales behind the changes found in the guidelines. This analysis is inspired by implementation theory and a description of some of the more general trends in the development of SEA and other environmental policies in a recent Chinese context. Beside a more top-down, intentional approach specifying indicators for different sectors based on Chinese experiences from the preceding years, another significant change, following the new guidelines, is a more bottom-up approach which gives more discretion to practitioners. This entails a call for practitioners to make decisions on indicators, which involves an interpretation of the ones present in sector guidance. Highlights: • Focusing on the new Chinese national SEA guidelines proposed in 2009 • Mapping and analysing the most recent change in the indicator system • Revealing the reasons and rationales behind the changes found in the new guidelines • A top-down intention specifying indicators for different sectors • A bottom-up effect in giving discretion and interpretation of using indicators.

Prediction of lake surface temperature using the air2water model: guidelines, challenges, and future perspectives

Directory of Open Access Journals (Sweden)

Sebastiano Piccolroaz

2016-04-01

Full Text Available Water temperature plays a primary role in controlling a wide range of physical, geochemical and ecological processes in lakes, with considerable influences on lake water quality and ecosystem functioning. Being able to reliably predict water temperature is therefore a desired goal, which stimulated the development of models of different type and complexity, ranging from simple regression-based models to more sophisticated process-based numerical models. However, both types of models suffer of some limitations: the first are not able to address some fundamental physical processes as e.g., thermal stratification, while the latter generally require a large amount of data in input, which are not always available. In this work, lake surface temperature is simulated by means of air2water, a hybrid physically-based/statistical model, which is able to provide a robust, predictive understanding of LST dynamics knowing air temperature only. This model showed performances that are comparable with those obtained by using process based models (a root mean square error on the order of 1°C, at daily scale, while retaining the simplicity and parsimony of regression-based models, thus making it a good candidate for long-term applications.The aim of the present work is to provide the reader with useful and practical guidelines for proper use of the air2water model and for critical analysis of results. Two case studies have been selected for the analysis: Lake Superior and Lake Erie. These are clear and emblematic examples of a deep and a shallow temperate lake characterized by markedly different thermal responses to external forcing, thus are ideal for making the results of the analysis the most general and comprehensive. Particular attention is paid to assessing the influence of missing data on model performance, and to evaluating when an observed time series is sufficiently informative for proper model calibration or, conversely, data are too scarce thus

A generalized model via random walks for information filtering

Energy Technology Data Exchange (ETDEWEB)

Ren, Zhuo-Ming, E-mail: zhuomingren@gmail.com [Department of Physics, University of Fribourg, Chemin du Musée 3, CH-1700, Fribourg (Switzerland); Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, ChongQing, 400714 (China); Kong, Yixiu [Department of Physics, University of Fribourg, Chemin du Musée 3, CH-1700, Fribourg (Switzerland); Shang, Ming-Sheng, E-mail: msshang@cigit.ac.cn [Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, ChongQing, 400714 (China); Zhang, Yi-Cheng [Department of Physics, University of Fribourg, Chemin du Musée 3, CH-1700, Fribourg (Switzerland)

2016-08-06

There could exist a simple general mechanism lurking beneath collaborative filtering and interdisciplinary physics approaches which have been successfully applied to online E-commerce platforms. Motivated by this idea, we propose a generalized model employing the dynamics of the random walk in the bipartite networks. Taking into account the degree information, the proposed generalized model could deduce the collaborative filtering, interdisciplinary physics approaches and even the enormous expansion of them. Furthermore, we analyze the generalized model with single and hybrid of degree information on the process of random walk in bipartite networks, and propose a possible strategy by using the hybrid degree information for different popular objects to toward promising precision of the recommendation. - Highlights: • We propose a generalized recommendation model employing the random walk dynamics. • The proposed model with single and hybrid of degree information is analyzed. • A strategy with the hybrid degree information improves precision of recommendation.

A generalized model via random walks for information filtering

International Nuclear Information System (INIS)

Ren, Zhuo-Ming; Kong, Yixiu; Shang, Ming-Sheng; Zhang, Yi-Cheng

2016-01-01

There could exist a simple general mechanism lurking beneath collaborative filtering and interdisciplinary physics approaches which have been successfully applied to online E-commerce platforms. Motivated by this idea, we propose a generalized model employing the dynamics of the random walk in the bipartite networks. Taking into account the degree information, the proposed generalized model could deduce the collaborative filtering, interdisciplinary physics approaches and even the enormous expansion of them. Furthermore, we analyze the generalized model with single and hybrid of degree information on the process of random walk in bipartite networks, and propose a possible strategy by using the hybrid degree information for different popular objects to toward promising precision of the recommendation. - Highlights: • We propose a generalized recommendation model employing the random walk dynamics. • The proposed model with single and hybrid of degree information is analyzed. • A strategy with the hybrid degree information improves precision of recommendation.

Generalized Ordinary Differential Equation Models.

Science.gov (United States)

Miao, Hongyu; Wu, Hulin; Xue, Hongqi

2014-10-01

Existing estimation methods for ordinary differential equation (ODE) models are not applicable to discrete data. The generalized ODE (GODE) model is therefore proposed and investigated for the first time. We develop the likelihood-based parameter estimation and inference methods for GODE models. We propose robust computing algorithms and rigorously investigate the asymptotic properties of the proposed estimator by considering both measurement errors and numerical errors in solving ODEs. The simulation study and application of our methods to an influenza viral dynamics study suggest that the proposed methods have a superior performance in terms of accuracy over the existing ODE model estimation approach and the extended smoothing-based (ESB) method.

Review of human factors guidelines and methods

International Nuclear Information System (INIS)

Rhodes, W.; Szlapetis, I.; Hay, T.; Weihrer, S.

1995-04-01

The review examines the use of human factors guidelines and methods in high technology applications, with emphasis on application to the nuclear industry. An extensive literature review was carried out identifying over 250 applicable documents, with 30 more documents identified during interviews with experts in human factors. Surveys were sent to 15 experts, of which 11 responded. The survey results indicated guidelines used and why these were favoured. Thirty-three of the most applicable guideline documents were described in detailed annotated bibliographies. A bibliographic list containing over 280 references was prepared. Thirty guideline documents were rated for their completeness, validity, applicability and practicality. The experts survey indicated the use of specific techniques. Ten human factors methods of analysis were described in general summaries, including procedures, applications, and specific techniques. Detailed descriptions of the techniques were prepared and each technique rated for applicability and practicality. Recommendations for further study of areas of importance to human factors in the nuclear field in Canada are given. (author). 8 tabs., 2 figs

Review of human factors guidelines and methods

Energy Technology Data Exchange (ETDEWEB)

Rhodes, W; Szlapetis, I; Hay, T; Weihrer, S [Rhodes and Associates Inc., Toronto, ON (Canada)

1995-04-01

The review examines the use of human factors guidelines and methods in high technology applications, with emphasis on application to the nuclear industry. An extensive literature review was carried out identifying over 250 applicable documents, with 30 more documents identified during interviews with experts in human factors. Surveys were sent to 15 experts, of which 11 responded. The survey results indicated guidelines used and why these were favoured. Thirty-three of the most applicable guideline documents were described in detailed annotated bibliographies. A bibliographic list containing over 280 references was prepared. Thirty guideline documents were rated for their completeness, validity, applicability and practicality. The experts survey indicated the use of specific techniques. Ten human factors methods of analysis were described in general summaries, including procedures, applications, and specific techniques. Detailed descriptions of the techniques were prepared and each technique rated for applicability and practicality. Recommendations for further study of areas of importance to human factors in the nuclear field in Canada are given. (author). 8 tabs., 2 figs.

Curriculum Guidelines for Pathology and Oral Pathology.

Science.gov (United States)

Journal of Dental Education, 1985

1985-01-01

Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care.

Directory of Open Access Journals (Sweden)

Tam H Ho

Full Text Available OBJECTIVE: To assess the impact of individualised, reconciled evidence-based recommendations (IRERs and multidisciplinary care in patients with chronic heart failure (CHF on clinical guideline compliance for CHF and common comorbid conditions. DESIGN AND SETTING: A retrospective hospital clinical audit conducted between 1st July 2006 and February 2011. PARTICIPANTS: A total of 255 patients with a diagnosis of CHF who attended the Multidisciplinary Ambulatory Consulting Services (MACS clinics, at the Royal Adelaide Hospital, were included. MAIN OUTCOME MEASURES: Compliance with Australian clinical guideline recommendations for CHF, atrial fibrillation, diabetes mellitus and ischaemic heart disease. RESULTS: Study participants had a median of eight medical conditions (IQR 6-10 and were on an average of 10 (±4 unique medications. Compliance with clinical guideline recommendations for pharmacological therapy for CHF, comorbid atrial fibrillation, diabetes or ischaemic heart disease was high, ranging from 86% for lipid lowering therapy to 98% anti-platelet agents. For all conditions, compliance with lifestyle recommendations was lower than pharmacological therapy, ranging from no podiatry reviews for CHF patients with comorbid diabetes to 75% for heart failure education. Concordance with many guideline recommendations was significantly associated if the patient had IRERs determined, a greater number of recommendations, more clinic visits or if patients participated in a heart failure program. CONCLUSIONS: Despite the high number of comorbid conditions and resulting complexity of the management, high compliance to clinical guideline recommendations was associated with IRER determination in older patients with CHF. Importantly these recommendations need to be communicated to the patient's general practitioner, regularly monitored and adjusted at clinic visits.

Kalman Filter for Generalized 2-D Roesser Models

Institute of Scientific and Technical Information of China (English)

SHENG Mei; ZOU Yun

2007-01-01

The design problem of the state filter for the generalized stochastic 2-D Roesser models, which appears when both the state and measurement are simultaneously subjected to the interference from white noise, is discussed. The wellknown Kalman filter design is extended to the generalized 2-D Roesser models. Based on the method of "scanning line by line", the filtering problem of generalized 2-D Roesser models with mode-energy reconstruction is solved. The formula of the optimal filtering, which minimizes the variance of the estimation error of the state vectors, is derived. The validity of the designed filter is verified by the calculation steps and the examples are introduced.

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks

Science.gov (United States)

Ansari, Shabnam; Rashidian, Arash

2012-01-01

Objectives We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as ‘necessary’ tasks. Result Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks’ weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors. Discussion Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings

Modeling and Design Guidelines for P⁺ Guard Rings in Lightly Doped CMOS Substrates

DEFF Research Database (Denmark)

Shen, Ming; Mikkelsen, Jan H.; Zhang, Ke

2013-01-01

of ${rm P}^{+}$ guard rings in terms of S-parameters, which is useful for substrate noise mitigation in mixed-signal system-on-chips. Validation of the model has been done by both electromagnetic simulation and experimental results from guard rings implemented using a standard 0.18-$mu{rm m}$ CMOS process....... In addition, design guidelines have been drawn for minimizing the guard ring size while maintaining the noise suppression performance....

Guidelines For Evaluation Of Natural Gas Projects

International Nuclear Information System (INIS)

Farag, H.; El Messirie, A.

2004-01-01

This paper is objected to give guidelines for natural gas projects appraisal These guidelines are summarized in modeling of natural gas demand forecast and energy pricing policies for different gas consumers mainly in the manufacturing, mining, transport, trade and agriculture sectors. Analysis of the results is made through sensitivity analysis and decision support system ( DSS )

42 CFR 81.24 - Guidelines for leukemia.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Guidelines for leukemia. 81.24 Section 81.24 Public... Causation § 81.24 Guidelines for leukemia. (a) For claims involving leukemia, DOL will calculate one or more probability of causation estimates from up to three of the four alternate leukemia risk models included in...

National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

Science.gov (United States)

Checkland, Kath

2004-11-01

This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

A Model Fit Statistic for Generalized Partial Credit Model

Science.gov (United States)

Liang, Tie; Wells, Craig S.

2009-01-01

Investigating the fit of a parametric model is an important part of the measurement process when implementing item response theory (IRT), but research examining it is limited. A general nonparametric approach for detecting model misfit, introduced by J. Douglas and A. S. Cohen (2001), has exhibited promising results for the two-parameter logistic…

Postdoctoral program guidelines.

Energy Technology Data Exchange (ETDEWEB)

Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina; Liu, Yanli; Ferreira, Summer Rhodes; Biedermann, Laura Butler; Cruz-Campa, Jose Luis; Hall, Lisa Michelle; Liu, Xiaohua H.; Ekoto, Isaac

2012-04-01

We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up to five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.

Guidelines in electrodiagnostic medicine. American Association of Electrodiagnostic Medicine.

Science.gov (United States)

1992-02-01

The American Association of Electrodiagnostic Medicine (AAEM) is committed to the development of sound and clinically relevant guidelines through review of literature, expert opinion and consensus. In 1979, with the assistance of its Professional Practice Committee and association leaders, the association published its initial guidelines, Guidelines in Electrodiagnostic Medicine, covering the practice of electrodiagnostic medicine. The committee is charged with ongoing revision of the document, as needed, and the current version includes standards of practice in clinical electromyography, risks in electrodiagnostic medicine, basic equipment requirements, and the role of paramedical support. In 1988, Educational Guidelines for Electrodiagnostic Training Programs (Appendix A) was prepared by the AAEM Training Program Committee and added to aid training program directors in establishing new training programs or in reviewing the current status of the educational aspects of existing programs. In 1986, the AAEM charged its Quality Assurance Committee with the responsibility for the development of guidelines pertinent to electrodiagnostic medical consultations. The impetus for the charge was the requests received from members of the AAEM and other interested parties for educational material on indications for and conduct of electrodiagnostic medical consultations. As a result of the committee's efforts, Suggested Guidelines for Electrodiagnostic Medical Consultations (Appendix D), was published in 1989 and additional sections added subsequently. The current document includes (1) general indications for an electrodiagnostic medical consultation for patients with suspected myopathies, neuromuscular junction disorders, polyneuropathies, mononeuropathies, plexopathies, radiculopathies, neuronopathies and central nervous system disorders, (2) specific indications for patients with suspected lumbosacral or cervical radiculopathies, (3) general principles of electrodiagnostic

A general model for membrane-based separation processes

DEFF Research Database (Denmark)

Soni, Vipasha; Abildskov, Jens; Jonsson, Gunnar Eigil

2009-01-01

behaviour will play an important role. In this paper, modelling of membrane-based processes for separation of gas and liquid mixtures are considered. Two general models, one for membrane-based liquid separation processes (with phase change) and another for membrane-based gas separation are presented....... The separation processes covered are: membrane-based gas separation processes, pervaporation and various types of membrane distillation processes. The specific model for each type of membrane-based process is generated from the two general models by applying the specific system descriptions and the corresponding...

Testing Parametric versus Semiparametric Modelling in Generalized Linear Models

NARCIS (Netherlands)

Härdle, W.K.; Mammen, E.; Müller, M.D.

1996-01-01

We consider a generalized partially linear model E(Y|X,T) = G{X'b + m(T)} where G is a known function, b is an unknown parameter vector, and m is an unknown function.The paper introduces a test statistic which allows to decide between a parametric and a semiparametric model: (i) m is linear, i.e.

Proposed ethical guidelines and legislative framework for permitting gestational surrogacy in Singapore.

Science.gov (United States)

Heng, Boon Chin

2007-09-01

Gestational surrogacy is currently banned in Singapore but is much debated. Some ethical guidelines and legislation for permitting gestational surrogacy in Singapore are proposed and discussed including: (i) review and approval of gestational surrogacy by the Ministry of Health on a case-by-case basis; (ii) stringent guidelines for gonadotrophin stimulation, IVF and ICSI procedures in 'traditional' surrogacy; (iii) restriction of gestational surrogates to parous married women with stable family relationships; (iv) exclusion of foreign women from acting as gestational surrogates, except for close relatives of the recipient couple; (v) reimbursement and/or compensation of gestational surrogates based on the direct expenses model; (vi) exclusion of medical professionals from surrogate recruitment and reimbursement; (vii) the surrogacy contract must make it legally binding for the prospective recipient couple to accept the child, even if it is born with congenital deformities; (viii) stringent guidelines for combining surrogacy with egg donation from a third woman, who is neither the social nor gestational mother. Policymakers in Singapore should conduct a public referendum on the legalization of gestational surrogacy and actively consult the views of healthcare professionals, religious and community leaders, as well as the general public, before reaching any decision.

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

Science.gov (United States)

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors

Toward improved guideline quality: using the COGS statement with GEM.

Science.gov (United States)

Shiffman, Richard N; Michel, Georges

2004-01-01

The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized approach to representing guideline documents using XML. In this work, we demonstrate the sufficiency of GEM for describing COGS components. Using the mapping between COGS and GEM elements we built an XSLT application to examine a guideline's adherence (or non-adherence) to the COGS checklist. Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways.

Industry guidelines for the calibration of maximum anemometers

Energy Technology Data Exchange (ETDEWEB)

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

1996-12-31

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

Inspector qualification guidelines

International Nuclear Information System (INIS)

Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-01

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

Inspector qualification guidelines

Energy Technology Data Exchange (ETDEWEB)

Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-15

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

Free and open source enabling technologies for patient-centric, guideline-based clinical decision support: a survey.

Science.gov (United States)

Leong, T Y; Kaiser, K; Miksch, S

2007-01-01

Guideline-based clinical decision support is an emerging paradigm to help reduce error, lower cost, and improve quality in evidence-based medicine. The free and open source (FOS) approach is a promising alternative for delivering cost-effective information technology (IT) solutions in health care. In this paper, we survey the current FOS enabling technologies for patient-centric, guideline-based care, and discuss the current trends and future directions of their role in clinical decision support. We searched PubMed, major biomedical informatics websites, and the web in general for papers and links related to FOS health care IT systems. We also relied on our background and knowledge for specific subtopics. We focused on the functionalities of guideline modeling tools, and briefly examined the supporting technologies for terminology, data exchange and electronic health record (EHR) standards. To effectively support patient-centric, guideline-based care, the computerized guidelines and protocols need to be integrated with existing clinical information systems or EHRs. Technologies that enable such integration should be accessible, interoperable, and scalable. A plethora of FOS tools and techniques for supporting different knowledge management and quality assurance tasks involved are available. Many challenges, however, remain in their implementation. There are active and growing trends of deploying FOS enabling technologies for integrating clinical guidelines, protocols, and pathways into the main care processes. The continuing development and maturation of such technologies are likely to make increasingly significant contributions to patient-centric, guideline-based clinical decision support.

Calibration and validation of a general infiltration model

Science.gov (United States)

Mishra, Surendra Kumar; Ranjan Kumar, Shashi; Singh, Vijay P.

1999-08-01

A general infiltration model proposed by Singh and Yu (1990) was calibrated and validated using a split sampling approach for 191 sets of infiltration data observed in the states of Minnesota and Georgia in the USA. Of the five model parameters, fc (the final infiltration rate), So (the available storage space) and exponent n were found to be more predictable than the other two parameters: m (exponent) and a (proportionality factor). A critical examination of the general model revealed that it is related to the Soil Conservation Service (1956) curve number (SCS-CN) method and its parameter So is equivalent to the potential maximum retention of the SCS-CN method and is, in turn, found to be a function of soil sorptivity and hydraulic conductivity. The general model was found to describe infiltration rate with time varying curve number.

Ethical guidelines, animal profile, various animal models used in periodontal research with alternatives and future perspectives.

Science.gov (United States)

Pasupuleti, Mohan Kumar; Molahally, Subramanya Shetty; Salwaji, Supraja

2016-01-01

Laboratory animal models serve as a facilitator to investigate the etiopathogenesis of periodontal disease, are used to know the efficacy of reconstructive and regenerative procedures, and are also helpful in evaluation of newer therapeutic techniques including laser and implant therapies prior to application in the human beings. The aim of this review is to know the different animal models used in various specialties of dental research and to know the ethical guidelines prior to the usage of experimental models with main emphasis on how to refine, replace, and reduce the number of animal models usage in the laboratory. An online search for experimental animal models used in dental research was performed using MEDLINE/PubMed database. Publications from 2009 to May 2013 in the specialty of periodontics were included in writing this review. A total of 652 references were published in PubMed/MEDLINE databases based on the search terms used. Out of 245 studies, 241 were related to the periodontal research published in English from 2009 to 2013. Relevant papers were chosen according to the inclusion and exclusion criteria. After extensive electronic and hand search on animal models, it has been observed that various animal models were used in dental research. Search on animal models used for dental research purpose revealed that various animals such as rats, mice, guinea pigs, rabbit, beagle dogs, goats, and nonhuman primates were extensively used. However, with the new advancement of ex vivo animal models, it has become easy to investigate disease pathogenesis and to test the efficacy of newer therapeutic modalities with the reduced usage of animal models. This review summarized the large amount of literature on animal models used in periodontal research with main emphasis on ethical guidelines and on reducing the animal model usage in future perspective.

Ethical guidelines, animal profile, various animal models used in periodontal research with alternatives and future perspectives

Directory of Open Access Journals (Sweden)

Mohan Kumar Pasupuleti

2016-01-01

Full Text Available Laboratory animal models serve as a facilitator to investigate the etiopathogenesis of periodontal disease, are used to know the efficacy of reconstructive and regenerative procedures, and are also helpful in evaluation of newer therapeutic techniques including laser and implant therapies prior to application in the human beings. The aim of this review is to know the different animal models used in various specialties of dental research and to know the ethical guidelines prior to the usage of experimental models with main emphasis on how to refine, replace, and reduce the number of animal models usage in the laboratory. An online search for experimental animal models used in dental research was performed using MEDLINE/PubMed database. Publications from 2009 to May 2013 in the specialty of periodontics were included in writing this review. A total of 652 references were published in PubMed/MEDLINE databases based on the search terms used. Out of 245 studies, 241 were related to the periodontal research published in English from 2009 to 2013. Relevant papers were chosen according to the inclusion and exclusion criteria. After extensive electronic and hand search on animal models, it has been observed that various animal models were used in dental research. Search on animal models used for dental research purpose revealed that various animals such as rats, mice, guinea pigs, rabbit, beagle dogs, goats, and nonhuman primates were extensively used. However, with the new advancement of ex vivo animal models, it has become easy to investigate disease pathogenesis and to test the efficacy of newer therapeutic modalities with the reduced usage of animal models. This review summarized the large amount of literature on animal models used in periodontal research with main emphasis on ethical guidelines and on reducing the animal model usage in future perspective.

Partially Observed Mixtures of IRT Models: An Extension of the Generalized Partial-Credit Model

Science.gov (United States)

Von Davier, Matthias; Yamamoto, Kentaro

2004-01-01

The generalized partial-credit model (GPCM) is used frequently in educational testing and in large-scale assessments for analyzing polytomous data. Special cases of the generalized partial-credit model are the partial-credit model--or Rasch model for ordinal data--and the two parameter logistic (2PL) model. This article extends the GPCM to the…

Cosmological models in general relativity

Indian Academy of Sciences (India)

Cosmological models in general relativity. B B PAUL. Department of Physics, Nowgong College, Nagaon, Assam, India. MS received 4 October 2002; revised 6 March 2003; accepted 21 May 2003. Abstract. LRS Bianchi type-I space-time filled with perfect fluid is considered here with deceler- ation parameter as variable.

Formalization of Medical Guidelines

Czech Academy of Sciences Publication Activity Database

Peleška, Jan; Anger, Z.; Buchtela, David; Šebesta, K.; Tomečková, Marie; Veselý, Arnošt; Zvára, K.; Zvárová, Jana

2005-01-01

Roč. 1, - (2005), s. 133-141 ISSN 1801-5603 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : GLIF model * formalization of guidelines * prevention of cardiovascular diseases Subject RIV: IN - Informatics, Computer Science

Doctors’ Knowledge of Hypertension Guidelines Recommendations Reflected in Their Practice

Directory of Open Access Journals (Sweden)

Nafees Ahmad

2018-01-01

Full Text Available Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008. Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor. SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07% had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20. Statistically significant correlation (rs = 0.635, P<0.001 was observed between doctors’ knowledge and practice scores. A total of 349 (67.1% prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008, left ventricular hypertrophy (OR = 0.091, P=0.001 and heart failure (OR = 1.923, P=0.039 were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.

Generalizations of the noisy-or model

Czech Academy of Sciences Publication Activity Database

Vomlel, Jiří

2015-01-01

Roč. 51, č. 3 (2015), s. 508-524 ISSN 0023-5954 R&D Projects: GA ČR GA13-20012S Institutional support: RVO:67985556 Keywords : Bayesian networks * noisy-or model * classification * generalized linear models Subject RIV: JD - Computer Applications, Robotics Impact factor: 0.628, year: 2015 http://library.utia.cas.cz/separaty/2015/MTR/vomlel-0447357.pdf

Guidelines for Mass Screening of Congenital Hypothyroidism (2014 revision)

Science.gov (United States)

Nagasaki, Keisuke; Minamitani, Kanshi; Anzo, Makoto; Adachi, Masanori; Ishii, Tomohiro; Onigata, Kazumichi; Kusuda, Satoshi; Harada, Shohei; Horikawa, Reiko; Minagawa, Masanori; Mizuno, Haruo; Yamakami, Yuji; Fukushi, Masaru; Tajima, Toshihiro

2015-01-01

Purpose of developing the guidelines: Mass screening for congenital hypothyroidism started in 1979 in Japan, and the prognosis for intelligence has been improved by early diagnosis and treatment. The incidence was about 1/4000 of the birth population, but it has increased due to diagnosis of subclinical congenital hypothyroidism. The disease requires continuous treatment, and specialized medical facilities should make a differential diagnosis and treat subjects who are positive in mass screening to avoid unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism (1998 version) were developed by the Mass Screening Committee of the Japanese Society for Pediatric Endocrinology in 1998. Subsequently, new findings on prognosis and problems in the adult phase have emerged. Based on these new findings, the 1998 guidelines were revised in the current document (hereinafter referred to as the Guidelines). Target disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician specialists in pediatric endocrinology, pediatric specialists, physicians referring patients to pediatric practitioners, general physicians, laboratory technicians in charge of mass screening, and patients. PMID:26594093

Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery.

Science.gov (United States)

Khan, Sohail Ahmad; Rodrigues, Gabrial; Kumar, Pramod; Rao, Padma G M

2006-06-01

To study the impact of guidelines on surgical antibiotic prophylaxis in clinical practice, barriers involved in adherence to guidelines and how to overcome the same. Literature pertaining to prophylactic antibiotic usage was searched. Medscape, Medline, Cochrane, Surgical Infection Prevention (SIP) project databases were reviewed. Recent articles from relevant journals, texts, and standard guidelines were also studied. Local guidelines seem more likely to be accepted and followed than those developed nationally. Major barriers involved in adherence to guidelines include lack of awareness about the guidelines, general perception of guideline as a bureaucratic rather than educational tool. Some practitioners perceive guidelines as "cookbook medicine" that does not permit them to make their own medical decisions. Other barriers are complex, multi-step systems that create confusion, decrease accountability. Methods for guideline adherence include surveillance and data analysis, new systems to facilitate documentation and improving workflow, education regarding current evidence-based guidelines and promoting the development of local guidelines or protocol, development and implementation of reminders to facilitate adherence to the local guidelines. A multidisciplinary steering team of surgeons, infectious disease specialists, pharmacists, anesthesiologists, microbiologists and nurses should develop local guidelines suitable to their institution and methods for adherence to prevent the surgical site infections. The gap between evidence-based guidelines and practice must be addressed in order to achieve optimal practice in this domain.

Treatment of gonorrhoea in Auckland, New Zealand: marked variation in prescriber adherence to treatment guidelines.

Science.gov (United States)

Forster, Rose; Ng, Diana; Upton, Arlo; Franklin, Rick; Thomas, Mark

2017-06-01

The relentless emergence and spread of strains of Neisseria gonorrhoeae that are resistant to many antimicrobial agents has led to frequent changes in treatment guidelines, with a consequent risk that prescribers may not be aware of current guidelines. To determine the proportion of patients with gonorrhoea who were treated with a regimen consistent with the New Zealand Sexual Health Society (NZSHS) guidelines. We audited the treatment given to adult patients with laboratory-proven gonorrhoea in Auckland, New Zealand, during the first 6 months of 2015. Treatment compliant with the current NZSHS guidelines was administered in only 65% (458/706) episodes overall. Guideline-compliant treatment was much more likely to be prescribed for patients who presented to a sexual health clinic (89%) than for patients who presented to either a general practice or other community clinic (52%) or to a hospital (56%) (P Auckland region. Improved compliance with treatment guidelines, particularly in patients who present either to general practice or to hospitals, is necessary to maintain the efficacy of current treatment regimens. © 2017 Royal Australasian College of Physicians.

Generalized Born Models of Macromolecular Solvation Effects

Science.gov (United States)

Bashford, Donald; Case, David A.

2000-10-01

It would often be useful in computer simulations to use a simple description of solvation effects, instead of explicitly representing the individual solvent molecules. Continuum dielectric models often work well in describing the thermodynamic aspects of aqueous solvation, and approximations to such models that avoid the need to solve the Poisson equation are attractive because of their computational efficiency. Here we give an overview of one such approximation, the generalized Born model, which is simple and fast enough to be used for molecular dynamics simulations of proteins and nucleic acids. We discuss its strengths and weaknesses, both for its fidelity to the underlying continuum model and for its ability to replace explicit consideration of solvent molecules in macromolecular simulations. We focus particularly on versions of the generalized Born model that have a pair-wise analytical form, and therefore fit most naturally into conventional molecular mechanics calculations.

Infrared problems in two-dimensional generalized σ-models

International Nuclear Information System (INIS)

Curci, G.; Paffuti, G.

1989-01-01

We study the correlations of the energy-momentum tensor for classically conformally invariant generalized σ-models in the Wilson operator-product-expansion approach. We find that these correlations are, in general, infrared divergent. The absence of infrared divergences is obtained, as one can expect, for σ-models on a group manifold or for σ-models with a string-like interpretation. Moreover, the infrared divergences spoil the naive scaling arguments used by Zamolodchikov in the demonstration of the C-theorem. (orig.)

Generalized Landau-Lifshitz models on the interval

International Nuclear Information System (INIS)

Doikou, Anastasia; Karaiskos, Nikos

2011-01-01

We study the classical generalized gl n Landau-Lifshitz (L-L) model with special boundary conditions that preserve integrability. We explicitly derive the first non-trivial local integral of motion, which corresponds to the boundary Hamiltonian for the sl 2 L-L model. Novel expressions of the modified Lax pairs associated to the integrals of motion are also extracted. The relevant equations of motion with the corresponding boundary conditions are determined. Dynamical integrable boundary conditions are also examined within this spirit. Then the generalized isotropic and anisotropic gl n Landau-Lifshitz models are considered, and novel expressions of the boundary Hamiltonians and the relevant equations of motion and boundary conditions are derived.

A QCD Model Using Generalized Yang-Mills Theory

International Nuclear Information System (INIS)

Wang Dianfu; Song Heshan; Kou Lina

2007-01-01

Generalized Yang-Mills theory has a covariant derivative, which contains both vector and scalar gauge bosons. Based on this theory, we construct a strong interaction model by using the group U(4). By using this U(4) generalized Yang-Mills model, we also obtain a gauge potential solution, which can be used to explain the asymptotic behavior and color confinement.

ACC/AHA guidelines superior to ESC/EAS guidelines for primary prevention with statins in non-diabetic Europeans

DEFF Research Database (Denmark)

Mortensen, Martin Bødtker; Nordestgaard, Børge G; Afzal, Shoaib

2017-01-01

Aim We compared the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and the 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines on prevention of atherosclerotic cardiovascular disease (ASCVD) using different risk prediction models [US......-calibrated around decision thresholds for statin therapy. For a Class I recommendation, 42% of individuals qualified for statins using the ACC/AHA guidelines vs. 6% with the ESC/EAS guidelines. Using ACC/AHA- vs. ESC/EAS-defined statin eligibility led to a substantial gain in sensitivity (+62% for any ASCVD and+76......% for fatal ASCVD) with a smaller loss in specificity (-35% for any ASCVD and -36% for fatal ASCVD). Similar differences between the ACC/AHA and ESC/EAS guidelines were found for men and women separately, and for Class IIa recommendations. The sensitivity and specificity of a US-PCE risk of 5% were similar...

Procedure guideline for thyroid scintigraphy (version 3)

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.

2007-01-01

The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the 99m Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)

36 CFR 1150.2 - Applicability: Buildings and facilities subject to guidelines and standards.

Science.gov (United States)

2010-07-01

... facilities subject to guidelines and standards. 1150.2 Section 1150.2 Parks, Forests, and Public Property... General Information § 1150.2 Applicability: Buildings and facilities subject to guidelines and standards... provided in paragraph (c) of this section, the standards issued under the Architectural Barriers Act of...

A generalized model via random walks for information filtering

Science.gov (United States)

Ren, Zhuo-Ming; Kong, Yixiu; Shang, Ming-Sheng; Zhang, Yi-Cheng

2016-08-01

There could exist a simple general mechanism lurking beneath collaborative filtering and interdisciplinary physics approaches which have been successfully applied to online E-commerce platforms. Motivated by this idea, we propose a generalized model employing the dynamics of the random walk in the bipartite networks. Taking into account the degree information, the proposed generalized model could deduce the collaborative filtering, interdisciplinary physics approaches and even the enormous expansion of them. Furthermore, we analyze the generalized model with single and hybrid of degree information on the process of random walk in bipartite networks, and propose a possible strategy by using the hybrid degree information for different popular objects to toward promising precision of the recommendation.

10 CFR 960.4-1 - System guideline.

Science.gov (United States)

2010-01-01

... DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE... at the site shall allow for the physical separation of radioactive waste from the accessible environment after closure in accordance with the requirements of 40 CFR part 191, subpart B, as implemented by...

Introductory to the ESPEN guidelines on enteral nutrition

DEFF Research Database (Denmark)

Lochs, H.; Allison, S.P.; Meier, R.

2006-01-01

used inconsistently depending on medical disciplines as well as regional and personal preferences. Therefore, to increase explanatory accuracy it was necessary to unify them. In this chapter terms and definitions used throughout all guidelines are explained. Additionally answers to more general...

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

Science.gov (United States)

Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

2012-12-01

Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

Guidelines for postdoctoral training in rehabilitation psychology.

Science.gov (United States)

Stiers, William; Hanson, Stephanie; Turner, Aaron P; Stucky, Kirk; Barisa, Mark; Brownsberger, Mary; Van Tubbergen, Marie; Ashman, Teresa; Kuemmel, Angela

2012-11-01

This article describes the methods and results of a national conference that was held to (1) develop consensus guidelines about the structure and process of rehabilitation psychology postdoctoral training programs and (2) create a Council of Rehabilitation Psychology Postdoctoral Training Programs to promote training programs' abilities to implement the guidelines and to formally recognize programs in compliance with the guidelines. Forty-six conference participants were chosen to include important stakeholders in rehabilitation psychology, representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, and persons involved in medical education practice and research. Consensus guidelines were developed for rehabilitation psychology postdoctoral training program structure and process and for establishing the Council of Rehabilitation Psychology Postdoctoral Training Programs. The Conference developed aspirational guidelines for postdoctoral education and training programs in applied rehabilitation psychology and established a Council of Rehabilitation Psychology Postdoctoral Training Programs as a means of promoting their adoption by training programs. These efforts are designed to promote quality, consistency, and excellence in the education and training of rehabilitation psychology practitioners and to promote competence in their practice. It is hoped that these efforts will stimulate discussion, assist in the development of improved teaching and evaluation methods, lead to interesting research questions, and generally facilitate the continued systematic development of the profession of rehabilitation psychology. PsycINFO Database Record (c) 2012 APA, all rights reserved

Do current national and international guidelines have specific recommendations for older adults with bipolar disorder?

DEFF Research Database (Denmark)

Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A

2016-01-01

a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. METHODS: The International Society of Bipolar Disorders OABD task force compiled...... and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). RESULTS: There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD....... General principles for treating OABD with medication are recommended to be similar to those for younger adults, with special caution for side effects due to somatic comorbidity and concomitant medications. Therapeutic lithium serum levels are suggested to be lower but recommendations are very general...

21 CFR 104.5 - General principles.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false General principles. 104.5 Section 104.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION NUTRITIONAL QUALITY GUIDELINES FOR FOODS General Provisions § 104.5 General principles. (a) A...

Belgian guidelines for economic evaluations: second edition.

Science.gov (United States)

Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

2014-12-01

The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

Summary of best guidelines and validation of CFD modeling in livestock buildings to ensure prediction quality

DEFF Research Database (Denmark)

Rong, Li; Nielsen, Peter Vilhelm; Bjerg, Bjarne Schmidt

2016-01-01

scale pig barns was simulated to show the procedures of validating a CFD simulation in livestock buildings. After summarizing the guideline and/or best practice for CFD modeling, the authors addressed the issues related to numerical methods and the governing equations, which were limited to RANS models....... Although it is not necessary to maintain the same format of reporting the CFD modeling as presented in this paper, the authors would suggest including all the information related to the selection of turbulence models, difference schemes, convergence criteria, boundary conditions, geometry simplification......, simulating domain etc. This information is particularly important for the readers to evaluate the quality of the CFD simulation results....

SuML: A Survey Markup Language for Generalized Survey Encoding

Science.gov (United States)

Barclay, MW; Lober, WB; Karras, BT

2002-01-01

There is a need in clinical and research settings for a sophisticated, generalized, web based survey tool that supports complex logic, separation of content and presentation, and computable guidelines. There are many commercial and open source survey packages available that provide simple logic; few provide sophistication beyond “goto” statements; none support the use of guidelines. These tools are driven by databases, static web pages, and structured documents using markup languages such as eXtensible Markup Language (XML). We propose a generalized, guideline aware language and an implementation architecture using open source standards.

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

Science.gov (United States)

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

2015-09-21

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

Multivariate statistical modelling based on generalized linear models

CERN Document Server

Fahrmeir, Ludwig

1994-01-01

This book is concerned with the use of generalized linear models for univariate and multivariate regression analysis. Its emphasis is to provide a detailed introductory survey of the subject based on the analysis of real data drawn from a variety of subjects including the biological sciences, economics, and the social sciences. Where possible, technical details and proofs are deferred to an appendix in order to provide an accessible account for non-experts. Topics covered include: models for multi-categorical responses, model checking, time series and longitudinal data, random effects models, and state-space models. Throughout, the authors have taken great pains to discuss the underlying theoretical ideas in ways that relate well to the data at hand. As a result, numerous researchers whose work relies on the use of these models will find this an invaluable account to have on their desks. "The basic aim of the authors is to bring together and review a large part of recent advances in statistical modelling of m...

Adherence to Eating and Drinking Guidelines for Adults with Intellectual Disabilities and Dysphagia.

Science.gov (United States)

Chadwick, Darren D.; Jolliffe, Jane; Goldbart, Juliet

2003-01-01

The extent to which 40 individuals with intellectual disorders and dysphagia and their caregivers adhered to speech and language pathology dysphagia guidelines was evaluated across four settings. Although adherence was generally high, there were significant differences across settings, type of guidelines, and between people who were fed by…

EOP MIT General Circulation Model (MITgcm)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data contains a regional implementation of the Massachusetts Institute of Technology general circulation model (MITgcm) at a 1-km spatial resolution for the...

Post-traumatic stress disorder--best practice GP guidelines.

Science.gov (United States)

Forbes, David; Wolfgang, Bronwyn; Cooper, John; Creamer, Mark; Barton, David

2009-03-01

Approximately 50-65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed. This article describes a brief algorithm based on the Australian guidelines and outlines key recommendations. General practitioners are often the first point of contact with the health care system for someone who has experienced a traumatic event. Patients experiencing trauma within the past 2 weeks require psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. If the patient wishes to talk about the event with you, support them in doing so. However, it is important not to push those who prefer not to talk about the event. Trauma focused psychological treatment is the first line of treatment for PTSD, although antidepressant medication may have an adjuvant role in some patients or in those with comorbidities.

[The NHG guideline 'Sleep problems and sleeping pills'

NARCIS (Netherlands)

Damen-van Beek, Z.; Lucassen, P.L.; Gorgels, W.J.M.J.; Smelt, A.F.; Knuistingh Neven, A.; Bouma, M.

2015-01-01

- The Dutch College of General Practitioners' (NHG) guideline 'Sleep problems and sleeping pills' provides recommendations for the diagnosis and treatment of the most prevalent sleep problems and for the management of chronic users of sleeping pills.- The preferred approach for sleeplessness is not

a Proposal for Generalization of 3d Models

Science.gov (United States)

Uyar, A.; Ulugtekin, N. N.

2017-11-01

In recent years, 3D models have been created of many cities around the world. Most of the 3D city models have been introduced as completely graphic or geometric models, and the semantic and topographic aspects of the models have been neglected. In order to use 3D city models beyond the task, a generalization is necessary. CityGML is an open data model and XML-based format for the storage and exchange of virtual 3D city models. Level of Details (LoD) which is an important concept for 3D modelling, can be defined as outlined degree or prior representation of real-world objects. The paper aim is first describes some requirements of 3D model generalization, then presents problems and approaches that have been developed in recent years. In conclude the paper will be a summary and outlook on problems and future work.

Field Programmable Gate Array Failure Rate Estimation Guidelines for Launch Vehicle Fault Tree Models

Science.gov (United States)

Al Hassan, Mohammad; Novack, Steven D.; Hatfield, Glen S.; Britton, Paul

2017-01-01

Today's launch vehicles complex electronic and avionic systems heavily utilize the Field Programmable Gate Array (FPGA) integrated circuit (IC). FPGAs are prevalent ICs in communication protocols such as MIL-STD-1553B, and in control signal commands such as in solenoid/servo valves actuations. This paper will demonstrate guidelines to estimate FPGA failure rates for a launch vehicle, the guidelines will account for hardware, firmware, and radiation induced failures. The hardware contribution of the approach accounts for physical failures of the IC, FPGA memory and clock. The firmware portion will provide guidelines on the high level FPGA programming language and ways to account for software/code reliability growth. The radiation portion will provide guidelines on environment susceptibility as well as guidelines on tailoring other launch vehicle programs historical data to a specific launch vehicle.

Measure Guideline. Steam System Balancing and Tuning for Multifamily Residential Buildings

Energy Technology Data Exchange (ETDEWEB)

Choi, Jayne [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Ludwig, Peter [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Brand, Larry [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States)

2013-04-01

This guideline provides building owners, professionals involved in multifamily audits, and contractors insights for improving the balance and tuning of steam systems. It provides readers an overview of one-pipe steam heating systems, guidelines for evaluating steam systems, typical costs and savings, and guidelines for ensuring quality installations. It also directs readers to additional resources for details not included here. Measures for balancing a distribution system that are covered include replacing main line vents and upgrading radiator vents. Also included is a discussion on upgrading boiler controls and the importance of tuning the settings on new or existing boiler controls. The guideline focuses on one-pipe steam systems, though many of the assessment methods can be generalized to two-pipe steam systems.

Crash data modeling with a generalized estimator.

Science.gov (United States)

Ye, Zhirui; Xu, Yueru; Lord, Dominique

2018-05-11

The investigation of relationships between traffic crashes and relevant factors is important in traffic safety management. Various methods have been developed for modeling crash data. In real world scenarios, crash data often display the characteristics of over-dispersion. However, on occasions, some crash datasets have exhibited under-dispersion, especially in cases where the data are conditioned upon the mean. The commonly used models (such as the Poisson and the NB regression models) have associated limitations to cope with various degrees of dispersion. In light of this, a generalized event count (GEC) model, which can be generally used to handle over-, equi-, and under-dispersed data, is proposed in this study. This model was first applied to case studies using data from Toronto, characterized by over-dispersion, and then to crash data from railway-highway crossings in Korea, characterized with under-dispersion. The results from the GEC model were compared with those from the Negative binomial and the hyper-Poisson models. The cases studies show that the proposed model provides good performance for crash data characterized with over- and under-dispersion. Moreover, the proposed model simplifies the modeling process and the prediction of crash data. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

NARCIS (Netherlands)

Lagro-Janssen, A.L.M.

2005-01-01

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

Generalized versus non-generalized neural network model for multi-lead inflow forecasting at Aswan High Dam

Directory of Open Access Journals (Sweden)

A. El-Shafie

2011-03-01

Full Text Available Artificial neural networks (ANN have been found efficient, particularly in problems where characteristics of the processes are stochastic and difficult to describe using explicit mathematical models. However, time series prediction based on ANN algorithms is fundamentally difficult and faces problems. One of the major shortcomings is the search for the optimal input pattern in order to enhance the forecasting capabilities for the output. The second challenge is the over-fitting problem during the training procedure and this occurs when ANN loses its generalization. In this research, autocorrelation and cross correlation analyses are suggested as a method for searching the optimal input pattern. On the other hand, two generalized methods namely, Regularized Neural Network (RNN and Ensemble Neural Network (ENN models are developed to overcome the drawbacks of classical ANN models. Using Generalized Neural Network (GNN helped avoid over-fitting of training data which was observed as a limitation of classical ANN models. Real inflow data collected over the last 130 years at Lake Nasser was used to train, test and validate the proposed model. Results show that the proposed GNN model outperforms non-generalized neural network and conventional auto-regressive models and it could provide accurate inflow forecasting.

Development of human factors design review guidelines

International Nuclear Information System (INIS)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul

1997-10-01

The Objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25, Human factors engineering program review model' and '26, Review criteria for human actors aspects of advanced controls and instrumentation', which are related to the development of human factors safety regulation guides be ing performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we well update the guidelines by reviewing the literature related to alarm design published after 1994

Development of human factors design review guidelines

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea)

1997-10-01

The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: 25. Human Factors Engineering Program Review Model and 26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation, which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we will update the guidelines by reviewing the literature related to alarm design published after 1994. (author). 12 refs., 5 figs., 2 tabs.

Guidelines for Inter-Enterprise Management (IEM), GLOBEMEN Deliverable D23

DEFF Research Database (Denmark)

Tølle, Martin; Vesterager, Johan

2002-01-01

This document is a deliverable of Work package 2 of the IMS Globemen (GMN) project: D23 Guidelines for Inter-Enterprise Management (IEM). IMS Globemen is an inter-regional project aiming to develop methods, tools and architectures to support inter-enterprise operations in one-of-kind industries......-Project, the developed solution for Inter-Enterprise Management. The structure of the deliverable is as follows: - Chapter 1 introduces the guidelines and outlines the structure of the deliverable - Chapter 2 defines key terms along with a list of acronyms used in the deliverable - Chapter 3 gives a general introduction...... for inter-enterprise management (IEM). - Chapter 5 contains the actual Guidelines The chapter contains guidelines for how to prepare enterprise network in being able to set up and manage virtual enterprises. The section consists of a set of activities an enterprise should/could consider when preparing...

Generalized heat-transport equations: parabolic and hyperbolic models

Science.gov (United States)

Rogolino, Patrizia; Kovács, Robert; Ván, Peter; Cimmelli, Vito Antonio

2018-03-01

We derive two different generalized heat-transport equations: the most general one, of the first order in time and second order in space, encompasses some well-known heat equations and describes the hyperbolic regime in the absence of nonlocal effects. Another, less general, of the second order in time and fourth order in space, is able to describe hyperbolic heat conduction also in the presence of nonlocal effects. We investigate the thermodynamic compatibility of both models by applying some generalizations of the classical Liu and Coleman-Noll procedures. In both cases, constitutive equations for the entropy and for the entropy flux are obtained. For the second model, we consider a heat-transport equation which includes nonlocal terms and study the resulting set of balance laws, proving that the corresponding thermal perturbations propagate with finite speed.

Guidelines for Professional Training of Junior Medical Staff in the Context of European Experience

Science.gov (United States)

Sosnova, Myroslava

2016-01-01

The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists' professional training, in particular, published by European Union of Medical…

The general dynamic model

DEFF Research Database (Denmark)

Borregaard, Michael K.; Matthews, Thomas J.; Whittaker, Robert James

2016-01-01

Aim: Island biogeography focuses on understanding the processes that underlie a set of well-described patterns on islands, but it lacks a unified theoretical framework for integrating these processes. The recently proposed general dynamic model (GDM) of oceanic island biogeography offers a step...... towards this goal. Here, we present an analysis of causality within the GDM and investigate its potential for the further development of island biogeographical theory. Further, we extend the GDM to include subduction-based island arcs and continental fragment islands. Location: A conceptual analysis...... of evolutionary processes in simulations derived from the mechanistic assumptions of the GDM corresponded broadly to those initially suggested, with the exception of trends in extinction rates. Expanding the model to incorporate different scenarios of island ontogeny and isolation revealed a sensitivity...

Siting guidelines and their role in repository site selection

International Nuclear Information System (INIS)

Hanlon, C.L.

1985-01-01

The first requirement of the Nuclear Waste Policy Act was for the Secretary of Energy to issue general guidelines for siting repositories. The guidelines were to specify detailed geologic considerations that would be the primary criteria for the selection of sites in various host rocks, as well as factors that would qualify or disqualify any site from development as a repository. These guidelines were clearly intended to provide not only the framework for the siting program but also the stimulus for establishing effective communication and consultation among the parties involved in the program. The Act further required that the guidelines be a factor in the development of all future decision documents of the Office of Civilian Radioactive Waste Management, including the environmental assessments that would accompany the nomination of sites for characterization, the site-characterization plans that are to be prepared before the sinking of exploratory shafts at any candidate site, and the environmental impact statement that is to support the recommendation of a site for development as a repository. More than two years after its passage, the intention of the Act for the guidelines has been realized. Concurred in by the Nuclear Regulatory Commission on June 22, 1984, and issued by the Department in November 1984, the guidelines include postclosure technical guidelines that apply to conditions governing the long-term performance of the repository system; preclosure technical guidelines that apply to conditions governing the siting, construction, operation, and closure of the repository; and system guidelines whose objective is to ensure that the regulatory requirements of the Environmental Protection Agency and the Nuclear Regulatory Commission are met

Evidence-based practice guidelines in OHS: are they agree-able?

Science.gov (United States)

Hulshof, Carel; Hoenen, John

2007-01-01

The purpose of this study was to evaluate the acceptance, validity, reliability and feasibility of the AGREE (Appraisal of Guidelines and REsearch and Evaluation) instrument to assess the quality of evidence-based practice guidelines for occupational physicians. In total, 6 practice guidelines of the Netherlands Society of Occupational Medicine (NVAB) were appraised by 20 occupational health professionals and experts in guideline development or implementation. Although appraisers often disagreed on individual item scores, the internal consistency and interrater reliability for most domains was sufficient. The AGREE criteria were in general considered relevant and no major suggestions for additional items for use in the context of occupational health were brought up. The domain scores for the individual guidelines show a wide variety: 'applicability' had on average the lowest mean score (53%) while 'scope and purpose' had the highest one (87%). Low scores indicate where improvements are possible and necessary, e.g. by providing more information about the development. Key experts in occupational health report that AGREE is a relevant and easy to use instrument to evaluate quality aspects and the included criteria provide a good framework to develop or update evidence-based practice guidelines in the field of occupational health.

[Application of the grayscale standard display function to general purpose liquid-crystal display monitors for clinical use].

Science.gov (United States)

Tanaka, Nobukazu; Naka, Kentaro; Sueoka, Masaki; Higashida, Yoshiharu; Morishita, Junji

2010-01-20

Interpretations of medical images have been shifting to soft-copy readings with liquid-crystal display (LCD) monitors. The display function of the medical-grade LCD monitor for soft-copy readings is recommended to calibrate the grayscale standard display function (GSDF) in accordance with the guidelines of Japan and other countries. In this study, the luminance and display function of five models of eight general purpose LCD monitors were measured to gain an understanding of their characteristics. Moreover, the display function (gamma 2.2 or gamma 1.8) of general purpose LCD monitors was converted to GSDF through the use of a look-up table, and the detectability of a simulated lung nodule in the chest x-ray image was examined. As a result, the maximum luminance, contrast ratio, and luminance uniformity of general purpose LCD monitors, except for one model of two LCD monitors, met the management grade 1 standard in the guideline JESRA X-0093-2005. In addition, the detectability of simulated lung nodule in the mediastinal space was obviously improved by converting the display function of a general purpose LCD monitor into GSDF.

Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China.

Science.gov (United States)

Wang, Zuowei; Gao, Keming; Hong, Wu; Xing, Mengjuan; Wu, Zhiguo; Chen, Jun; Zhang, Chen; Yuan, Chengmei; Huang, Jia; Peng, Daihui; Wang, Yong; Lu, Weihong; Yi, Zhenghui; Yu, Xin; Zhao, Jingping; Fang, Yiru

2014-06-05

With the recent attention to evidence-based medicine in psychiatry, a number of treatment guidelines for bipolar disorders have been published. This survey investigated prescribing patterns and predictors for guideline disconcordance in the acute treatment of a manic and mixed episode across mainland China. The pharmacological treatments of 2828 patients with a recent hypomanic/manic episode or mixed state were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. The most common pattern of pharmacological treatments for an acute manic or mixed episode was a mood stabilizer plus an atypical antipsychotic (n = 1345, 47.6%), and the rate of guideline-disconcordant treatments was 11.1%. The patients who were treated in general hospitals were more likely to receive guideline-disconcordant treatments than those who were treated in psychiatric hospitals, with an OR of 1.84 (95% CI 1.44-2.36). Similarly, the patients with a mixed episode at study entry were more likely to receive guideline-disconcordant treatments than those with a manic episode, with an OR of 1.69 (95% CI 1.22-2.35). In contrast, the patients with a longer duration of disease (>5 years) were less likely to receive guideline-disconcordant treatments than those with a short duration, with an OR of 0.47 (95% CI 0.36-0.60). In mainland China, the disconcordance with treatment guidelines for a most recent acute manic or mixed episode was modest under naturalistic conditions. The higher risk for disconcordance in general hospitals than in psychiatric hospitals suggests that special education based on treatment guidelines to practitioners in general hospitals is necessary in order to reduce the risk for disconcordant treatments.

Generalized Path Analysis and Generalized Simultaneous Equations Model for Recursive Systems with Responses of Mixed Types

Science.gov (United States)

Tsai, Tien-Lung; Shau, Wen-Yi; Hu, Fu-Chang

2006-01-01

This article generalizes linear path analysis (PA) and simultaneous equations models (SiEM) to deal with mixed responses of different types in a recursive or triangular system. An efficient instrumental variable (IV) method for estimating the structural coefficients of a 2-equation partially recursive generalized path analysis (GPA) model and…

Reliability assessment of competing risks with generalized mixed shock models

International Nuclear Information System (INIS)

Rafiee, Koosha; Feng, Qianmei; Coit, David W.

2017-01-01

This paper investigates reliability modeling for systems subject to dependent competing risks considering the impact from a new generalized mixed shock model. Two dependent competing risks are soft failure due to a degradation process, and hard failure due to random shocks. The shock process contains fatal shocks that can cause hard failure instantaneously, and nonfatal shocks that impact the system in three different ways: 1) damaging the unit by immediately increasing the degradation level, 2) speeding up the deterioration by accelerating the degradation rate, and 3) weakening the unit strength by reducing the hard failure threshold. While the first impact from nonfatal shocks comes from each individual shock, the other two impacts are realized when the condition for a new generalized mixed shock model is satisfied. Unlike most existing mixed shock models that consider a combination of two shock patterns, our new generalized mixed shock model includes three classic shock patterns. According to the proposed generalized mixed shock model, the degradation rate and the hard failure threshold can simultaneously shift multiple times, whenever the condition for one of these three shock patterns is satisfied. An example using micro-electro-mechanical systems devices illustrates the effectiveness of the proposed approach with sensitivity analysis. - Highlights: • A rich reliability model for systems subject to dependent failures is proposed. • The degradation rate and the hard failure threshold can shift simultaneously. • The shift is triggered by a new generalized mixed shock model. • The shift can occur multiple times under the generalized mixed shock model.

Environmental guidelines for reuse of ash in civil engineering applications - phase 2; Miljoeriktlinjer foer askanvaendning i anlaeggningsbyggande - etapp 2

Energy Technology Data Exchange (ETDEWEB)

Bendz, David; Wik, Ola; Elert, Mark; Haakansson, Karsten

2006-07-15

exposure scenarios including exposure pathways and points of compliance. Risk evaluation becomes an issue of comparing the estimated (-modeled) increased concentrations at specified target points with general human and environmental toxicological criteria. Guidelines have been calculated for two different types of constructions, with or without an impermeable (asphalt-) pavement that prevents rain water from infiltrating into the road. Also the possible exposure of intruding ground water has been taken into account. A set of ashes, for which data on total content and leachability was available in the ALLASKA and MALTE database, have been classified according to three categories of applications/situations. The results show that due to lack of data it could not be assessed whether naphthalene, bens(a)pyren, antimony and selen in ashes imply an insignificant risk or not. Only guidelines for leachability could be calculated for antimony and selen, showing that 90% of the ashes fall below the guidelines and thus constitute an insignificant risk in a construction. Cadmium, copper, chromium, mercury, nickel and zinc show a large margin to the calculated guidelines for total content and leachability for most ashes. Thus, ashes in constructions constitute an acceptable risk with respect to these elements. Arsenic and lead in ashes fall below the guideline values for leaching, although with small margins in some cases. However, the total content of arsenic in some ashes exceeds the guideline values when used in an unpaved construction. Accordingly, it can not be excluded that the reuse of some ashes in some applications may imply a certain risk. Spreading as dust, deposition on vegetables and the subsequent intake has reveled itself as an important exposure pathway. Little data, theory and models are available on dust generation and transport, the calculations made here are rough and conservative. Also, guidelines for the ash construction left in place in the post use phase are

Guidelines for generators of hazardous chemical waste at LBL and guidelines for generators of radioactive and mixed waste at LBL

International Nuclear Information System (INIS)

1991-09-01

In part one of this document the Governing Documents and Definitions sections provide general guidelines and regulations applying to the handling of hazardous chemical wastes. The remaining sections provide details on how you can prepare your waste properly for transport and disposal. They are correlated with the steps you must take to properly prepare your waste for pickup. The purpose of the second part of this document is to provide the acceptance criteria for the transfer of radioactive and mixed waste to LBL's Hazardous Waste Handling Facility (HWHF). These guidelines describe how you, as a generator of radioactive or mixed waste, can meet LBL's acceptance criteria for radioactive and mixed waste

29 CFR 215.2 - General.

Science.gov (United States)

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false General. 215.2 Section 215.2 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR GUIDELINES, SECTION 5333(b), FEDERAL TRANSIT LAW § 215.2 General. Upon receipt of copies of applications for Federal assistance subject to 49 U...

Foundations of linear and generalized linear models

CERN Document Server

Agresti, Alan

2015-01-01

A valuable overview of the most important ideas and results in statistical analysis Written by a highly-experienced author, Foundations of Linear and Generalized Linear Models is a clear and comprehensive guide to the key concepts and results of linear statistical models. The book presents a broad, in-depth overview of the most commonly used statistical models by discussing the theory underlying the models, R software applications, and examples with crafted models to elucidate key ideas and promote practical model building. The book begins by illustrating the fundamentals of linear models,

[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

Science.gov (United States)

Planjar-Prvan, Miljenka; Granić, Davorka

2005-01-01

The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

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

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

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

Modeling containment of large wildfires using generalized linear mixed-model analysis

Science.gov (United States)

Mark Finney; Isaac C. Grenfell; Charles W. McHugh

2009-01-01

Billions of dollars are spent annually in the United States to contain large wildland fires, but the factors contributing to suppression success remain poorly understood. We used a regression model (generalized linear mixed-model) to model containment probability of individual fires, assuming that containment was a repeated-measures problem (fixed effect) and...

Gap Between Clinical Practice and Guidelines: A National Survey of the Knowledge of Recommended Heart Failure Guidelines Among Chinese Physicians.

Science.gov (United States)

Gan, Tianyi; Zhang, Yuhui; Liu, Nini; Huang, Yuhui; Liang, Tuo; Zhao, Xuemei; Zhang, Jian

We investigated the current level of knowledge of Chinese heart failure (HF) guidelines among physicians, as a reference for the promotion and transformation of HF knowledge. Physicians from 88 hospitals in 27 provinces of China completed our survey between July and December 2014. The questions covered the main points included in the Chinese HF diagnosis and treatment guidelines (2014). A total of 2146 physicians, aged 20 to 62 years (35.6 ± 7.6 years), completed the survey. The correctness rate of their answers to the 15 multiple-choice questions in the HF questionnaire was generally low (mean 32.6%). The mean correctness rate for 10 blank-filling questions about the target doses of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and β-blockers was 42.5%. On the basis of their responses, physicians whose knowledge of the guidelines was "excellent," "good," "medium," and "bad" accounted for 1.1%, 11.4%, 14.2%, and 73.4%, respectively. Physicians who possessed a higher level of qualifications had significantly greater awareness of HF guidelines than those with relatively low qualifications (P knowledge about HF. There is a need to improve physicians' education about HF in China.

Dietary Guidelines for the Asia Pacific Region.

Science.gov (United States)

Binns, Colin W; Lee, Mi Kyung; Kagawa, Masaharu; Low, Wah Yun; Liqian, Qiu; Guldan, Georgia S; Hokama, Tomiko; Nanishi, Keiko; Oy, Sreymom; Tang, Li; Zerfas, Alfred

2017-03-01

Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.

Interoperability Guidelines for Lithuanian E-Learning Management Systems

Directory of Open Access Journals (Sweden)

Eugenijus Kurilovas

2013-08-01

Full Text Available Purpose – the paper aims to analyse e-learning content and repositories along with the problems of learning organisation interoperability. The main objective of the paper is to analyse scientific research results and the newest international experience in the area and to provide interoperability guidelines and recommendations for the implementation of appropriate Lithuanian state programmes. The learning content and repositories recommendations are designed for the implementation of the Lithuanian education portal project as well as Lithuanian Virtual University (LVU programme’s information services’ (LABT / eLABa and e-learning services’ (LieDM sub-programmes. The whole education institution recommendations are designed for the maintenance and development of LVU programme’s management services’ (LieMSIS system.Design/methodology/approach – methods used for the general analysis of proposed interoperability guidelines (reccomendations were bibliographic research and comparative analysis of Lithuanian and foreign scientific works published in periodicals and large-scale EU-funded interoperability projects deliverables. System analysis and comparative analysis methods were used in order to formulate and analyse systems’ interoperability guidelines and recommendations. The author employed the experimental research method while working in the appropriate EU-funded interoperability projects to form the guidelines (recommendations. In order to summarize the results, the evaluative research method was used.Findings – the international guidelines and recommendations presented in the paper could be suitable for implementation while developing Lithuanian state education information systems such as the Lithuanian education portal, the Lithuanian academic libraries’ (eLABa system, the Lithuanian distance learning system (LieDM, and the Lithuanian universities’ management system (LieMSIS.Research limitations/implications – the paper

Emergency operating procedures guidelines for pressurized water reactors - a progress report

International Nuclear Information System (INIS)

Lyon, W.C.

1984-01-01

Emergency Operating Procedures (EOPs) contain the instructions the operator will follow to control a nuclear plant whenever a condition exists that potentially jeopardizes the fuel cladding, the reactor coolant system (RCS) pressure boundary, or the containment. The EOPs are prepared from guidelines which contain the major operator instructions that will be in the EOPs. Guidelines have been prepared by owners' groups having Babcock and Wilcox (BandW), Combustion Engineering (CE), General Electric (GE), and Westinghouse (W) plants. These guidelines cover many aspects of full power operation. Future effort is anticipated to complete coverage of transient events, including severe accidents, all power conditions, and shutdown. This paper describes the philosophy which has guided NRC technical review of guidelines, progress achieved in providing comprehensive coverage of emergency conditions for PWRs, and anticipated future technical activities

Vitamin D: Current Guidelines and Future Outlook.

Science.gov (United States)

Pilz, Stefan; Trummer, Christian; Pandis, Marlene; Schwetz, Verena; Aberer, Felix; Grübler, Martin; Verheyen, Nicolas; Tomaschitz, Andreas; März, Winfried

2018-02-01

Vitamin D is of public health interest because its deficiency is common and is associated with musculoskeletal diseases, as well as extraskeletal diseases, such as cancer, cardiovascular diseases, and infections. Several health authorities have reviewed the existing literature and published nutritional vitamin D guidelines for the general population. There was a wide consensus that serum 25-hydroxyvitamin D [25(OH)D] concentration should be used to assess vitamin D status and intake, and that musculoskeletal, and not extraskeletal, effects of vitamin D should be the basis for nutritional vitamin D guidelines. Recommended target levels for 25(OH)D range from 25 to 50 nmol/l (10 to 20 ng/ml), corresponding to a vitamin D intake of 400 to 800 International Units (10 to 20 μg) per day. It is of concern that significant sections of the general population do not meet these recommended vitamin D levels. This definitely requires action from a public health perspective. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Safety culture enhancement through the implementation of IAEA guidelines

International Nuclear Information System (INIS)

Mengolini, A.; Debarberis, L.

2007-01-01

This paper presents the methodology applied and the results achieved in adapting and implementing the IAEA guidelines on safety culture to a research reactor as a step towards supporting its Life Management Program. The background is presented together with the effort undertaken to develop awareness on safety culture and the enhancement programme hereafter developed. The present study shows how issues of safety culture, management awareness and commitment deserve attention and can be of fundamental relevance also for research reactors. The study presents how guidelines developed specifically for nuclear power installations (NPPs) can be adapted to meet the needs and peculiarities of other nuclear installations. Moreover, the difficulties met during the implementation of the guidelines are discussed and important information and lessons can be learnt for the nuclear industry in general

Developing and implementing health and sustainability guidelines for institutional food service.

Science.gov (United States)

Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

2012-05-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

Virtual reality verification of workplace design guidelines for the process plant control room

International Nuclear Information System (INIS)

Droeivoldsmo, Asgeir; Nystad, Espen; Helgar, Stein

2001-02-01

Early identification of potential human factors guideline-violations and corrective input into the design process is desired for efficient and cost-effective control room design. Virtual reality (VR) technology makes it possible to perform evaluation of the design of the control room at an early stage of the design process, but can we trust the results from such evaluations? This paper describes an experimental validation of a VR model against the real world in five different guideline verification tasks. Results indicate that guideline verification in the VR model can be done with satisfactory accuracy for a number of evaluations. However, some guideline categories require further development of measurement tools and use of a model with higher resolution than the model used in this study. (Author). 30 refs., 4 figs., 1 tab

Implementing guidelines: Proposed definitions of neuropsychology services in pediatric oncology.

Science.gov (United States)

Baum, Katherine T; Powell, Stephanie K; Jacobson, Lisa A; Gragert, Marsha N; Janzen, Laura A; Paltin, Iris; Rey-Casserly, Celiane M; Wilkening, Greta N

2017-08-01

Several organizations have published guidelines for the neuropsychological care of survivors of childhood cancer. However, there is limited consensus in how these guidelines are applied. The model of neuropsychology service delivery is further complicated by the variable terminology used to describe recommended services. In an important first step to translate published guidelines into clinical practice, this paper proposes definitions for specific neuropsychological processes and services, with the goal of facilitating consistency across sites to foster future clinical program development and to clarify clinical practice guidelines. © 2017 Wiley Periodicals, Inc.

Practical guidelines for qualitative research using online forums.

Science.gov (United States)

Im, Eun-Ok; Chee, Wonshik

2012-11-01

With an increasing number of Internet research in general, the number of qualitative Internet studies has recently increased. Online forums are one of the most frequently used qualitative Internet research methods. Despite an increasing number of online forum studies, very few articles have been written to provide practical guidelines to conduct an online forum as a qualitative research method. In this article, practical guidelines in using an online forum as a qualitative research method are proposed based on three previous online forum studies. First, the three studies are concisely described. Practical guidelines are proposed based on nine idea categories related to issues in the three studies: (a) a fit with research purpose and questions, (b) logistics, (c) electronic versus conventional informed consent process, (d) structure and functionality of online forums, (e) interdisciplinary team, (f) screening methods, (g) languages, (h) data analysis methods, and (i) getting participants' feedback.

Generalized algebra-valued models of set theory

NARCIS (Netherlands)

Löwe, B.; Tarafder, S.

2015-01-01

We generalize the construction of lattice-valued models of set theory due to Takeuti, Titani, Kozawa and Ozawa to a wider class of algebras and show that this yields a model of a paraconsistent logic that validates all axioms of the negation-free fragment of Zermelo-Fraenkel set theory.

Parameter Estimation for a Computable General Equilibrium Model

DEFF Research Database (Denmark)

Arndt, Channing; Robinson, Sherman; Tarp, Finn

We introduce a maximum entropy approach to parameter estimation for computable general equilibrium (CGE) models. The approach applies information theory to estimating a system of nonlinear simultaneous equations. It has a number of advantages. First, it imposes all general equilibrium constraints...

Multivariate covariance generalized linear models

DEFF Research Database (Denmark)

Bonat, W. H.; Jørgensen, Bent

2016-01-01

are fitted by using an efficient Newton scoring algorithm based on quasi-likelihood and Pearson estimating functions, using only second-moment assumptions. This provides a unified approach to a wide variety of types of response variables and covariance structures, including multivariate extensions......We propose a general framework for non-normal multivariate data analysis called multivariate covariance generalized linear models, designed to handle multivariate response variables, along with a wide range of temporal and spatial correlation structures defined in terms of a covariance link...... function combined with a matrix linear predictor involving known matrices. The method is motivated by three data examples that are not easily handled by existing methods. The first example concerns multivariate count data, the second involves response variables of mixed types, combined with repeated...

FDG PET and PET/CT : EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, Ronald; O'Doherty, Mike J.; Weber, Wolfgang A.; Mottaghy, Felix M.; Lonsdale, Markus N.; Stroobants, Sigrid G.; Oyen, Wim J. G.; Kotzerke, Joerg; Hoekstra, Otto S.; Pruim, Jan; Marsden, Paul K.; Tatsch, Klaus; Hoekstra, Corneline J.; Visser, Eric P.; Arends, Bertjan; Verzijlbergen, Fred J.; Zijlstra, Josee M.; Comans, Emile F. I.; Lammertsma, Adriaan A.; Paans, Anne M.; Willemsen, Antoon T.; Beyer, Thomas; Bockisch, Andreas; Schaefer-Prokop, Cornelia; Delbeke, Dominique; Baum, Richard P.; Chiti, Arturo; Krause, Bernd J.

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, Ronald; O'Doherty, Mike J.; Weber, Wolfgang A.; Mottaghy, Felix M.; Lonsdale, Markus N.; Stroobants, Sigrid G.; Oyen, Wim J. G.; Kotzerke, Joerg; Hoekstra, Otto S.; Pruim, Jan; Marsden, Paul K.; Tatsch, Klaus; Hoekstra, Corneline J.; Visser, Eric P.; Arends, Bertjan; Verzijlbergen, Fred J.; Zijlstra, Josee M.; Comans, Emile F. I.; Lammertsma, Adriaan A.; Paans, Anne M.; Willemsen, Antoon T.; Beyer, Thomas; Bockisch, Andreas; Schaefer-Prokop, Cornelia; Delbeke, Dominique; Baum, Richard P.; Chiti, Arturo; Krause, Bernd J.

2010-01-01

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about[18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, R.; O'Doherty, M.J.; Weber, W.A.; Mottaghy, F.M.; Lonsdale, M.N.; Stroobants, S.G.; Oyen, W.J.G.; Kotzerke, J.; Hoekstra, O.S.; Pruim, J.; Marsden, P.K.; Tatsch, K.; Hoekstra, C.J.; Visser, E.P.; Arends, B.; Verzijlbergen, F.J.; Zijlstra, J.M.; Comans, E.F.I.; Lammertsma, A.A.; Paans, A.M.; Willemsen, A.T.; Beyer, T.; Bockisch, A.; Schaefer-Prokop, C.; Delbeke, D.; Baum, R.P.; Chiti, A.; Krause, B.J.

2010-01-01

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

General regression and representation model for classification.

Directory of Open Access Journals (Sweden)

Jianjun Qian

Full Text Available Recently, the regularized coding-based classification methods (e.g. SRC and CRC show a great potential for pattern classification. However, most existing coding methods assume that the representation residuals are uncorrelated. In real-world applications, this assumption does not hold. In this paper, we take account of the correlations of the representation residuals and develop a general regression and representation model (GRR for classification. GRR not only has advantages of CRC, but also takes full use of the prior information (e.g. the correlations between representation residuals and representation coefficients and the specific information (weight matrix of image pixels to enhance the classification performance. GRR uses the generalized Tikhonov regularization and K Nearest Neighbors to learn the prior information from the training data. Meanwhile, the specific information is obtained by using an iterative algorithm to update the feature (or image pixel weights of the test sample. With the proposed model as a platform, we design two classifiers: basic general regression and representation classifier (B-GRR and robust general regression and representation classifier (R-GRR. The experimental results demonstrate the performance advantages of proposed methods over state-of-the-art algorithms.

General Business 101.

Science.gov (United States)

Manitoba Dept. of Education, Winnipeg.

This teaching guide contains guidelines for conducting a secondary-level general business course. Intended to serve as an introduction to business and consumer fundamentals, the course provides socioeconomic background useful to students seeking vocational preparation for office and clerical occupations. The goals and objectives of the course are…

Modelling uncertainty with generalized credal sets: application to conjunction and decision

Science.gov (United States)

Bronevich, Andrey G.; Rozenberg, Igor N.

2018-01-01

To model conflict, non-specificity and contradiction in information, upper and lower generalized credal sets are introduced. Any upper generalized credal set is a convex subset of plausibility measures interpreted as lower probabilities whose bodies of evidence consist of singletons and a certain event. Analogously, contradiction is modelled in the theory of evidence by a belief function that is greater than zero at empty set. Based on generalized credal sets, we extend the conjunctive rule for contradictory sources of information, introduce constructions like natural extension in the theory of imprecise probabilities and show that the model of generalized credal sets coincides with the model of imprecise probabilities if the profile of a generalized credal set consists of probability measures. We give ways how the introduced model can be applied to decision problems.

Palliative Sedation: An Analysis of International Guidelines and Position Statements.

Science.gov (United States)

Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C

2015-09-01

To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English. Exclusion criteria were palliative sedation in children, acute illness, procedural, or burns, and predominantly ethical discussions. Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice and Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States. © The Author(s) 2014.

Generalized continua as models for classical and advanced materials

CERN Document Server

Forest, Samuel

2016-01-01

This volume is devoted to an actual topic which is the focus world-wide of various research groups. It contains contributions describing the material behavior on different scales, new existence and uniqueness theorems, the formulation of constitutive equations for advanced materials. The main emphasis of the contributions is directed on the following items - Modelling and simulation of natural and artificial materials with significant microstructure, - Generalized continua as a result of multi-scale models, - Multi-field actions on materials resulting in generalized material models, - Theories including higher gradients, and - Comparison with discrete modelling approaches.

Obstetric Thromboprophylaxis: The Swedish Guidelines

Directory of Open Access Journals (Sweden)

Pelle G. Lindqvist

2011-01-01

Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

Developing evidence-based guidelines for referral for short stature

NARCIS (Netherlands)

Grote, F.K.; Dommelen, P. van; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Verkerk, P.H.; Wit, J.M.; Buuren, S. van

2008-01-01

Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population.

Parameter Estimation for a Computable General Equilibrium Model

DEFF Research Database (Denmark)

Arndt, Channing; Robinson, Sherman; Tarp, Finn

2002-01-01

We introduce a maximum entropy approach to parameter estimation for computable general equilibrium (CGE) models. The approach applies information theory to estimating a system of non-linear simultaneous equations. It has a number of advantages. First, it imposes all general equilibrium constraints...

Radiological risk guidelines for nonreactor nuclear facilities at the Pacific Northwest Laboratory

International Nuclear Information System (INIS)

Lucas, D.E.; Ikenberry, T.A.

1993-09-01

Radiological risk evaluation guidelines for the public and workers have been developed at the Pacific Northwest Laboratory (PNL) based upon the Nuclear Safety Policy of the US Department of Energy (DOE) established in Secretary of Energy Notice SEN-35-91. The DOE nuclear safety policy states that the general public shall be protected such that no individual bears significant additional risk to health and safety from the operation of a DOE nuclear facility above the risks to which members of the general population are normally exposed. The radiological risk evaluation guidelines developed at PNL are unique in that they are (1) based upon quantitative risk goals and (2) provide a consistent level of risk management. These guidelines are used to evaluate the risk from radiological accidents that may occur during research and development activities at PNL, and are not intended for evaluation of routine exposures. A safety analyst uses the,frequency of the potential accident and the radiological dose to a given receptor to determine if the accident consequences meet the objectives of the Nuclear Safety Policy. The radiological risk evaluation guidelines are an effective tool for assisting in the management of risk at DOE nonreactor nuclear facilities. These guidelines (1) meet the nuclear safety policy of DOE, (2) establish a tool for managing risk at a consistent level within the defined constraints, and (3) set risk at an appropriate level, as compared with other risks encountered by the public and worker. Table S.1 summarizes the guidelines developed in this report

Generalized waste package containment model

International Nuclear Information System (INIS)

Liebetrau, A.M.; Apted, M.J.

1985-02-01

The US Department of Energy (DOE) is developing a performance assessment strategy to demonstrate compliance with standards and technical requirements of the Environmental Protection Agency (EPA) and the Nuclear Regulatory Commission (NRC) for the permanent disposal of high-level nuclear wastes in geologic repositories. One aspect of this strategy is the development of a unified performance model of the entire geologic repository system. Details of a generalized waste package containment (WPC) model and its relationship with other components of an overall repository model are presented in this paper. The WPC model provides stochastically determined estimates of the distributions of times-to-failure of the barriers of a waste package by various corrosion mechanisms and degradation processes. The model consists of a series of modules which employ various combinations of stochastic (probabilistic) and mechanistic process models, and which are individually designed to reflect the current state of knowledge. The WPC model is designed not only to take account of various site-specific conditions and processes, but also to deal with a wide range of site, repository, and waste package configurations. 11 refs., 3 figs., 2 tabs

A manual for implementing residual radioactive material guidelines

International Nuclear Information System (INIS)

Gilbert, T.L.; Yu, C.; Yuan, Y.C.; Zielen, A.J.; Jusko, M.J.; Wallo, A. III; Argonne National Lab., IL; Dames and Moore, West Valley, NY; Argonne National Lab., IL; USDOE Assistant Secretary for Nuclear Energy, Washington, DC

1989-06-01

This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material at sites identified by the Formerly Utilized Sites Remedial Action Program (FUSRAP) and the Surplus Facilities Management Program (SFMP). It describes the analysis and models used to derive site-specific guidelines for allowable residual concentrations of radionuclides in soil and the design and use of the RESRAD computer code for calculating guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. 36 refs., 16 figs, 22 tabs