END OF NICE 95 AND NICE NT SERVICES

CERN Multimedia

2002-01-01

You are concerned by this article if you still use a computer running NICE 95 or NICE NT. As recommended by the Desktop Forum, NICE 95 and NT services will be stopped according to the following schedule: 31st January 2003: NICE 95/NT will be frozen. Applications will still be able to run, but the helpdesk will not address any NICE 95/NT problems anymore. It will not be possible to reinstall NICE 95/NT anymore. Disk images of the original Windows 95 and Windows NT CDs are available on the network, but it will be up to the user to create those CDs, reinstall the machine(s), as well as to locate and install: the required applications, the device drivers for special hardware, the necessary security patches, an anti-virus software (Operational Circular Nº5 of CERN's Computing Rules requires that Windows PCs are regularly checked for viruses). The original Windows 95 and Windows NT CD images can be obtained from http://cern.ch/win/services/installation/CDImages (please enter your NICE username and pa...

Main-coolant-pump shaft-seal guidelines. Volume 1. Maintenance-manual guidelines. Final report

International Nuclear Information System (INIS)

Fair, C.E.; Greer, A.O.

1983-03-01

This report presents a set of guidelines and a listing of information and data which should be included in maintenance manuals and procedures for Main Coolant Pump Shaft Seals. The noted guidelines and data listing are developed from EPRI sponsored nuclear plant seal operating experience studies. The maintenance oriented results of the most recent such study is summarized. The shaft seal and its auxiliary supporting systems are discussed from both technical and maintenance related viewpoints

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

A cost effectiveness study establishing the impact and accuracy of implementing the NICE guidelines lowering plasma NTproBNP threshold in patients with clinically suspected heart failure at our institution.

Science.gov (United States)

Webb, Jessica; Draper, Jane; Rua, Tiago; Yiu, Yee; Piper, Susan; Teall, Thomas; Fovargue, Lauren; Bolca, Elena; Jackson, Tom; Claridge, Simon; Sieniewicz, Ben; Porter, Bradley; McDiarmid, Adam; Rajani, Ronak; Kapetanakis, Stamatis; Rinaldi, Christopher A; Razavi, Reza; McDonagh, Theresa A; Carr-White, Gerald

2018-04-15

The 2014 National Institute of Clinical Excellence (NICE) guidelines on the management of acute heart failure recommended using a plasma NT-proBNP threshold of 300pg/ml to assist in ruling out the diagnosis of heart failure (HF), updating previous guidelines recommending using a threshold of 400pg/ml. NICE based their recommendations on 6 studies performed in other countries. This study sought to determine the diagnostic and economic implications of using these thresholds in a large unselected UK population. Patient and clinical demographics were recorded for all consecutive suspected HF patients over 12months, as well as clinical outcomes including time to HF hospitalisation and time to death (follow up 15.8months). Of 1995 unselected patients admitted with clinically suspected HF, 1683 (84%) had a NTproBNP over the current NICE recommended threshold, of which 35% received a final diagnosis of HF. Lowering the threshold from 400 to 300pg/ml would have involved screening an additional 61 patients and only would have identified one new patient with HF (sensitivity 0.985, NPV 0.976, area under the curve (AUC) at 300pg/ml 0.67; sensitivity 0.983, NPV 0.977, AUC 0.65 at 400pg/ml). The economic implications of lowering the threshold would have involved additional costs of £42,842.04 (£702.33 per patient screened, or £ 42,824.04 per new HF patient). Applying the recent updated NICE guidelines to an unselected real world population increases the AUC but would have a significant economic impact and only identified one new patient with heart failure. Copyright © 2017 Elsevier B.V. All rights reserved.

End of NICE 95 and NICE NT services

CERN Multimedia

2003-01-01

You are concerned by this article if you still use a computer running NICE 95 or NICE NT. As recommended by the Desktop Forum, NICE 95 and NT services will be stopped according to the following schedule: 31st January 2003: NICE 95/NT will be frozen. Applications will still be able to run, but the helpdesk will not address any NICE 95/NT problems anymore. It will not be possible to reinstall NICE 95/NT anymore. Disk images of the original Windows 95 and Windows NT CDs are available on the network, but it will be up to the user to create those CDs, reinstall the machine(s), as well as to locate and install: - the required applications, - the device drivers for special hardware, - the necessary security patches, - an anti-virus software (Operational Circular N 5 of CERN's Computing Rules (http://cern.ch/ComputingRules) requires that Windows PCs are regularly checked for viruses). The original Windows 95 and Windows NT CD images can be obtained from http://cern.ch/win/services/installation/CDImages (please...

End of NICE 95 and NICE NT services

CERN Document Server

2003-01-01

You are concerned by this article if you still use a computer running NICE 95 or NICE NT. As recommended by the Desktop Forum, NICE 95 and NT services will be stopped according to the following schedule: 31st January 2003: NICE 95/NT will be frozen. Applications will still be able to run, but the helpdesk will not address any NICE 95/NT problems anymore. It will not be possible to reinstall NICE 95/NT anymore. Disk images of the original Windows 95 and Windows NT CDs are available on the network, but it will be up to the user to create those CDs, reinstall the machine(s), as well as to locate and install: - the required applications, - the device drivers for special hardware, - the necessary security patches, - an anti-virus software (Operational Circular N 5 of CERN's Computing Rules (http://cern.ch/ComputingRules) requires that Windows PCs are regularly checked for viruses). The original Windows 95 and Windows NT CD images can be obtained from http://cern.ch/win/services/installation/CDImages (please ...

A Review of NICE Methods and Processes Across Health Technology Assessment Programmes: Why the Differences and What is the Impact?

Science.gov (United States)

Cowles, Emma; Marsden, Grace; Cole, Amanda; Devlin, Nancy

2017-08-01

Decisions made by the National Institute for Health and Care Excellence (NICE) exert an influence on the allocation of resources within 'fixed' National Health Service budgets. Yet guidance for different types of health interventions is handled via different 'programmes' within NICE, which follow different methods and processes. The objective of this research was to identify differences in the processes and methods of NICE health technology assessment programmes and to explore how these could impact on allocative efficiency within the National Health Service. Data were extracted from the NICE technology appraisal programme, medical technologies guidance, diagnostic assessment programme, highly specialised technologies programme, and clinical guidelines process and methods manuals to undertake a systematic comparison. Five qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. The main differences identified were in the required evidence review period, or lack thereof, mandatory funding status, the provision of a reference case for economic evaluation, the requirement for and the type of economic analysis undertaken, and the decision making criteria used for appraisal. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. Nevertheless, from a strict utilitarian view, there are several potential areas of inefficiency that could lead to the misallocation of resources within the National Health Service, although some of these might be eliminated or reduced if an egalitarian view is taken. The challenge is determining where society is willing to trade health gains between different people.

End of NICE 95 and NICE NT services (Reminder)

CERN Multimedia

2003-01-01

You are concerned by this article if you still use a computer running NICE 95 or NICE NT. As recommended by the Desktop Forum, NICE 95 and NT services are progressively phased out according to the following schedule: Since 31st January 2003: NICE 95/NT have been frozen. Applications are still able to run, but the helpdesk does not address any NICE 95/NT problems anymore. It is not possible to reinstall NICE 95/NT anymore. Disk images of the original Windows 95 and Windows NT CDs are available on the network, but it is up to the user to create those CDs, reinstall the machine(s), as well as to locate and install: - the required applications, - the device drivers for special hardware, - the necessary security patches, - an anti-virus software (Operational Circular N 5 of CERN's Computing Rules (http://cern.ch/ComputingRules) requires that Windows PCs are regularly checked for viruses). The original Windows 95 and Windows NT CD images can be obtained from http://cern.ch/win/services/installation/CDImages (ple...

NICE recommendations for the assessment of stable chest pain: assessing the early economic and service impact in the rapid-access chest pain service.

Science.gov (United States)

Ashrafi, Reza; Raga, Santosh; Abdool, Ali; Disney, Andrew; Wong, Peter; Davis, Gershan K

2013-05-01

In 2010, guidelines published by the National Institute for Clinical Excellence (NICE) suggested a change in the way patients with stable chest pain of suspected cardiac origin were investigated. These guidelines removed exercise treadmill testing from routine use and introduced cardiac CT to regular use. To investigate whether these guidelines had improved our service provision by reducing the number of further investigations required to make a diagnosis, and to see if our costs had increased now that the less expensive exercise treadmill tests were not recommended. Clinic letters were used to assess patients pretest likelihood of coronary artery disease for two six-month cohorts of consecutive patients seen in the rapid access chest pain clinic (January-June 2010 and July-December 2011) using NICE published methodology, and to ascertain which investigations patients had. Using NICE modelled costs, we generated comparative hypothetical costs for each cohort and an average cost per patient. In the January-June 2010 cohort, 435 patients with chest pain were seen, and in July-December 2011, 334 patients were seen. In the pre-NICE guidelines cohort, 23% of patients required two investigations as compared with 11.4% in the post-NICE guidelines cohort, with no patient requiring three investigations as compared with 3% in the original cohort. There was no significant increase in costs per patient in the post-NICE guidance group. Implementing NICE guidance reduced the number of investigations needed per patient, and did not prove more expensive for our department in the short term.

77 FR 24764 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

Science.gov (United States)

2012-04-25

...-0053] Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices AGENCY... proposed voluntary NHTSA Driver Distraction Guidelines for in-vehicle electronic devices. The agency... Driver Distraction Guidelines for in-vehicle electronic devices (77 FR 11200). The proposed NHTSA...

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

Directory of Open Access Journals (Sweden)

Paul C Langley

2017-01-01

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

Are current UK National Institute for Health and Clinical Excellence (NICE) obesity risk guidelines useful? Cross-sectional associations with cardiovascular disease risk factors in a large, representative English population.

Science.gov (United States)

Tabassum, Faiza; Batty, G David

2013-01-01

The National Institute for Health and Clinical Excellence (NICE) has recently released obesity guidelines for health risk. For the first time in the UK, we estimate the utility of these guidelines by relating them to the established cardiovascular disease (CVD) risk factors. Health Survey for England (HSE) 2006, a population-based cross-sectional study in England was used with a sample size of 7225 men and women aged ≥35 years (age range: 35-97 years). The following CVD risk factor outcomes were used: hypertension, diabetes, total and high density lipoprotein cholesterol, glycated haemoglobin, fibrinogen, C-reactive protein and Framingham risk score. Four NICE categories of obesity were created based on body mass index (BMI) and waist circumference (WC): no risk (up to normal BMI and low/high WC); increased risk (normal BMI & very high WC, or obese & low WC); high risk (overweight & very high WC, or obese & high WC); and very high risk (obese I & very high WC or obese II/III with any levels of WC. Men and women in the very high risk category had the highest odds ratios (OR) of having unfavourable CVD risk factors compared to those in the no risk category. For example, the OR of having hypertension for those in the very high risk category of the NICE obesity groupings was 2.57 (95% confidence interval 2.06 to 3.21) in men, and 2.15 (1.75 to 2.64) in women. Moreover, a dose-response association between the adiposity groups and most of the CVD risk factors was observed except total cholesterol in men and low HDL in women. Similar results were apparent when the Framingham risk score was the outcome of interest. In conclusion, the current NICE definitions of obesity show utility for a range of CVD risk factors and CVD risk in both men and women.

Will the implementation of the 2007 National Institute for Health and Clinical Excellence (NICE) guidelines on childhood urinary tract infection (UTI) in the UK miss significant urinary tract pathology?

Science.gov (United States)

Deader, Rafia; Tiboni, Sonia G; Malone, Padraig S J; Fairhurst, Joanna

2012-08-01

• To investigate whether the implementation of the August 2007 National Institute for Health and Clinical Excellence (NICE) guidelines would miss significant urinary tract pathology in children with urinary tract infection (UTI). • All ultrasound (US) performed in children aged >6 months, during the year 1 August 2006 to 31 July 2007 for UTI, were retrospectively studied. • Each US scan in the study population of 346 was categorised dependent on whether it was appropriate or inappropriate to have been performed under the new guidelines and whether the US scan was normal or abnormal. • The records of each patient with an inappropriate abnormal US scan were re-analysed to see if patient management was affected by the US scan. • In 2011 patients with an original inappropriate abnormal US scan were re-evaluated to identify if any had presented with further urinary pathology. • In accordance with the NICE guidelines patients were divided by age. • Children aged 0.5-3 years: 78/95 (82%) US scans were inappropriate of which 12 (15%) were abnormal and four of these had a further documented UTI. After careful assessment of the US abnormalities it was judged that only one would have benefited from the initial US scan. • Children aged >3 years: 146/251 (58%) US scans were inappropriate of which 21(14%) were abnormal and six of these (29%) had a further documented UTI. After careful assessment of the US abnormalities it was judged that only three of 21 (14%) would have benefited from the initial US scan. • The vast majority of anomalies detected on the inappropriate US scans were of little clinical significance. • It is difficult to identify any patient who would have been truly disadvantaged if the US scan had not been performed after the initial UTI. • The NICE guidelines are safe to follow. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

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 survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines.

LENUS (Irish Health Repository)

Kennedy, Kieran M

2010-01-01

BACKGROUND: The aim of this study was to establish current practices amongst general practitioners in the West of Ireland with regard to the investigation, diagnosis and management of urinary tract infection (UTI) in children and to evaluate these practices against recently published guidelines from the National Institute for Health and Clinical Excellence (NICE). METHODS: A postal survey was performed using a questionnaire that included short clinical scenarios. All general practices in a single health region were sent a questionnaire, cover letter and SAE. Systematic postal and telephone contact was made with non-responders. The data was analysed using SPSS version 15. RESULTS: Sixty-nine general practitioners were included in the study and 50 (72%) responded to the questionnaire. All respondents agreed that it is important to consider diagnosis of UTI in all children with unexplained fever. Doctors accurately identified relevant risk factors for UTI in the majority (87%) of cases. In collecting urine samples from a one year old child, 80% of respondents recommended the use of a urine collection bag and the remaining 20% recommended collection of a clean catch sample. Respondents differed greatly in their practice with regard to detailed investigation and specialist referral after a first episode of UTI. Co-amoxiclav was the most frequently used antibiotic for the treatment of cystitis, with most doctors prescribing a five day course. CONCLUSIONS: In general, this study reveals a high level of clinical knowledge amongst doctors treating children with UTI in primary care in the catchment area of County Mayo. However, it also demonstrates wide variation in practice with regard to detailed investigation and specialist referral. The common practice of prescribing long courses of antibiotics when treating lower urinary tract infection is at variance with NICE\\'s recommendation of a three day course of antibiotics for cystitis in children over three months of age when

The impact of an educational intervention, the New GP Contract and NICE guidelines on anti-epilepsy therapeutic drug monitoring.

Science.gov (United States)

Minshall, I; Berry, D; Smith, D

2011-03-01

Since the early 1970s therapeutic drug monitoring (TDM) of anti-epilepsy drug (AED) levels has been available to assist in the review process of patients with epilepsy. Routine blood levels were not part of the Quality and Outcomes Framework in the New GP Contract, neither have they been generally recommended in National Guidelines (NICE and SIGN) for the management of patients with epilepsy. To assess the impact of an educational intervention, the New GP Contract and NICE guidelines on the number of requests for TDM. Retrospective study. 39 general practices serving Chester (13), the Rural area surrounding Chester (13) and Ellesmere Port (13). An educational intervention took place in the individual Chester practices between December 2001 and March 2003. For the Rural and Ellesmere Port practices there was one combined event in March 2004 and in March 2007, respectively. Practices were encouraged, not to routinely request TDM, except in certain circumstances. The number of TDM requests for Chester, Rural and Ellesmere Port were obtained from the local laboratory in Chester, plus other nearby hospitals, to provide control groups. The number of TDM requests from primary care for Chester, Rural, Ellesmere Port, Wirral, Crewe, Warrington and Wrexham, April to April, 2002 through to 2008, where available. There has been a fall in the number requests in all districts. The most significant falls were in Chester (47%), Rural (34%) and Ellesmere Port (47%), and corresponded to the time of their educational intervention. The fall has been less marked in Wirral (25%), Crewe (27%), Wrexham (10%) and Warrington (9%). In 2004, the first year after the introduction of the New GP Contract, TDM in Chester and the Rural fell significantly, while those in Ellesmere Port, Wirral, Crewe and Wrexham increased. TDM dropped significantly in Ellesmere Port in the year after their educational intervention. Despite the valproate assay being clinically unhelpful there were still 611 requests

Achieving high-quality care: a view from NICE.

Science.gov (United States)

Leng, Gillian; Partridge, Gemma

2018-01-01

The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published. A number of pieces of guidance relate to heart disease, including pharmaceutical agents, new medical technologies and clinical guidelines. Examples include guidelines on acute heart failure and atrial fibrillation, and advice on technologies including edoxaban and implantable cardioverter defibrillators.The research evidence is clear that a change in practice rarely comes about as a result of simply disseminating guidance on best practice. Simple dissemination is particularly ineffective if the guidance has not been produced by a well-respected, credible organisation. It is also clear from the literature that implementation is more successful when more than one approach is taken, and when there is alignment between efforts at organisational, local and national levels.At an organisational level, there should be support from the Board for quality improvement, with ongoing measurement of progress. Resources should be provided for targeted change programmes, particularly where new guidance suggests improvements are required. A systematic process for putting change in place should include identifying barriers to change, agreeing interventions to overcome the barriers and drive forward improvement and planning for implementation and evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Renal tract abnormalities missed in a historical cohort of young children with UTI if the NICE and AAP imaging guidelines were applied.

Science.gov (United States)

Narchi, Hassib; Marah, Muhaned; Khan, Asad Aziz; Al-Amri, Abdulla; Al-Shibli, Amar

2015-10-01

In a historical cohort of children with a urinary tract infection (UTI) who had already undergone all the imaging procedures, the aim was to determine renal tract abnormalities which would have been missed had we implemented the new guidelines from the National Institute for Health and Care Excellence in the United Kingdom (NICE) or the American Academy of Pediatrics (AAP). After a UTI episode, forty-three children (28 females, 65%) aged between 2 months and 2 years presenting at two general hospitals with a febrile UTI before 2008 underwent all the recommended imaging studies predating the new guidelines. Hydronephrosis was defined and graded according to the Society for Fetal Urology (SFU) classification. Hydronephrosis grade II (mild pelvicalyceal dilatation), grade III (moderate dilatation), and grade IV (gross dilatation with thinning of the renal cortex), duplication, vesicoureteral reflux (VUR) grade II and above, renal scarring and reduced renal uptake (<45%) on technetium-99m-labeled dimercaptosuccinic acid (DMSA) scintigraphy were considered significant abnormalities. We calculated the proportion of abnormalities which would have been missed had the new guidelines been used instead. The median of age was 7.6 months (mean 8.7, range 2-24 months), with the majority (n = 37, 86%) being under 1 year of age. Ultrasound (US) showed hydronephrosis in 14 (32%), all grade II. A voiding cystourethrogram (VCUG) was performed in all and showed VUR ≥ grade II in 16 (37%), including eight children (19%) where it was bilateral. DMSA scan showed scarring in 25 children (58%) of whom 11 (26%) had bilateral scars. Reduced differential renal uptake was present in 10 children (23%). Of the 29 children with normal US, 18 (62%) had renal scarring and nine (31%) had VUR ≥ grade II. The NICE guidelines would have missed 63% of the children with VUR ≥ grade II, including a high proportion of grades IV and V VUR, 44% of the children with renal scarring, and 20% of the

Comparative yield of positive brain Computed Tomography after implementing the NICE or SIGN head injury guidelines in two equivalent urban populations

International Nuclear Information System (INIS)

Summerfield, R.; Macduff, R.; Davis, R.; Sambrook, M.; Britton, I.

2011-01-01

Aims: To compare the yield of positive computed tomography (CT) brain examinations after the implementation of the National Institute for Clinical Excellence (NICE) or the Scottish Intercollegiate Guidance Network (SIGN) guidelines, in comparable urban populations in two teaching hospitals in England and Scotland. Materials and methods: Four hundred consecutive patients presenting at each location following a head injury who underwent a CT examination of the head according to the locally implemented guidelines were compared. Similar matched populations were compared for indication and yield. Yield was measured according to (1) positive CT findings of the sequelae of trauma and (2) intervention required with anaesthetic or intensive care unit (ICU) support, or neurosurgery. Results: The mean ages of patients at the English and Scottish centres were 49.9 and 49.2 years, respectively. Sex distribution was 64.1% male and 66.4% male respectively. Comparative yield was 23.8 and 26.5% for positive brain scans, 3 and 2.75% for anaesthetic support, and 3.75 and 2.5% for neurosurgical intervention. Glasgow Coma Score (GCS) 10% yield of positive scans. The choice of guideline to follow should be at the discretion of the local institution. The indications GCS <13 and clinical or radiological evidence of a skull fracture are highly predictive of intracranial pathology, and their presence should be an absolute indicator for fast-tracking the management of the patient.

Genetic testing for BRCA1: effects of a randomised study of knowledge provision on interest in testing and long term test uptake; implications for the NICE guidelines.

Science.gov (United States)

Hall, Julia; Gray, Susan; A'Hern, Roger; Shanley, Susan; Watson, Maggie; Kash, Kathryn; Croyle, Robert; Eeles, Rosalind

2009-01-01

Interest in searching for mutations in BRCA1 and BRCA2 is high. Knowledge regarding these genes and the advantages and limitations of genetic testing is limited. It is unknown whether increasing knowledge about breast cancer genetic testing alters interest in testing. Three hundred and seventy nine women (260 with a family history of breast cancer; 119 with breast cancer) from The Royal Marsden NHS Foundation Trust were randomised to receive or not receive written educational information on cancer genetics. A questionnaire was completed assessing interest in BRCA1 testing and knowledge on breast cancer genetics and screening. Actual uptake of BRCA1 testing is reported with a six year follow-up. Eighty nine percent of women at risk of breast cancer and 76% of women with breast cancer were interested in BRCA1 testing (P testing, the families of 66% of the at risk group and 13% of the women with breast cancer would be eligible for testing (probability of BRCA1 mutation >or=20%). Within six years of randomisation, genetic testing was actually undertaken on 12 women, only 10 of whom would now be eligible, on the NICE guidelines. There is strong interest in BRCA1 testing. Despite considerable ignorance of factors affecting the inheritance of breast cancer, education neither reduced nor increased interest to undergo testing. The NICE guidelines successfully triage those with a high breast cancer risk to be managed in cancer genetics clinics.

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

Science.gov (United States)

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

2016-03-01

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

Do NICE and CHI have no interest in safety? Opinion of the book NICE, CHI and the NHS reforms. Enabling excellence or imposing control?

Science.gov (United States)

Fletcher, P

2000-08-01

Seventeen eminent and experienced people have contributed to this most valuable review of NICE and CHI and their potential impact on clinical practice in the UK. There is essentially 100% agreement that the basic concept is a good one; we all want to have the highest possible quality of clinical practice and improvements in health care. This is all motherhood and apple-pie stuff which goes without question but the problem is how it is put into effect. The contributors are also in agreement and fear that central desire for control will outweigh the benefits. The most recent NICE action, which was leaked to the media as a 'preliminary opinion', concerned the use of beta-interferon for the treatment of multiple sclerosis (MS). The opinion seems to be that beta-interferon is very expensive, that, yes, it does help some sufferers but, no, it does not help others and because it costs more than the NHS can afford no one can have it. This seems to me to be a most unsatisfactory outcome. Surely what clinical excellence demands is the refinement of diagnostic capabilities so that those who will benefit may be distinguished from those who will not. In the meantime we do the best we can even if it does mean that the NHS has to pay for some patients who do not respond. This is the inevitable consequence of the belief that a 'free' and comprehensive health service can be provided out of general taxation. Beta-interferon for the treatment of MS is an example of the observable fact that medical science is advancing at a rate considerably in excess of possible increases in funding. Possibly the most important problem identified in this book is the absence of a relevant, high quality data source for the preparation of the numerous guidelines that NICE is expected to produce each year. In a fully grown science a starting point for a quantitative procedure is the establishment of a baseline and, having done that, the scientist's next step is to produce a standard curve for use in the

Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care--the Management of OsteoArthritis In Consultations (MOSAICS) study protocol.

Science.gov (United States)

Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Ong, Bie Nio; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

2014-08-27

There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. A mixed methods study with a nested cluster randomised controlled trial. This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations

NICE recommendations for psychotherapy in depression: Of limited clinical utility.

Science.gov (United States)

McQueen, D; Smith, P St John

2015-01-01

In 2009/10 NICE partially updated its guidelines on the treatment and management of depression in adults. Due to methodological shortcomings the recommendations for psychotherapy must be treated with caution. Despite recognising the heterogeneous and comorbid nature of depression, and the limitations of depression as a unitary diagnostic category, NICE treats depression as if it were a unitary entity differentiated only by severity. The guidance ignores important aetiological factors such as trauma, loss and maltreatment, personality and interpersonal difficulties. It excludes the largest naturalistic studies on clinical populations treated in the National Health Service on the grounds that they are observational studies conducted in heterogeneous groups with mixed neurotic disorders. It unquestioningly accepts that the "brand" of psychotherapy has construct validity, and ignores psychotherapy process research indicating significant commonalities, and overlap, between treatment modalities and evidence that individual practitioner effects are larger than the differences between treatment modalities. It fails to consider patient differences and preferences, which are known to influence uptake, completion and response. It takes an exclusively short-term perspective on a chronic relapsing disorder. It does not consider the evidence for longer-term treatments. It is of special concern that NICE misrepresents the findings of its own systematic review by implying that CBT and IPT are superior treatments. NICE's systematic review actually found no evidence of superiority between CBT, IPT, psychodynamic psychotherapy, or counselling. Based on the exclusion of much clinically relevant research demonstrating the effectiveness of psychodynamic psychotherapy and counselling many commentators have alleged a bias towards CBT in the guidance. With regard to service delivery NICE proposes the replacement of psychiatric assessment and individualised treatment plans, with an unproven

Communication between secondary and primary care following self-harm: are National Institute of Clinical Excellence (NICE guidelines being met?

Directory of Open Access Journals (Sweden)

Jordan Rita

2008-10-01

Full Text Available Abstract Background Most patients contact their general practitioner (GP following presentation to an Emergency Department (ED after a self-harm incident, and strategies to help GPs manage these patients include efficient communication between services. The aim of this study was to assess the standard of documentation and communication to primary care from secondary care as recommended by the National Institute of Clinical Excellence (NICE guidelines on the short-term management of people who self-harm. Methods An audit of medical records (ED and Psychiatric on people aged 16 years and over who had presented to the ED following self-harm, benchmarked according to government guidelines, was performed. Data were collected over a 4-week period at a general teaching hospital. Results We collected data on 93 consecutive episodes of self-harm; 62% of episodes were communicated to primary care, 58% of these communications were within 24 h and most within 3 days. Patient identifying details and follow-up arrangements were specified in most cases. Communication via psychiatric staff was most detailed. ED clinicians provided few communications and were of limited content. Communication with the patient's GP was not made in half of those cases seen by a mental health specialist. Conclusion Government guidelines are only partially being met. Reliance on communication by ED staff would leave a substantial proportion of patients discharged from the ED with no or minimal communication to primary care. Psychiatric services need to improve the rate of communication to the patient's GP following assessment A national sample of National Health Service (NHS trusts would establish if this is a problem elsewhere.

An evaluation of the effect that the implementation of the NICE rules may have on a diagnostic imaging department for the early management of head injuries

International Nuclear Information System (INIS)

Hickman, C.; Harvey, J.

2007-01-01

Introduction: Guidelines by the National Institute of Clinical Excellence (NICE) for the early management of minor head injuries initiate the use of computed tomography (CT) for patients who may be at risk of developing intracranial haematoma. This retrospective study was designed to evaluate the effect the implementation of the NICE guidelines would have on the diagnostic imaging department of a local district general hospital. The main objective was to establish if there would be an increase in the number of CT head referrals for patients with minor head injuries. Secondly to assess how the implementation of these guidelines would affect the workload to the diagnostic imaging department in terms of cost and time, and to discuss the issue of radiation dose to patients. Method: A sample of 100 patients who were referred from the Accident and Emergency department (A and E) for plain skull radiographs, over a 4-month period were selected. The clinical information on each of these patients' was then extracted and a data collection sheet was to assess each patient according to the NICE criteria. Results and conclusion: The study found an 18% (n = 100) increase in the referral rate for CT heads for patients presenting with minor head injuries. It was also found that the use of these guidelines would mean a decrease in cost to the diagnostic imaging department of Pounds 324. Furthermore a saving of 10 h of radiographers' time was established, although the effective radiation dose to patients would be increased by 29 mSv. The NICE guidelines have proved efficient in identifying patients with intracranial damage although this coincides with an 18% (n = 100) increase in referral rates for CT and increased radiation dose to patients. However, the use of these guidelines would reduce workload to the diagnostic imaging department in terms of cost and time

Secondary prevention for patients following a myocardial infarction: summary of NICE guidance

OpenAIRE

Skinner, J S; Cooper, A; Feder, G S

2007-01-01

Mortality from coronary heart disease has been falling in the UK since the 1970s, but remains higher than in most other Western countries. Most patients receive some treatment for secondary prevention after myocardial infarction, but not all patients are offered the most effective secondary prevention package. The recently published NICE guideline for secondary prevention in patients after myocardial infarction, summarised in this article, makes clear recommendations for management of patient...

Sustainable design guidelines to support the Washington State ferries terminal design manual : stormwater and material issues.

Science.gov (United States)

2011-08-01

In an effort to assist the developers of the terminal design manual in potentially addressing : sustainable design issues, the overall goal is to produce Sustainable Design Guidelines that : will specifically address the unique needs and requirements...

[The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

2007-02-15

In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and 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 Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

[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).

Women's understanding of the "Nice guy paradox": a phenomenological study

OpenAIRE

2010-01-01

M.A. The Nice Guy Paradox is a provocative perception that is commonly expressed within society and the mass media. According to this perception, nice guys are less successful in their relationships with women than other men. The Nice Guy Paradox causes much frustration and confusion for self-proclaimed nice guys. In addition, the implications of this perception may negatively influence the way in which men relate to women. For instance, the Nice Guy Paradox implies that if men want to be ...

Manual for implementing residual radioactive material guidelines using RESRAD, Version 5.0

Energy Technology Data Exchange (ETDEWEB)

Yu, C.; Zielen, A.J.; Cheng, J.J. [and others

1993-09-01

This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material. 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 doses, risks, and guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. Two new pathways, radon inhalation and soil ingestion, have been added to RESRAD. Twenty-seven new radionuclides have also been added, and the cutoff half-life for associated radionuclides has been reduced to six months. Other major improvements to the RESRAD code include the ability to run sensitivity analyses, the addition of graphical output, user-specified dose factors, updated databases, an improved groundwater transport model, optional input of a groundwater concentration and a solubility constant, special models for tritium and carbon-14, calculation of cancer incidence risk, and the use of a mouse with menus.

Manual for implementing residual radioactive material guidelines using RESRAD, Version 5.0

International Nuclear Information System (INIS)

Yu, C.; Zielen, A.J.; Cheng, J.J.

1993-09-01

This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material. 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 doses, risks, and guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. Two new pathways, radon inhalation and soil ingestion, have been added to RESRAD. Twenty-seven new radionuclides have also been added, and the cutoff half-life for associated radionuclides has been reduced to six months. Other major improvements to the RESRAD code include the ability to run sensitivity analyses, the addition of graphical output, user-specified dose factors, updated databases, an improved groundwater transport model, optional input of a groundwater concentration and a solubility constant, special models for tritium and carbon-14, calculation of cancer incidence risk, and the use of a mouse with menus

Sunlit Uplands: The Genius of the NICE Reference Case

Directory of Open Access Journals (Sweden)

Paul C Langley

2016-07-01

Full Text Available The NICE reference case has received widespread acceptance in health technology assessment. The lifetime cost-per-QALY model and constructed claims for product impact have been widely emulated in country-specific guidelines for formulary submission as well as in publications in the leading health technology journals. Unfortunately, from the perspective of the standards of normal science, adherence to the reference case standard means that the claims made are typically non-evaluable. They have to be taken at face value. They may suggest potential evaluable hypotheses for clinical and cost-effectiveness claims, but there is no requirement in the reference case for claims to be put in an evaluable form and for manufacturers to suggest possible protocols for product impact assessment. This is not an acceptable situation. Absent the standards for falsification and replication, which are at the core of the scientific method, we have no idea whether the claims accepted by NICE are right or even if they are wrong. If we accept the reference case paradigm should we conclude that the sunlit uplands of formulary decisions based on non-evaluable simulated claims for cost-effectiveness has been reached? Have we rejected natural selection in favor of intelligent design? Conflict of Interest None Type: Commentary

Implementing core NICE guidelines for osteoarthritis in primary care with a model consultation (MOSAICS): a cluster randomised controlled trial.

Science.gov (United States)

Dziedzic, K S; Healey, E L; Porcheret, M; Afolabi, E K; Lewis, M; Morden, A; Jinks, C; McHugh, G A; Ryan, S; Finney, A; Main, C; Edwards, J J; Paskins, Z; Pushpa-Rajah, A; Hay, E M

2018-01-01

To determine the effectiveness of a model osteoarthritis consultation, compared with usual care, on physical function and uptake of National Institute for Health and Care Excellence (NICE) osteoarthritis recommendations, in adults ≥45 years consulting with peripheral joint pain in UK general practice. Two-arm cluster-randomised controlled trial with baseline health survey. Eight general practices in England. 525 adults ≥45 years consulting for peripheral joint pain, amongst 28,443 population survey recipients. Four intervention practices delivered the model osteoarthritis consultation to patients consulting with peripheral joint pain; four control practices continued usual care. The primary clinical outcome of the trial was the SF-12 physical component score (PCS) at 6 months; the main secondary outcome was uptake of NICE core recommendations by 6 months, measured by osteoarthritis quality indicators. A Linear Mixed Model was used to analyse clinical outcome data (SF-12 PCS). Differences in quality indicator outcomes were assessed using logistic regression. 525 eligible participants were enrolled (mean age 67.3 years, SD 10.5; 59.6% female): 288 from intervention and 237 from control practices. There were no statistically significant differences in SF-12 PCS: mean difference at the 6-month primary endpoint was -0.37 (95% CI -2.32, 1.57). Uptake of core NICE recommendations by 6 months was statistically significantly higher in the intervention arm compared with control: e.g., increased written exercise information, 20.5% (7.9, 28.3). Whilst uptake of core NICE recommendations was increased, there was no evidence of benefit of this intervention, as delivered in this pragmatic randomised trial, on the primary outcome of physical functioning at 6 months. ISRCTN06984617. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

25 CFR 900.5 - Effect of these regulations on Federal program guidelines, manual, or policy directives.

Science.gov (United States)

2010-04-01

... SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT General Provisions § 900.5 Effect of these regulations... 25 Indians 2 2010-04-01 2010-04-01 false Effect of these regulations on Federal program guidelines, manual, or policy directives. 900.5 Section 900.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...

Manual for subject analysis

International Nuclear Information System (INIS)

2002-01-01

This document is one in a series of publications known as the ETDE/INIS Joint Reference Series and also constitutes a part of the ETDE Procedures Manual. It presents the rules, guidelines and procedures to be adopted by centers submitting input to the International Nuclear Information System (INIS) or the Energy Technology Data Exchange (ETDE). It is a manual for the subject analysis part of input preparation, meaning the selection, subject classification, abstracting and subject indexing of relevant publications, and is to be used in conjunction with the Thesauruses, Subject Categories documents and the documents providing guidelines for the preparation of abstracts. The concept and structure of the new manual are intended to describe in a logical and efficient sequence all the steps comprising the subject analysis of documents to be reported to INIS or ETDE. The manual includes new chapters on preparatory analysis, subject classification, abstracting and subject indexing, as well as rules, guidelines, procedures, examples and a special chapter on guidelines and examples for subject analysis in particular subject fields. (g.t.; a.n.)

An introduction to use of the USACE HTRW program's data validation guidelines engineering manual

International Nuclear Information System (INIS)

Becker, L.D.; Coats, K.H.

1994-01-01

Data validation has been defined by regulatory agencies as a systematic process (consisting of data editing, screening, checking, auditing, verification, certification, and review) for comparing data to established criteria in order to provide assurance that data are adequate for their intended use. A problem for the USACE HTRW Program was that clearly defined data validation guidelines were available only for analytical data quality level IV. These functional data validation guidelines were designed for validation of data produced using protocols from the US E.P.A.'s Contract Laboratory Program (CLP). Unfortunately, USACE experience demonstrates that these level IV functional data validation guidelines were being used to validate data not produced under the CLP. The resulting data validation product was less than satisfactory for USACE HTRW needs. Therefore, the HTRW-MCX initiated an Engineering Manual (EM) for validation of analytical data quality levels other than IV. This EM is entitle ''USACE HTRW Data Validation Guidelines.'' Use of the EM is required for validation of analytical data relating to projects under the jurisdiction of the Department of the Army, Corps of Engineers, Hazardous, Toxic, and Radioactive Waste Program. These data validation guidelines include procedures and checklists for technical review of analytical data at quality levels I, II, III, and V

Biomechanical evaluation of the Nice knot

OpenAIRE

Hill, Shannon W.; Chapman, Christopher R.; Adeeb, Samer; Duke, Kajsa; Beaupre, Lauren; Bouliane, Martin J.

2016-01-01

Background: The Nice knot is a bulky double-stranded knot. Biomechanical data supporting its use as well as the number of half hitches required to ensure knot security is lacking. Materials and Methods: Nice knots with, one, two, or three half-hitches were compared with the surgeon′s and Tennessee slider knots with three half hitches. Each knot was tied 10 times around a fixed diameter using four different sutures: FiberWire (Arthrex, Naples, FL), Ultrabraid (Smith and Nephew, Andover, MA...

Fuel Conservation by the Application of Spill Prevention and Failsafe Engineering (A Guideline Manual)

Energy Technology Data Exchange (ETDEWEB)

Goodier, J. Leslie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Water and Land Resources Department, Office of Marine and Environmental Engineering; Siclari, Robert J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Water and Land Resources Department, Office of Marine and Environmental Engineering; Garrity, Phyllis A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Water and Land Resources Department, Office of Marine and Environmental Engineering

1980-10-30

From a series of nationwide plant surveys dedicated to spill prevention, containment and countermeasure evaluation, coupled with spill response action activities, a need was determined for a spill prevention guideline manual. From Federally accumulated statistics for oil and hazardous substance spills, the authors culled information on spills of hydrocarbon products. In 1978, a total of 1456 oil spills were reported compared to 1451 in 1979. The 1978 spills were more severe, however, since 7,289,163 gallons of oil were accidentally discharged. In 1979, the gallons spilled was reduced to 3,663,473. These figures are derived from reported spills; it is highly possible that an equal amount was spilled and not reported. Spills effectively contained within a plant property that do not enter a navigational waterway need not be reported. Needless to say, there is a tremendous annual loss of oil products due to accidental spillage during transportation, cargo transfer, bulk storage and processing. As an aid to plant engineers and managers, Federal workers, fire marshalls and fire and casualty insurance inspectors, the document is offered as a spill prevention guide. The manual defines state-of-the-art spill prevention practices and automation techniques that can reduce spills caused by human error. Whenever practical, the cost of implementation is provided to aid equipment acquisition and installation budgeting. To emphasize the need for spill prevention activities, historic spills are briefly described after which remedial action is defined in an appropriate section of the manual. The section on plant security goes into considerable depth since to date no Federal agency or trade association has provided industry with guidelines on this important phase of plant operation. The intent of the document is to provide finger-tip reference material that can be used by interested parties in a nationwide effort to reduce loss of oil from preventable spills.

MR imaging of patients with localisation-related seizures: initial experience at 3.0T and relevance to the NICE guidelines

International Nuclear Information System (INIS)

Griffiths, P.D.; Coley, S.C.; Connolly, D.J.A.; Hodgson, T.; Romanowski, C.A.J.; Widjaja, E.; Darwent, G.; Wilkinson, I.D.

2005-01-01

The purpose of this study is to describe our initial experience of imaging adults with localisation-related epilepsy using MR imaging at 3.0T. We discuss the findings in the context of the recently released NICE guidelines that provide detailed advice on imaging people with epilepsy in the UK. 120 consecutive people over the age of 16 years with localisation-related epilepsy were referred for clinical MR examinations from a regional neuroscience centre in England. None of the people had had MR examinations prior to the present study. High resolution MR imaging was performed taking advantage of the high field strength and high performance gradients of the system. Two experienced neuroradiologists reported on the examinations independently and the presence and type of pathology was recorded. There was complete agreement between the two reporters in all 120 cases. The overall frequency of abnormalities shown by MR was 31/120 (26%) and the commonest abnormality shown was mesial temporal sclerosis found in 10/120 (8%). Tumours were shown in 4/120, all of which appeared low grade as judged by imaging criteria. Epilepsy is the commonest neurological condition and demands a significant resource in order to provide good care for sufferers. Recent guidelines published in the UK have suggested that the majority of people with epilepsy should receive brain MR as part of their routine assessment. Our work shows that using the most sophisticated MR imaging in a highly selected population there is a modest pick-up rate of brain abnormalities. If a widespread epilepsy-imaging programme is started the detection rate is likely to be much lower. Although MR is acknowledged to be a reliable way of detecting pathology in people with epilepsy there is a dearth of information studying the health economics of imaging epilepsy in relation to patient management and outcomes

An Update on NiCE Support for BISON

Energy Technology Data Exchange (ETDEWEB)

McCaskey, Alex [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Billings, Jay Jay [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Deyton, Jordan H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wojtowicz, Anna [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-09-01

The Nuclear Energy Advanced Modeling and Simulation program (NEAMS) from the Department of Energy s Office of Nuclear Energy has funded the development of a modeling and simulation workflow environment to support the various codes in its nuclear energy scientific computing toolkit. This NEAMS Integrated Computational Environment (NiCE) provides extensible tools and services that enable efficient code execution, input generation, pre-processing visualizations, and post-simulation data analysis and visualization for a large portion of the NEAMS Toolkit. A strong focus for the NiCE development team throughout FY 2015 has been support for the Multiphysics Object Oriented Simulation Environment (MOOSE) and the NEAMS nuclear fuel performance modeling application built on that environment, BISON. There is a strong desire in the program to enable and facilitate the use of BISON throughout nuclear energy research and industry. A primary result of this desire is the need for strong support for BISON in NiCE. This report will detail improvements to NiCE support for BISON. We will present a new and improved interface for interacting with BISON simulations in a variety of ways: (1) improved input model generation, (2) embedded mesh and solution data visualizations, and (3) local and remote BISON simulation launch. We will also show how NiCE has been extended to provide support for BISON code development.

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

An Update on Improvements to NiCE Support for RELAP-7

Energy Technology Data Exchange (ETDEWEB)

McCaskey, Alex [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wojtowicz, Anna [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Deyton, Jordan H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Patterson, Taylor C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Billings, Jay Jay [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-01-01

The Multiphysics Object-Oriented Simulation Environment (MOOSE) is a framework that facilitates the development of applications that rely on finite-element analysis to solve a coupled, nonlinear system of partial differential equations. RELAP-7 represents an update to the venerable RELAP-5 simulator that is built upon this framework and attempts to model the balance-of-plant concerns in a full nuclear plant. This report details the continued support and integration of RELAP-7 and the NEAMS Integrated Computational Environment (NiCE). RELAP-7 is fully supported by the NiCE due to on-going work to tightly integrate NiCE with the MOOSE framework, and subsequently the applications built upon it. NiCE development throughout the first quarter of FY15 has focused on improvements, bug fixes, and feature additions to existing MOOSE-based application support. Specifically, this report will focus on improvements to the NiCE MOOSE Model Builder, the MOOSE application job launcher, and the 3D Nuclear Plant Viewer. This report also includes a comprehensive tutorial that guides RELAP-7 users through the basic NiCE workflow: from input generation and 3D Plant modeling, to massively parallel job launch and post-simulation data visualization.

Guidelines for the verification and validation of expert system software and conventional software: User's manual. Volume 7

International Nuclear Information System (INIS)

Mirsky, S.M.; Hayes, J.E.; Miller, L.A.

1995-03-01

This report provides a step-by-step guide, or user manual, for personnel responsible for the planning and execution of the verification and validation (V ampersand V), and developmental testing, of expert systems, conventional software systems, and various other types of artificial intelligence systems. While the guide was developed primarily for applications in the utility industry, it applies well to all industries. The user manual has three sections. In Section 1 the user assesses the stringency of V ampersand V needed for the system under consideration, identifies the development stage the system is in, and identifies the component(s) of the system to be tested next. These three pieces of information determine which Guideline Package of V ampersand V methods is most appropriate for those conditions. The V ampersand V Guideline Packages are provided in Section 2. Each package consists of an ordered set of V ampersand V techniques to be applied to the system, guides on choosing the review/evaluation team, measurement criteria, and references to a book or report which describes the application of the method. Section 3 presents details of 11 of the most important (or least well-explained in the literature) methods to assist the user in applying these techniques accurately

Evidence based guidelines and current practice for physiotherapy management of knee osteoarthritis.

Science.gov (United States)

Walsh, Nicola E; Hurley, Michael V

2009-03-01

To document physiotherapy provision for patients with knee osteoarthritis (OA) in relation to the United Kingdom (UK) recently published National Institute of health and Clinical Excellence (NICE) guidelines for osteoarthritis. Questionnaire survey of chartered physiotherapists. 300 postal questionnaires were distributed to Physiotherapy Departments requesting information regarding source of referrals, treatment aims, preferred methods of treatment and service delivery. Responses were received from 83 physiotherapists (28 %), predominantly working in the UK National Health Service. Approximately equal numbers of referrals came from primary and secondary care. Aims of physiotherapy management were to; encourage self-management; increase strength and range of movement; reduce pain; and improve function. To achieve these, exercise was utilised by 100% of practitioners, often supplemented with electrotherapeutic modalities (66%), manual therapy (64%) and acupuncture (60%). The majority of patients received individual treatment for a total contact time of 1-2 hours, whilst most group interventions lasted 5-6 hours. Approximately half (54%) of respondents reported using outcome measures to determine treatment efficacy. Although knee OA is usually managed in primary care, the similar number of referrals from primary and secondary care may suggest a deviation from evidence-based management guidelines. The guidelines' recommendations of exercise, patient education and self-management are observed by physiotherapists, but other modalities are often used despite poor or no research evidence supporting their efficacy. Whether any of these interventions are clinically beneficial is speculative as treatment outcomes were frequently under-evaluated.

Impact of UK NICE clinical guidelines 168 on referrals to a specialist academic leg ulcer service.

Science.gov (United States)

Davies, Huw Ob; Popplewell, Matthew; Bate, Gareth; Kelly, Lisa; Darvall, Katy; Bradbury, Andrew W

2018-03-01

Background Leg ulcers are a common cause of morbidity and disability and result in significant health and social care expenditure. The UK National Institute for Health and Care Excellence (NICE) Clinical Guideline (CG)168, published in July 2013, sought to improve care of patients with leg ulcers, recommending that patients with a break in the skin below the knee that had not healed within two weeks be referred to a specialist vascular service for diagnosis and management. Aim Determine the impact of CG168 on referrals to a leg ulcer service. Methods Patients referred with leg ulceration during an 18-month period prior to CG168 (January 2012-June 2013) and an 18-month period commencing six months after (January 2014-June 2015) publication of CG168 were compared. Results There was a two-fold increase in referrals (181 patients, 220 legs vs. 385 patients, 453 legs) but no change in mean age, gender or median-duration of ulcer at referral (16.6 vs. 16.2 weeks). Mean-time from referral to specialist appointment increased (4.8 vs. 6 weeks, p = 0.0001), as did legs with superficial venous insufficiency (SVI) (36% vs. 44%, p = 0.05). There was a trend towards more SVI endovenous interventions (32% vs. 39%, p = 0.271) with an increase in endothermal (2 vs. 32 legs, p = 0.001) but no change in sclerotherapy (24 vs. 51 legs) treatments. In both groups, 62% legs had compression. There was a reduction in legs treated conservatively with simple dressings (26% vs. 15%, p = 0.0006). Conclusions Since CG168, there has been a considerable increase in leg ulcer referrals. However, patients are still not referred until ulceration has been present for many months. Although many ulcers are multi-factorial and the mainstay of treatment remains compression, there has been an increase in SVI endovenous intervention. Further efforts are required to persuade community practitioners to refer patients earlier, to educate patients and encourage further investment in

French made nice & easy

CERN Document Server

REA, The Editors of

2012-01-01

Whether travelling to a foreign country or to your favorite international restaurant, this Nice & Easy guide gives you just enough of the language to get around and be understood. Much of the material in this book was developed for government personnel who are often assigned to a foreign country on a moment's notice and need a quick introduction to the language.

4th June: AIS and NICE/MAIL unique authentication

CERN Multimedia

AIS and NICE teams

2007-01-01

Over the past few years, the IT department has been in the process of streamlining CERN users' access to all central computing services. The long term goal is to converge on a unique computer account, which will increase computer security and simplify account maintenance. The next step of this process will occur on 4th June 2007, as of when authenticating on the AIS applications (EDH, HRT, CET, APT, ERT, CRA, Foundation, ...) and on NICE (Windows) and MAIL will be done using the same username and password. As a reminder, this account can also be used on EDMS, INDICO, CDS and SIMBA. So starting on 4th June 2007, authentication on the AIS applications must be done using your AIS username and your MAIL/NICE password. Thanks for your understanding, The AIS and NICE teams

AFM-CMM integrated instrument user manual

DEFF Research Database (Denmark)

Marinello, Francesco; Bariani, Paolo

This manual gives general important guidelines for a proper use of the integrated AFM-CMM instrument. More information can be collected reading: • N. Kofod Ph.D thesis [1]; • P. Bariani Ph.D thesis [2]; • Dualscope DME 95-200 operation manuals [3]; • SPIP help [4] • Stitching software user manual...

4th June: AIS and NICE/MAIL unique authentication

CERN Multimedia

The AIS and NICE teams

2007-01-01

Over the past few years, the IT department has been in the process of streamlining CERN users' access to all central computing services. The long term goal is to converge on a unique computer account, which will increase computer security and simplify account maintenance. The next step of this process will occur on the 4th June 2007, as of when authenticating on the AIS applications (EDH, HRT, CET, APT, ERT, CRA, Foundation, ...) and on NICE (Windows) and MAIL will be done using the same username and password. As a reminder, this account can also be used on EDMS, INDICO, CDS and SIMBA. Thus starting on the 4th June 2007, authentication on the AIS applications must be done using your AIS username and your MAIL/NICE password. Thanks for your understanding, The AIS and NICE teams

EPAC in Nice

Energy Technology Data Exchange (ETDEWEB)

Anon.

1990-09-15

The signpost to the accelerator future points in several directions, and the second European Particle Accelerator Conference (EPAC), held in Nice from 12-16 June provided a good opportunity to survey the terrain ahead. Building on the experience of the first EPAC, held in Rome in 1988, the organizers planned for a large meeting and were rewarded with 800 participants. In parallel, the involvement of industry, with a comprehensive 44-strong exhibition, prompted many speakers to refer to the symbiosis of accelerators and industry.

EPAC in Nice

International Nuclear Information System (INIS)

Anon.

1990-01-01

The signpost to the accelerator future points in several directions, and the second European Particle Accelerator Conference (EPAC), held in Nice from 12-16 June provided a good opportunity to survey the terrain ahead. Building on the experience of the first EPAC, held in Rome in 1988, the organizers planned for a large meeting and were rewarded with 800 participants. In parallel, the involvement of industry, with a comprehensive 44-strong exhibition, prompted many speakers to refer to the symbiosis of accelerators and industry

Guidelines for the verification and validation of expert system software and conventional software: User`s manual. Volume 7

Energy Technology Data Exchange (ETDEWEB)

Mirsky, S.M.; Hayes, J.E.; Miller, L.A. [Science Applications International Corp., McLean, VA (United States)

1995-03-01

This report provides a step-by-step guide, or user manual, for personnel responsible for the planning and execution of the verification and validation (V&V), and developmental testing, of expert systems, conventional software systems, and various other types of artificial intelligence systems. While the guide was developed primarily for applications in the utility industry, it applies well to all industries. The user manual has three sections. In Section 1 the user assesses the stringency of V&V needed for the system under consideration, identifies the development stage the system is in, and identifies the component(s) of the system to be tested next. These three pieces of information determine which Guideline Package of V&V methods is most appropriate for those conditions. The V&V Guideline Packages are provided in Section 2. Each package consists of an ordered set of V&V techniques to be applied to the system, guides on choosing the review/evaluation team, measurement criteria, and references to a book or report which describes the application of the method. Section 3 presents details of 11 of the most important (or least well-explained in the literature) methods to assist the user in applying these techniques accurately.

Metrication manual

International Nuclear Information System (INIS)

Harper, A.F.A.; Digby, R.B.; Thong, S.P.; Lacey, F.

1978-04-01

In April 1978 a meeting of senior metrication officers convened by the Commonwealth Science Council of the Commonwealth Secretariat, was held in London. The participants were drawn from Australia, Bangladesh, Britain, Canada, Ghana, Guyana, India, Jamaica, Papua New Guinea, Solomon Islands and Trinidad and Tobago. Among other things, the meeting resolved to develop a set of guidelines to assist countries to change to SI and to compile such guidelines in the form of a working manual

DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK.

Science.gov (United States)

de Folter, Joost; Trusheim, Mark; Jonsson, Pall; Garner, Sarah

2018-01-01

Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way. A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors. We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created. This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.

Tropospheric characteristics over sea ice during N-ICE2015

Science.gov (United States)

Kayser, Markus; Maturilli, Marion; Graham, Robert; Hudson, Stephen; Cohen, Lana; Rinke, Annette; Kim, Joo-Hong; Park, Sang-Jong; Moon, Woosok; Granskog, Mats

2017-04-01

Over recent years, the Arctic Ocean region has shifted towards a younger and thinner sea-ice regime. The Norwegian young sea ICE (N-ICE2015) expedition was designed to investigate the atmosphere-snow-ice-ocean interactions in this new ice regime north of Svalbard. Here we analyze upper-air measurements made by radiosondes launched twice daily together with surface meteorology observations during N-ICE2015 from January to June 2015. We study the multiple cyclonic events observed during N-ICE2015 with respect to changes in the vertical thermodynamic structure, sudden increases in moisture content and temperature, temperature inversions and boundary layer dynamics. The influence of synoptic cyclones is strongest under polar night conditions, when radiative cooling is most effective and the moisture content is low. We find that transitions between the radiatively clear and opaque state are the largest drivers of changes to temperature inversion and stability characteristics in the boundary layer during winter. In spring radiative fluxes warm the surface leading to lifted temperature inversions and a statically unstable boundary layer. The unique N-ICE2015 dataset is used for case studies investigating changes in the vertical structure of the atmosphere under varying synoptic conditions. The goal is to deepen our understanding of synoptic interactions within the Arctic climate system, to improve model performance, as well as to identify gaps in instrumentation, which precludes further investigations.

The NICE ADHD health technology assessment: A review and critique

Directory of Open Access Journals (Sweden)

Schlander Michael

2008-01-01

Full Text Available Abstract Background Health technology assessments (HTAs by the National Institute for Health and Clinical Excellence (NICE enjoy high levels of international attention. The present analysis addresses NICE's appraisal of methylphenidate, atomoxetine and dexamphetamine for attention-deficit/hyperactivity disorder (ADHD in children and adolescents, published in March 2006. Methods A qualitative study of NICE Technology Appraisal No. 98 was done focusing on the >600-page technology assessment report, which aimed at evaluating ADHD treatment strategies by a clinical effectiveness review and an economic analysis using meta-analytical techniques and a cost-effectiveness model. Results The technology assessment was unable to differentiate between the various drugs in terms of efficacy, and its economic model was ultimately driven by cost differences. While the assessment concluded that the economic model "clearly identified an optimal treatment strategy" with first-line dexamphetamine, the NICE appraisal committee subsequently found it impossible to distinguish between the different strategies on grounds of cost-effectiveness. Analyzing the assessment reveals gaps and inconsistencies concerning data selection (ultimately relying on a small number of short-term studies only, data synthesis (pooling of heterogeneous study designs and clinical endpoints, and economic model structure (identifying double-counting of nonresponders as a likely source of bias, alongside further methodological anomalies. Conclusion Many conclusions of the NICE technology assessment rest on shaky grounds. There remains a need for a new, state-of-the-art systematic review of ADHD treatment strategies including economic evaluation, which ideally should address outcomes beyond children's health-related quality of life, such as long-term sequelae of the disorder and caregiver burden.

Can the NICE "end-of-life premium" be given a coherent ethical justification?

Science.gov (United States)

Cookson, Richard

2013-12-01

In 2009 the UK National Institute for Health and Clinical Excellence (NICE) announced that its health technology appraisal committees would henceforth give special additional weight to health gains from life-extending end-of-life treatments. This was a response to mounting concern from NICE's stakeholders that effective new drugs for end-stage cancer often fail NICE's standard test of cost effectiveness. This change of policy may be justifiable on procedural grounds as the result of a democratic political process responding to stakeholder concerns. However, according to the "accountability for reasonableness" framework proposed by the philosopher Norman Daniels and endorsed by NICE, there also needs to be transparency about the substantive ethical grounds for public health care resource allocation decisions. In that spirit, I analyze eleven potentially relevant justifications for the NICE "end-of-life premium," drawn from the economics and philosophy literature: (1) rule of rescue, (2) fair chances, (3) ex post willingness to pay, (4) caring externality, (5) financial protection, (6) symbolic value, (7) diminishing marginal value of future life years, (8) concentration of benefits, (9) dread, (10) time to set your affairs in order, and (11) severity of illness. I conclude that none of them yields a coherent ethical justification for the NICE end-of-life premium.

The stormwater management manual for Malaysia

International Nuclear Information System (INIS)

Md Nasir Md Noh

2006-01-01

The government of Malaysia considers land and water as two very important natural resources. Consequently, the conservation practice of these natural resources remain top priority agenda with various laws and policies apart from manuals and guidelines available for practitioners to follow right from planning, design and implementation stages. Among the laws and regulations are national land code, land conservation act, local government act, street, drainage and building act, town and country planning act, and environmental quality act among others. In addition, stormwater management manual for Malaysia developed by department of irrigation and drainage, guidelines on the prevention and control of soil erosion and siltation in Malaysia developed by department of environment, standard specification for road works established by public works department, use of flood detention ponds as part of open space set up by department of town and country planning, and guideline for agricultural development at slope terrain published by department of agriculture are some of the established manuals and guidelines utilized around the country. The stormwater management manual for malaysia (msma) is the latest of the series of guidelines available in the country for inculcating up to date stormwater management apart from ensuring sustainable soil and water conservation practice in Malaysia. This manual has been published in 2000 and started to be utilized since 1 January 2001. Ever since msma has been widely used for the planning, design and implementation of various land development activities in the country. Among the key points highlighted in this manual are water quantity control and water quality control. Water quantity control focuses on the flash flood control technique due to the increase rate of water flowing out of developed areas while water quality control meant for the controlled of non-point source pollution generated by developed areas by contemplating on the best

CERN Technology on Display in Nice

CERN Multimedia

2000-01-01

Bob Dobinson (center) and Brian Martin (right) presenting technology transfer from CERN to indus exhibition in Nice. Nice in November was the scene of the EU sponsored Information Science Technologies, IST2000 exhibition, where CERN was invited to present a stand focussing on the benefits to small companies and start-ups from association with CERN and the IST program. Companies from France, Israel and the UK were featured. Network technology standards that CERN has helped to develop have been adopted by the European Space Agency for use in future space vehicles, and these too were on show. The challenges of data acquisition and data handling for the LHC are not insurmountable, but need to be approached with a combination of advanced technology and close industrial collaboration. One important aspect is that of high speed networking, an important component in both on-line and off-line computing (GRIDs). Real time data acquisition systems for the LHC require networks with high throughput, low latency, high rel...

2012 Guidelines for Water Reuse

Science.gov (United States)

This manual is a revision of the "2004 Water Reuse Guidelines." This document is a summary of reuse guidelines, with supporting information, for the benefit of utilities of utilities and regulatory agencies, particularly EPA.

Manual for a Volunteer Services System.

Science.gov (United States)

Helgerson, Linda; And Others

This manual presents guidelines for planning, monitoring, and controlling the development and operation of volunteer assistance programs. The materials included address questions related to both the process of establishing a volunteer program and the administration of a volunteer management system. The manual is not intended to provide a blueprint…

Host Families Matter: The Homestay Manual.

Science.gov (United States)

Peace Corps, Washington, DC. Information Collection and Exchange Div.

This manual provides guidelines, sample documents, and sample lesson plans for the trainers, trainees, and host families involved in homestays for Peace Corps volunteers. The manual contains 11 sections that deal with the following topics: (1) introduction; (2) policy, timelines, and responsibilities; (3) medical and financial issues; (4) host…

Methodological quality of guidelines in gastroenterology.

Science.gov (United States)

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

2014-06-01

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

National Institute for Health and Care Excellence updates the stable chest pain guideline with radical changes to the diagnostic paradigm.

Science.gov (United States)

Timmis, Adam; Roobottom, Carl A

2017-07-01

In the 2016 update of the stable chest pain guideline, the National Institute for Health and Care Excellence (NICE) has made radical changes to the diagnostic paradigm that it-like other international guidelines-had previously placed at the centre of its recommendations. No longer are quantitative assessments of the disease probability considered necessary to determine the need for diagnostic testing and the choice of test. Instead, the recommendation is for no diagnostic testing if chest pain is judged to be 'non-anginal' and CT coronary angiography (CTCA) in patients with 'typical' or 'atypical' chest pain with additional perfusion imaging only if there is uncertainty about the functional significance of coronary lesions. The new emphasis on anatomical-as opposed to functional-testing is driven in large part by cost-effectiveness analysis and despite inevitable resource implications NICE calculates that annual savings for the population of England will be significant. In making CTCA the default diagnostic testing strategy in its updated chest pain guideline, NICE has responded emphatically to calls from trialists for CTCA to have a greater role in the diagnostic pathway of patients with suspected angina. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

RWE NUKEM's 'Living' Nuclear Compendium eNICE. An internet-based, multifunctional nuclear information platform

International Nuclear Information System (INIS)

Kwasny, R.; Max, A.

2002-01-01

Information has become a commodity particularly important to industry, science, and politics. Information becomes critical because of its rapid change. The basis and the catalyst of this change in information are the information technologies now available, and the Internet with its varied contents. This makes the Internet a new market place which, although it is open, can quickly turn into an information maze because of its sheer volume. Also the nuclear industry must find its way through this maze. eNICE was created in order to build a bridge between the flood of information in the Internet and the information really needed in a specific case. eNICE (e stands for electronic, and NICE stands for Nuclear Information Compendium Europe), a living Internet-based nuclear compendium in the English language, is a unique combination of a broad spectrum of information and data about the use of nuclear power in Europe. The information and data contained in eNICE are interconnected with the World Wide Web in such a way that structured searching for nuclear information is possible quickly and efficiently. This avoids the difficulties sometimes encountered in searches in the Internet as a consequence of the unstructured volume of information. A monthly update of eNICE ensures that the data available are up to date and reliable. eNICE also offers direct access to the library used by RWE NUKEM for internal purposes. (orig.) [de

An Update on Improvements to NiCE Support for PROTEUS

Energy Technology Data Exchange (ETDEWEB)

Bennett, Andrew [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); McCaskey, Alexander J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Billings, Jay Jay [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-09-01

The Department of Energy Office of Nuclear Energy's Nuclear Energy Advanced Modeling and Simulation (NEAMS) program has supported the development of the NEAMS Integrated Computational Environment (NiCE), a modeling and simulation workflow environment that provides services and plugins to facilitate tasks such as code execution, model input construction, visualization, and data analysis. This report details the development of workflows for the reactor core neutronics application, PROTEUS. This advanced neutronics application (primarily developed at Argonne National Laboratory) aims to improve nuclear reactor design and analysis by providing an extensible and massively parallel, finite-element solver for current and advanced reactor fuel neutronics modeling. The integration of PROTEUS-specific tools into NiCE is intended to make the advanced capabilities that PROTEUS provides more accessible to the nuclear energy research and development community. This report will detail the work done to improve existing PROTEUS workflow support in NiCE. We will demonstrate and discuss these improvements, including the development of flexible IO services, an improved interface for input generation, and the addition of advanced Fortran development tools natively in the platform.

Update of the Dutch manual for costing studies in health care.

Directory of Open Access Journals (Sweden)

Tim A Kanters

Full Text Available Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version.An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute.The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1 costs within the health care sector; 2 patient and family costs; and 3 costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added.The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

A comparison of the treatment recommendations for neurogenic lower urinary tract dysfunction in the national institute for health and care excellence, European Association of Urology and international consultations on incontinence guidelines.

Science.gov (United States)

Jaggi, Ashley; Drake, Marcus; Siddiqui, Emad; Fatoye, Francis

2018-04-17

Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed. The guidelines generally agree on their approach to conservative management, including behavioral therapies, and catheterization techniques. There was discrepancy on the benefit of using an alpha blocker in NLUTD and bladder outlet obstruction (BOO) and administering Botulinum toxin A (Onabotulinum-A) in NLUTD. The highest degree of divergence was seen in recommendations for surgical treatments, where the EAU made gender-specific recommendations, and gave continent urinary diversion higher preference than given in the NICE and ICI guidelines. In the absence of high-quality clinical evidence, many of the recommendations made across all three guidelines are based on expert opinion. NICE, the EAU and ICI have similarities but they place differing emphasis on costs and expert opinion, which translated in notably different recommendations. It is evident that increased research efforts, possibly in the form of prospective registries, pragmatic trials, and resource utilization studies are necessary to improve the underlying evidence base for NLUTD, and subsequently the strength and concordance of recommendations across guidelines. © 2018 Wiley Periodicals, Inc.

Cuerpo de Paz Manual de Sistema de Programacion y Capacitacion (Peace Corps Programming and Training System Manual): T0063.

Science.gov (United States)

Peace Corps, Washington, DC.

This Spanish version of the Peace Corps Programming and Training System Manual is designed to help field staff members of the Peace Corps train volunteers. Its task descriptions, guidelines, examples, and definitions are intended to be practical and informative rather than restrictive. The manual is divided into six major sections: (1)…

ISE System Development Methodology Manual

Energy Technology Data Exchange (ETDEWEB)

Hayhoe, G.F.

1992-02-17

The Information Systems Engineering (ISE) System Development Methodology Manual (SDM) is a framework of life cycle management guidelines that provide ISE personnel with direction, organization, consistency, and improved communication when developing and maintaining systems. These guide-lines were designed to allow ISE to build and deliver Total Quality products, and to meet the goals and requirements of the US Department of Energy (DOE), Westinghouse Savannah River Company, and Westinghouse Electric Corporation.

Review of the role of NICE in promoting the adoption of innovative cardiac technologies.

Science.gov (United States)

Groves, Peter H; Pomfrett, Chris; Marlow, Mirella

2018-05-17

The National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) promotes the adoption of innovative diagnostic and therapeutic technologies into National Health Service (NHS) clinical practice through the publication of guidance and briefing documents. Since the inception of the programme in 2009, there have been 7 medical technologiesguidance, 3 diagnostics guidance and 23 medtechinnovation briefing documents published that are relevant to the heart and circulation. Medical technologies guidance is published by NICE for selected single technologies if they offer plausible additional benefits to patients and the healthcare system. Diagnostic guidance is published for diagnostic technologies if they have the potential to improve health outcomes, but if their introduction may be associated with an increase in overall cost to the NHS. Medtechinnovation briefings provide evidence-based advice to those considering the implementation of new medical devices or diagnostic technologies. This review provides reference to all of the guidance and briefing medical technology documents that NICE has published that are relevant to the heart and circulation and reflect on their diverse recommendations. The interaction of MTEP with other NICE programmes is integral to its effectiveness and the means by which consistency is ensured across the different NICE programmes is described. The importance of the input of clinical experts from the cardiovascular professional community and the engagement by NICE with cardiovascular professional societies is highlighted as being fundamental to ensuring the quality of guidance outputs as well as to promoting their implementation and adoption. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Caveat emptor NICE

DEFF Research Database (Denmark)

Dowie, Jack; Kaltoft, Mette Kjer; Nielsen, Jesper Bo

2015-01-01

Concern with the threshold applied in cost-effectiveness analyses by bodies such as NICE distracts attention from their biased use of the principle. The bias results from the prior requirement that an intervention be effective (usually 'clinically effective') before its cost-effectiveness...... is considered. The underlying justification for the use of cost-effectiveness as a criterion, whatever the threshold adopted, is that decisions in a resource-constrained system have opportunity costs. Their existence rules out any restriction to those interventions that are 'incrementally cost-effective......' at a chosen threshold and requires acceptance of those that are 'decrementally cost-effective' at the same threshold. Interventions that fall under the linear ICER line in the South-West quadrant of the cost-effectiveness plane are cost-effective because they create net health benefits, as do those...

Nitrogen Cycle Evaluation (NiCE) Chip for the Simultaneous Analysis of Multiple N-Cycle Associated Genes.

Science.gov (United States)

Oshiki, Mamoru; Segawa, Takahiro; Ishii, Satoshi

2018-02-02

Various microorganisms play key roles in the Nitrogen (N) cycle. Quantitative PCR (qPCR) and PCR-amplicon sequencing of the N cycle functional genes allow us to analyze the abundance and diversity of microbes responsible in the N transforming reactions in various environmental samples. However, analysis of multiple target genes can be cumbersome and expensive. PCR-independent analysis, such as metagenomics and metatranscriptomics, is useful but expensive especially when we analyze multiple samples and try to detect N cycle functional genes present at relatively low abundance. Here, we present the application of microfluidic qPCR chip technology to simultaneously quantify and prepare amplicon sequence libraries for multiple N cycle functional genes as well as taxon-specific 16S rRNA gene markers for many samples. This approach, named as N cycle evaluation (NiCE) chip, was evaluated by using DNA from pure and artificially mixed bacterial cultures and by comparing the results with those obtained by conventional qPCR and amplicon sequencing methods. Quantitative results obtained by the NiCE chip were comparable to those obtained by conventional qPCR. In addition, the NiCE chip was successfully applied to examine abundance and diversity of N cycle functional genes in wastewater samples. Although non-specific amplification was detected on the NiCE chip, this could be overcome by optimizing the primer sequences in the future. As the NiCE chip can provide high-throughput format to quantify and prepare sequence libraries for multiple N cycle functional genes, this tool should advance our ability to explore N cycling in various samples. Importance. We report a novel approach, namely Nitrogen Cycle Evaluation (NiCE) chip by using microfluidic qPCR chip technology. By sequencing the amplicons recovered from the NiCE chip, we can assess diversities of the N cycle functional genes. The NiCE chip technology is applicable to analyze the temporal dynamics of the N cycle gene

Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people.

Science.gov (United States)

Coulthard, P; Craig, D; Holden, C; Robb, N D; Sury, M; Chopra, S; Holroyd, I

2015-04-24

Describe current dental sedation practice for under 19-year-olds in the UK and compare it with the recommendations of NICE guidance 112. Members of the Society for the Advancement of Anaesthesia in Dentistry and members of the Dental Sedation Teachers Group were invited to participate in an online survey. Two hundred and sixty-six dentists and doctors completed the survey. Eighty-two percent were operator and sedationist (operator-sedationist). Ninety-five percent provided written information and 94% obtained written consent. Eighty-four percent kept a written or electronic sedation record. Eighty-six percent complied with life support training expectations. Eighty-six percent had immediate access to resuscitation equipment. Sixty-seven percent of sedationists reported that treatment could not be completed under sedation for sedation was unsuccessful, 61% said they would schedule general anaesthesia and 54.5% would schedule advanced sedation care. Forty-nine percent believed that a dentist was an appropriate person to provide advanced sedation for 12-18 years. Only 24% thought a dentist should provide advanced sedation for childrensedation was thought to be primary care by 33% and secondary care by 68%. We found good agreement between the current practice of sedation and the recommendations of the NICE guidance 112.

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

Science.gov (United States)

Rose, Micah; Rice, Stephen; Craig, Dawn

2017-07-05

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Aircraft operations management manual

Science.gov (United States)

1992-01-01

The NASA aircraft operations program is a multifaceted, highly diverse entity that directly supports the agency mission in aeronautical research and development, space science and applications, space flight, astronaut readiness training, and related activities through research and development, program support, and mission management aircraft operations flights. Users of the program are interagency, inter-government, international, and the business community. This manual provides guidelines to establish policy for the management of NASA aircraft resources, aircraft operations, and related matters. This policy is an integral part of and must be followed when establishing field installation policy and procedures covering the management of NASA aircraft operations. Each operating location will develop appropriate local procedures that conform with the requirements of this handbook. This manual should be used in conjunction with other governing instructions, handbooks, and manuals.

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

Science.gov (United States)

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

2014-01-01

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

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

Science.gov (United States)

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Nice Teams Finish Last The Secret to Unleashing Your Team's Maximum Potential

CERN Document Server

Miller, Brian Cole

2010-01-01

Don't rock the boat. Don't make waves. Don't offend anyone. There's a palpable feeling that clouds many team meetings and keeps them from being productive: over-politeness. And while the conflict that naturally exists in most organizations hasn't gone away, it manifests itself in passive-aggression, mediocrity, and a molasses-like inability to get anything done. Nice Teams Finish Last provides the antidote to this all-too-common tendency, giving managers, team leaders and members, and facilitators the practical support they need to battle "the nice trap" and start getting results! The book hel

Generating Nice Linear Systems for Matrix Gaussian Elimination

Science.gov (United States)

Homewood, L. James

2004-01-01

In this article an augmented matrix that represents a system of linear equations is called nice if a sequence of elementary row operations that reduces the matrix to row-echelon form, through matrix Gaussian elimination, does so by restricting all entries to integers in every step. Many instructors wish to use the example of matrix Gaussian…

Guidelines for a radiology department

International Nuclear Information System (INIS)

1981-05-01

This manual presents guidelines for hospitals on a radiology quality assurance and dose measurement audit program and a system of planned actions that monitor and record the performance and effectiveness of the radiological service

Instructional Guidelines. Welding.

Science.gov (United States)

Fordyce, H. L.; Doshier, Dale

Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

Public Health Pest Control Category Manual.

Science.gov (United States)

Bowman, James S.; Turmel, Jon P.

This manual provides information needed to meet the standards for pesticide applicator certification. It presents pest control guidelines for those organisms of public health significance. Fact sheets with line drawings discuss pests such as cockroaches, bedbugs, lice, ants, beetles, bats, birds, and rodents. (CS)

Sludge Digestion Manual; Handboek Slibgisting

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-09-15

This manual offers a guideline for developing, designing, optimizing and operating sludge digestion installations based on sewage sludge. It also offers tools for solving operation problems [Dutch] Het Handboek is een leidraad voor het ontwikkelen, ontwerpen, optimaliseren en bedrijven van slibgistingsinstallaties voor zuiveringsslib. Ook geeft het handvatten voor het oplossen van operationele problemen.

Auxiliary mine ventilation manual

International Nuclear Information System (INIS)

Workplace Safety North

2010-01-01

An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

Auxiliary mine ventilation manual

Energy Technology Data Exchange (ETDEWEB)

Workplace Safety North

2010-07-01

An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

Guidelines and criteria for planning Slovenian settlements

Directory of Open Access Journals (Sweden)

Andrej Pogačnik

2001-01-01

Full Text Available The article deals with proposals for directing settlement development and management in Slovenia on the national level. They should be integrated in the spatial order, a part of the national spatial plan. First a short chronology of research with similar topics and simultaneous critical analysis is presented. The methodology and possible models for structuring directives is elaborated. Based on recent research by domestic authors, European guidelines and own ideas, a manual was devised, dividing guidelines hierarchically between the national, regional and local level. The second part or rather different type of text attached to the manual is a glossary. It also includes an index for further research of various sources.

Operator's manual actions in case of fire; Acciones manuales del operador en caso de incendio

Energy Technology Data Exchange (ETDEWEB)

Saez de Tejada Madina, P.; Perez Lobo, E. M.; Velasco Ramirez, R.; Velasco Ramirez, R.; Fernandez Ramos, P.

2012-07-01

Vandellos II, following the guidelines GS 01.19 of CSN and RG 1.189 rev. 2, has identified the need to consider a number of local manual actions to be performed by the staff of shift operation and need to be validated according NUREG 1852. The local manual actions include corrective and preventive actions, such as local start and shooting of bombs, checking positions ... According NUREG-1852 these actions must be validated with conditions as similar as possible to those expected, in conjunction with the operating of Vandellos II.

[Guideline-conform psychiatric psychotherapeutic treatment for patients with schizophrenia : A normative evaluation of necessary personnel requirements].

Science.gov (United States)

Mehl, S; Falkai, P; Berger, M; Löhr, M; Rujescu, D; Wolff, J; Kircher, T

2016-03-01

Although national treatment guidelines and current publications of the German Federal Joint Committee (Gemeinsamer Bundesausschuss) recommend cognitive behavior therapy for all patients with schizophrenia, the implementation of these recommendations in current inpatient and outpatient treatment is only rudimentary. The aim of this study was to systematically search randomized controlled studies (RCTs), meta-analyses and the guidelines of the German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the British National Institute for Health and Clinical Excellence (NICE) in order to assess the number of personnel necessary for psychiatric and therapeutic inpatient treatment in line with present guidelines. Moreover, the number of staff required was compared with the personnel resources designated by the German psychiatry personnel regulations (Psych-PV). The German and NICE guidelines, RCTs and meta-analyses were analyzed and an adequate weekly treatment plan for an inpatient unit was developed. Moreover, the number of personnel necessary to realize the treatment plan was calculated. In order to realize adequate inpatient treatment approximately 107 min extra for medical psychotherapeutic personnel per patient and week (of which 72 min for psychotherapy) and another 60 min for nursing staff per patient and week are required in addition to the current Psych-PV regulations. Thus, implementation in an open ward with 20 inpatients would require 3.62 positions for physicians, 0.7 positions in psychology and 12.85 positions for nursing staff (including management positions and night shifts). These evidence-based recommendations for precise specifications of inpatient treatment should lead to improved inpatient treatment in line with present guidelines. Moreover, outpatients and day patients could be included in this treatment model. The results should be considered in the construction of the future prospective payment system for

A review of clinical guidelines.

LENUS (Irish Health Repository)

Andrews, E J

2012-02-03

BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

Manual on decontamination of surfaces

International Nuclear Information System (INIS)

1979-01-01

The manual is intended for those who are responsible for the organization and implementation of decontamination programmes for facilities where radioactive materials are handled mainly on a laboratory scale. It contains information and guidelines on practical methods for decontaminating working spaces, equipment, laboratory benches and protective clothing. Useful information is also provided on the removal of loose skin contamination from personnel by mild, non-medical processes. Methods of removing skin contamination needing medical supervision, or of internal decontamination, which is entirely a medical process, are not covered in this manual. Large-scale decontamination of big nuclear facilities is also considered as outside its scope

Oregon School Bond Manual. Fifth Edition.

Science.gov (United States)

Oregon State Dept. of Education, Salem.

To help school districts comply with Oregon's school bond laws, this manual provides guidelines for school district attorneys and personnel in the issuance and sale of school bonds. The document describes the proper time sequence of the bonding procedure, including elections, school board authorizations, necessary certificates, bond registration…

ERIC User Services Manual. Revised Edition.

Science.gov (United States)

Wagner, Judith O., Comp.

This manual explains how the user services functions, usually performed by a User Services Coordinator, can be conducted in the 16 ERIC (Educational Resources Information Center) Clearinghouses and the various adjunct ERIC Clearinghouses. It provides guidelines, suggestions, and examples of how ERIC components currently perform the user services…

School Crisis Management Manual: Guidelines for Administrators. Second Edition.

Science.gov (United States)

Smith, Judie

This three-part manual is intended for principals and other administrators responsible for developing and managing school crisis plans. Part 1, preparation for a school crisis, includes sections on the selection and training of members of the school crisis team, steps in developing a school crisis plan, and four crisis scenarios to train team…

Radiation protection technician job task analysis manual

International Nuclear Information System (INIS)

1990-03-01

This manual was developed to assist all DOE contractors in the design and conduct of job task analysis (JTA) for the radiation protection technician. Experience throughout the nuclear industry and the DOE system has indicated that the quality and efficiency in conducting a JTA at most sites is greatly enhanced by using a generic task list for the position, and clearly written guidelines on the JTA process. This manual is designed to provide this information for personnel to use in developing and conducting site-specific JTAs. (VC)

Sustainable design guidelines to support the Washington State ferries terminal design manual : design guideline application and refinement.

Science.gov (United States)

2013-08-01

The Sustainable Design Guidelines were developed in Phase I of this research program (WA-RD : 816.1). Here we are reporting on the Phase II effort that beta-tested the Phase I Guidelines on : example ferry terminal designs and refinements made ...

Guidelines on best practice in the X-ray imaging of children. A manual for all X-ray departments

International Nuclear Information System (INIS)

Cook, J.; Pettett, A.; Shah, K.

1998-01-01

When we were first asked to participate in a CEC project looking at best practice in paediatric radiology, we did not appreciate how much our own practice could be improved. The department already had high standards of radiography. However, despite our initial reservations we found that by reassessing all our practices, including choice of screen/film systems, use of filters, grids and exposure factors we were able to standardise our techniques and reduce our doses in many areas by over 50%, while still maintaining diagnostic quality. The published European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Paediatrics (1996) was our initiative. They provide a combination of positioning and visibility criteria. Radiographs which do not meet these criteria are not thought to be diagnostic and alternatively aesthetically high quality radiographs which exceed these criteria are not deemed necessary. The reference dose levels in the European Guidelines are those above which corrective action should be taken. The dose measurements in our guidelines are much lower and represent what is achievable with the available equipment at QMHC, while still meeting the European Quality Criteria. A new age of Digital radiography is replacing conventional radiography. However, as digital techniques can mask high doses, careful observation of quality criteria and recommended technique is even more important to obtain the most benefit from these technical advances. Despite the time consuming nature of the initial study the whole department has benefited and we encourage all those involved in the X-ray imaging of children to consider re-evaluating their own practices using these guidelines as a reference for comparison. We recognise that all the recommendations given are entirely dependent on the range of equipment available and pathology expected but can be modified to meet individual departmental needs. If practices/ techniques; diagnostic quality of radiographs or

Computer-based guidelines for concrete pavements : HIPERPAV III : user manual

Science.gov (United States)

2009-10-01

This user manual provides guidance on how to use the new High PERformance PAVing (HIPERPAV) III software program for the analysis of early-age Portland cement concrete pavement (PCCP) behavior. HIPERPAV III includes several improvements over prev...

Evaluation of manual and automatic manually triggered ventilation performance and ergonomics using a simulation model.

Science.gov (United States)

Marjanovic, Nicolas; Le Floch, Soizig; Jaffrelot, Morgan; L'Her, Erwan

2014-05-01

In the absence of endotracheal intubation, the manual bag-valve-mask (BVM) is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually triggered system, and to compare it with manual BVM ventilation. A respiratory system bench model was assembled using a lung simulator connected to a manikin to simulate a patient with unprotected airways. Fifty health-care providers from different professional groups (emergency physicians, residents, advanced paramedics, nurses, and paramedics; n = 10 per group) evaluated manual BVM ventilation, and compared it with an automatic manually triggered device (EasyCPR). Three pathological situations were simulated (restrictive, obstructive, normal). Standard ventilation parameters were recorded; the ergonomics of the system were assessed by the health-care professionals using a standard numerical scale once the recordings were completed. The tidal volume fell within the standard range (400-600 mL) for 25.6% of breaths (0.6-45 breaths) using manual BVM ventilation, and for 28.6% of breaths (0.3-80 breaths) using the automatic manually triggered device (EasyCPR) (P < .0002). Peak inspiratory airway pressure was lower using the automatic manually triggered device (EasyCPR) (10.6 ± 5 vs 15.9 ± 10 cm H2O, P < .001). The ventilation rate fell consistently within the guidelines, in the case of the automatic manually triggered device (EasyCPR) only (10.3 ± 2 vs 17.6 ± 6, P < .001). Significant pulmonary overdistention was observed when using the manual BVM device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the automatic manually triggered device (EasyCPR) to be better than those of the manual device. The use of an automatic manually triggered device may improve ventilation efficiency and decrease the risk of

Maintenance Personnel Performance Simulation (MAPPS) model. Users' Manual

International Nuclear Information System (INIS)

Kopstein, F.F.; Wolf, J.J.

1985-09-01

This report (MAPPS User's Manual) is the last report to be published from this program and provides detailed guidelines for utilization of the MAPPS model. Although the model has been developed to be highly user-friendly and provides interactive means for controlling and running of the model, the user's manual is provided as a guide for the user in the event clarification or direction is required. The user will find that in general the model requires primarily user input that is self explanatory. Once initial familiarization with the model has been achieved by the user, the amount of interaction between the user's manual and the computer model will be minimal. It is suggested however that even the experienced user keep the user's manual handy for quick reference. 5 refs., 10 figs., 7 tabs

[New Scientific Evidence-based Public Health Guidelines and Practical Manual for Prevention of Sick House Syndrome].

Science.gov (United States)

Kishi, Reiko; Yoshino, Hiroshi; Araki, Atsuko; Saijo, Yasuaki; Azuma, Kenichi; Kawai, Toshio; Yamato, Hiroshi; Osawa, Haruki; Shibata, Eiji; Tanaka, Masatoshi; Masuchi, Ayumi; Minatoya, Machiko; Ait Bamai, Yu

2018-01-01

Recently, we have published a book containing evidence-based public health guidelines and a practical manual for the prevention of sick house syndrome. The manual is available through the homepage of the Ministry of Health, Labour and Welfare (http://www.mhlw.go.jp/file/06-Seisakujouhou-11130500-Shokuhinanzenbu/0000155147.pdf). It is an almost completely revised version of the 2009 version. The coauthors are 13 specialists in environmental epidemiology, exposure sciences, architecture, and risk communication. Since the 1970s, health problems caused by indoor chemicals, biological pollution, poor temperature control, humidity, and others in office buildings have been recognized as sick building syndrome (SBS) in Western countries, but in Japan it was not until the 1990s that people living in new or renovated homes started to describe a variety of nonspecific subjective symptoms such as eye, nose, and throat irritation, headache, and general fatigue. These symptoms resembled SBS and were designated "sick house syndrome (SHS)." To determine the strategy for prevention of SHS, we conducted a nationwide epidemiological study in six cities from 2003-2013 by randomly sampling 5,709 newly built houses. As a result 1,479 residents in 425 households agreed to environmental monitoring for indoor aldehydes and volatile organic compounds (VOCs). After adjustment for possible risk factors, some VOCs and formaldehyde were dose-dependently shown to be significant risk factors. We also studied the dampness of the houses, fungi, allergies, and others. This book is fully based on the scientific evidence collected through these studies and other newly obtained information, especially from the aspect of architectural engineering. In addition to SHS, we included chapters on recent information about "multi-chemical sensitivity."

Study of developing nuclear fabrication facility's integrated emergency response manual

International Nuclear Information System (INIS)

Kim, Taeh Yeong; Cho, Nam Chan; Han, Seung Hoon; Moon, Jong Han; Lee, Jin Hang; Min, Guem Young; Han, Ji Ah

2016-01-01

Public begin to pay attention to emergency management. Thus, public's consensus on having high level of emergency management system up to advanced country's is reached. In this social atmosphere, manual is considered as key factor to prevent accident or secure business continuity. Therefore, we first define possible crisis at KEPCO Nuclear Fuel (hereinafter KNF) and also make a 'Reaction List' for each crisis situation at the view of information-design. To achieve it, we analyze several country's crisis response manual and then derive component, indicate duties and roles at the information-design point of view. From this, we suggested guideline to make 'Integrated emergency response manual(IERM)'. The manual we used before have following few problems; difficult to applicate at the site, difficult to deliver information. To complement these problems, we searched manual elements from the view of information-design. As a result, we develop administrative manual. Although, this manual could be thought as fragmentary manual because it confined specific several agency/organization and disaster type

Total quality management implementation guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-12-01

These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

Iceless Icy Moons: Is the Nice Model In Trouble?

Science.gov (United States)

Dones, Henry C. Luke; Levison, H. F.

2012-05-01

Nimmo and Korycansky (2012; henceforth NK12) stated that if the outer Solar System underwent a Late Heavy Bombardment (LHB) in the Nice model, the mass striking the icy satellites at speeds up to tens of km/s would have vaporized so much ice that moons such as Mimas, Enceladus, and Miranda would have been devolatilized. NK12's possible explanations of this apparent discrepancy with observations include (1) the mass influx was a factor of 10 less than that in the Nice model; (2) the mass distribution of the impactors was top-heavy, so that luck might have saved some of the moons from suffering large, vapor-removing impacts; or (3) the inner moons formed after the LHB. NK12 calculated the mass influx onto the satellites from the lunar impact rate estimated by Gomes et al. (2005) and scaling factors calculated by Zahnle et al. (1998, 2003; also see Barr and Canup 2010). Production of vapor in hypervelocity impacts is calculated from Kraus et al. (2011). Our preliminary results show that there is about an order-of-magnitude uncertainty in the mass striking the satellites during the LHB, with NK12's estimate at the upper end of the range. We will discuss how the mass influx depends on the velocity and mass distributions of the impactors. The Nice model lives. We thank the NASA Lunar Science Institute (http://lunarscience.nasa.gov/) for support. Barr, A.C., Canup, R.M., Nature Geoscience 3, 164-167 (2010). Gomes, R., Levison, H.F., Tsiganis, K., Morbidelli, A., Nature 435, 466-469 (2005). Kraus, R.G., Senft, L.E., Stewart, S.T., Icarus 214, 724-738 (2011). Nimmo, F., Korycansky, D.G., Icarus, in press, http://www.sciencedirect.com/science/article/pii/S0019103512000310 (2012). Zahnle, K., Dones, L., Levison, H.F., Icarus 136, 202-222 (1998). Zahnle, K., Schenk, P., Levison, H.F., Dones, L., Icarus 163, 263-289 (2003).

Nutrition. Michigan School Food Service Training Manual.

Science.gov (United States)

Michigan State Univ., East Lansing. Cooperative Extension Service.

Definitions, advantages, and functions of nutrition are the starting point for this food service training manual, which includes lessons on proteins, carbohydrates, minerals, and water- and fat-soluble vitamins. Energy foods for child nutrition programs are also identified, as are balanced diets and meal pattern guidelines. Class activities,…

Nice Work de David Lodge : Un « Condition of England novel » des années 1980 ? Nice Work: A « Condition of England novel » of the 1980s?

Directory of Open Access Journals (Sweden)

Armelle Parey

2009-11-01

Full Text Available In Nice Work, David Lodge appropriates the model of the « condition-of-England novel » which he transposes into the 1980s. More than a mere transposition, Nice Work turns out to be an open rewriting of the Victorian novels quoted in epigraphs since the text, with its comical aspect and its auto-reflexive dimension, distances itself from realism. Far from being innocent, this rewriting considers critically the Thatcher era as well as contemporary literary theory and gives a discerning homage to Victorian novels.

Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise

Science.gov (United States)

Schünemann, Holger J.; Wiercioch, Wojtek; Etxeandia, Itziar; Falavigna, Maicon; Santesso, Nancy; Mustafa, Reem; Ventresca, Matthew; Brignardello-Petersen, Romina; Laisaar, Kaja-Triin; Kowalski, Sérgio; Baldeh, Tejan; Zhang, Yuan; Raid, Ulla; Neumann, Ignacio; Norris, Susan L.; Thornton, Judith; Harbour, Robin; Treweek, Shaun; Guyatt, Gordon; Alonso-Coello, Pablo; Reinap, Marge; Brožek, Jan; Oxman, Andrew; Akl, Elie A.

2014-01-01

Background: Although several tools to evaluate the credibility of health care guidelines exist, guidance on practical steps for developing guidelines is lacking. We systematically compiled a comprehensive checklist of items linked to relevant resources and tools that guideline developers could consider, without the expectation that every guideline would address each item. Methods: We searched data sources, including manuals of international guideline developers, literature on guidelines for guidelines (with a focus on methodology reports from international and national agencies, and professional societies) and recent articles providing systematic guidance. We reviewed these sources in duplicate, extracted items for the checklist using a sensitive approach and developed overarching topics relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions and suggestions for items to be added. Results: We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers. The topics and included items cover all stages of the guideline enterprise, from the planning and formulation of guidelines, to their implementation and evaluation. The final checklist includes links to training materials as well as resources with suggested methodology for applying the items. Interpretation: The checklist will serve as a resource for guideline developers. Consideration of items on the checklist will support the development, implementation and evaluation of guidelines. We will use crowdsourcing to revise the checklist and keep it up to date. PMID:24344144

Guidelines for the Development of Instructional Materials Selection Policies. Handbook I.

Science.gov (United States)

Motomatsu, Nancy, Ed.

This manual was developed to assist school district personnel in the development of policies and procedures for selecting instructional materials. The manual describes State of Washington laws and regulations that govern the selection, use, and disposal of instructional materials and presents criteria and guidelines for selecting materials. Also…

Prehrana in telesna aktivnost nosečnice

OpenAIRE

Ciglar, Ksenija

2012-01-01

V diplomskem delu smo predstavili nosečnost kot stanje fizioloških in psiholoških sprememb ter prehrano in telesno aktivnost nosečnice. Zdrava in uravnotežena prehrana je pomembna v vseh življenjskih obdobjih ženske, še posebej pa pred nosečnostjo, v nosečnosti in v času laktacije. Telesna ali športna dejavnost pa vpliva pozitivno na nosečničino zdravje in dobro počutje. Diplomsko delo je sestavljeno iz dveh delov. V prvem (teoretičnem) delu je predstavljena fiziologija nosečnosti, prehrana ...

National Institute for Clinical Excellence guidelines on the surgical management of otitis media with effusion: are they being followed and have they changed practice?

Science.gov (United States)

Daniel, Matija; Kamani, Tawakir; El-Shunnar, Suliman; Jaberoo, Marie-Claire; Harrison, Anna; Yalamanchili, Seema; Harrison, Laura; Cho, Wai-Sum; Fergie, Neil; Bayston, Roger; Birchall, John P

2013-01-01

UK National Institute of Clinical Excellence (NICE) guidelines on surgical management of otitis media with effusion (OME) in children call for an initial 3 month period of observation, with ventilation tube (VT) insertion considered for children with persistent bilateral OME with a hearing level in better ear of 25-30 dB HL or worse ("core criteria"), or for children not meeting those audiologic criteria but when OME has significant impact on developmental, social or educational status (exceptional circumstances). We aimed to establish whether guidelines are followed and whether they have changed clinical practice. Retrospective case-notes review in five different centres, analysing practice in accordance with guidelines in all children having first VT insertion before (July-December 06) and after (July-December 08) guidelines introduction. Records of 319 children were studied, 173 before and 146 after guidelines introduction. There were no significant differences in practice according to guidelines before and after their introduction with respect to having 2 audiograms 3 months apart (57.8 vs. 54.8%), OME persisting at least 3 months (94.8 vs. 92.5%), or fulfilment of the 25 dB audiometric criteria (68.2 vs. 61.0%). Practice in accordance with the core criteria fell significantly from 43.9 to 32.2% (Chi squared p=0.032). However, if the exceptional cases were included there was no significant difference (85.5 vs. 87.0%), as the proportion of exceptional cases rose from 48.3 to 62.2% (Chi squared p=0.021). This study shows that 87.0% of children have VTs inserted in accordance with NICE guidelines providing exceptional cases are included, but only 32.2% comply with the core criteria. A significant number have surgery due to the invoking of exceptional criteria, suggesting that clinicians are personalising the treatment to each individual child. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Dilemma-focused intervention for unipolar depression: a treatment manual.

Science.gov (United States)

Feixas, Guillem; Compañ, Victoria

2016-07-12

This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general

The development of the UK National Institute of Health and Care Excellence evidence-based clinical guidelines on motor neurone disease.

Science.gov (United States)

Oliver, David; Radunovic, Aleksandar; Allen, Alexander; McDermott, Christopher

2017-08-01

The care of people with motor neuron disease/amyotrophic lateral sclerosis is often complex and involves a wide multidisciplinary team approach. The National Institute for Health and Care Excellence (NICE) in the UK has produced an evidence based guideline for the management of patients. This has made recommendations, based on clear evidence or consensus discussion. The evidence is often limited and areas for further research are suggested.

Ruxolitinib for the treatment of myelofibrosis: a NICE single technology appraisal.

Science.gov (United States)

Wade, Ros; Rose, Micah; Neilson, Aileen Rae; Stirk, Lisa; Rodriguez-Lopez, Rocio; Bowen, David; Craig, Dawn; Woolacott, Nerys

2013-10-01

The National Institute for Health and Care Excellence (NICE) invited the manufacturer of ruxolitinib (Novartis) to submit clinical and cost-effectiveness evidence for ruxolitinib within its licensed indication (the treatment of disease-related splenomegaly or symptoms in adult patients with myelofibrosis), according to the Institute's Single Technology Appraisal process. The Centre for Reviews and Dissemination and Centre for Health Economics at the University of York were commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and the resulting NICE guidance TA289 issued in June 2013. The ERG critically reviewed the evidence presented in the manufacturer's submission and identified areas requiring clarification, for which the manufacturer provided additional evidence. The main clinical effectiveness data were derived from two phase III, multicentre, randomised controlled trials (RCTs): Controlled myelofibrosis study with oral JAK inhibitor treatment (COMFORT)-II compared ruxolitinib with best available therapy (BAT), and COMFORT-I compared ruxolitinib with placebo. These RCTs demonstrated that ruxolitinib confers significant benefits in terms of spleen size reduction and improvement in symptom burden. In the COMFORT-II trial, a reduction in spleen volume of ≥35 % was achieved in 28 % of ruxolitinib-treated patients compared with 0 % of patients in the BAT group (p Service (NHS) resources for treating disease-related splenomegaly or symptoms in adults with myelofibrosis. Ruxolitinib is not recommended for the treatment of disease-related splenomegaly or symptoms in adult patients with primary myelofibrosis (also known as chronic idiopathic myelofibrosis), post-polycythaemia vera myelofibrosis and post-essential thrombocythaemia myelofibrosis in NICE TA289.

Slaughterhouse Inspection (Egypt). Training Manual : Guidelines for the Planning and Organisation of Training Activities

NARCIS (Netherlands)

Blomne Sopov, M.; Ghouti, C.A.; Benlafquih, R.; Vugt, van F.; Latief, A.M.A.

2014-01-01

The training manual was prepared for the inspectors of slaughterhouses in Egypt to support the training activities of the General Organization for Veterinary Services (GOVS). The manual has two main parts: 1. Overview on how to design, organize, implement and evaluate training programs in general 2.

Programmer's manual for CAMCON: Compliance Assessment Methodology CONtroller

International Nuclear Information System (INIS)

Rechard, R.P.; Gilkey, A.P.; Rudeen, D.K.; Byle, K.A.; Iuzzolino, H.J.

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system

The Marfan Syndrome: Physical Activity Guidelines for Physical Educators, Coaches and Physicians.

Science.gov (United States)

Romeo, Thomas J.

Intended for physical educators, this manual provides guidelines for providing safe and effective physical activity programs for children with Marfan syndrome, a congenital condition involving the connective tissues and the probable cause of sudden death by heart failure of some young competitive athletes in recent cases. The manual includes…

Golimumab for the treatment of ankylosing spondylitis : a NICE single technology appraisal

NARCIS (Netherlands)

Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing

News from the library : Working with words? The Chicago Manual of Style is there to help

CERN Multimedia

CERN Library

2010-01-01

Among the many useful resources the Library can offer you, the style manuals occupy a central role.   According to Wikipedia, "a style guide or style manual is a set of standards for the writing and design of documents, either for general use or for a specific publication, organization or field. The implementation of a style guide provides uniformity in style and formatting of a document." The 16th edition of the Chicago Manual of Style is now available online to the CERN community. It will provide you with general guidelines for preparing electronic manuscripts for books, along with citation, spelling, punctuation and abbreviations guidelines. You can access it here. Don't hesitate to send us your suggestions for any other style manuals that could be added to the Library collection. The contact email address for feedback is library.desk@cern.ch.      

The environmental survey manual

International Nuclear Information System (INIS)

1987-08-01

The purpose of this manual is to provide guidance to the Survey and Sampling and Analysis teams that conduct the one-time Environmental Survey of the major US Department of Energy (DOE) operating facilities. This manual includes a discussion of DOE's policy on environmental issues, a review of statutory guidance as it applies to the Survey, the procedures and protocols to be used by the Survey teams, criteria for the use of the Survey teams in evaluating existing environmental data for the Survey effort, generic technical checklists used in every Survey, health and safety guidelines for the personnel conducting the Survey, including the identification of potential hazards, prescribed protective equipment, and emergency procedures, the required formats for the Survey reports, guidance on identifying environmental problems that need immediate attention by the Operations Office responsible for the particular facility, and procedures and protocols for the conduct of sampling and analysis

A Performance Evaluation for IT/IS Implementation in Organisation: Preliminary New IT/IS Capability Evaluation (NICE Model

Directory of Open Access Journals (Sweden)

Hafez Salleh

2011-12-01

Full Text Available Most of the traditional IT/IS performance measures are based on productivity and process, which mainly focus on method of investment appraisal. There is a need to produce alternative holistic measurement models that enable soft and hard issues to be measured qualitatively. A New IT/IS Capability Evaluation (NICE framework has been designed to measure the capability of organisations to'successfully implement IT systems' and it is applicable across industries.The idea is to provide managers with measurement tools to enable them to identify where improvements are required within their organisations and to indicate their readiness prior to IT investment. The NICE framework investigates four organisational key elements: IT, Environment, Process and People, and is composed of six progressive stages of maturity that a company can achieve its IT/IS capabilities. For each maturity stage, the NICE framework describes a set of critical success factors that must be in place for the company to achieve each stage.

Noise-immune cavity-enhanced analytical atomic spectrometry - NICE-AAS - A technique for detection of elements down to zeptogram amounts

Science.gov (United States)

Axner, Ove; Ehlers, Patrick; Hausmaninger, Thomas; Silander, Isak; Ma, Weiguang

2014-10-01

Noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) is a powerful technique for detection of molecular compounds in gas phase that is based on a combination of two important concepts: frequency modulation spectroscopy (FMS) for reduction of noise, and cavity enhancement, for prolongation of the interaction length between the light and the sample. Due to its unique properties, it has demonstrated unparalleled detection sensitivity when it comes to detection of molecular constituents in the gas phase. However, despite these, it has so far not been used for detection of atoms, i.e. for elemental analysis. The present work presents an assessment of the expected performance of Doppler-broadened (Db) NICE-OHMS for analytical atomic spectrometry, then referred to as noise-immune cavity-enhanced analytical atomic spectrometry (NICE-AAS). After a description of the basic principles of Db-NICE-OHMS, the modulation and detection conditions for optimum performance are identified. Based on a previous demonstrated detection sensitivity of Db-NICE-OHMS of 5 × 10- 12 cm- 1 Hz- 1/2 (corresponding to a single-pass absorbance of 7 × 10- 11 over 10 s), the expected limits of detection (LODs) of Hg and Na by NICE-AAS are estimated. Hg is assumed to be detected in gas phase directly while Na is considered to be atomized in a graphite furnace (GF) prior to detection. It is shown that in the absence of spectral interferences, contaminated sample compartments, and optical saturation, it should be feasible to detect Hg down to 10 zg/cm3 (10 fg/m3 or 10- 5 ng/m3), which corresponds to 25 atoms/cm3, and Na down to 0.5 zg (zg = zeptogram = 10- 21 g), representing 50 zg/mL (parts-per-sextillion, pps, 1:1021) in liquid solution (assuming a sample of 10 μL) or solely 15 atoms injected into the GF, respectively. These LODs are several orders of magnitude lower (better) than any previous laser-based absorption technique previously demonstrated under atmospheric

PRIS-WEDAS. User’s Manual to the Web Enabled Data Acquisition System for PRIS

International Nuclear Information System (INIS)

2015-01-01

The user manual for the Web Enabled Data Acquisition System (WEDAS), a system that supports the Power Reactor Information System (PRIS), provides instructions, guidelines and detailed definitions for each of the data items required for PRIS. The purpose of this manual is to ensure PRIS performance data are collected consistently and that the required quality of data collection is ensured. This PRIS-WEDAS user’s manual replaces reporting instructions published in the IAEA Technical Reports Series No. 428

New recommendations for management of eating disorders (anorexia nervosa, bulimia nervosa from NICE

Directory of Open Access Journals (Sweden)

Vitaliy Bezsheiko

2017-08-01

Full Text Available The UK's National Institute for Health and Care Excellence (NICE, one of the most authoritative institutions in the field of evidence-based medicine, has issued standards for management of patients with anorexia and bulimia nervosa.

Civil Engineering & Design Standards Manual

OpenAIRE

Vänttinen, Eetu

2014-01-01

Civil Discipline Engineering department in Foster Wheeler Energia Oy takes care of the construction of foundation, steel frame, platforms, cladding/roofing, HVAC, elevator, hoist and central vacuum system of the boiler building. The goal of the thesis was to compile a design manual for the department to ease up the startup of the design of a new project and standardize the design. Main objective was to gather together all the existing guidelines, standards and directives regarding the des...

Association between NICE guidance on biologic therapies with rates of hip and knee replacement among rheumatoid arthritis patients in England and Wales

DEFF Research Database (Denmark)

Hawley, Samuel; Cordtz, René; Dreyer, Lene

2018-01-01

OBJECTIVE: To estimate the impact of NICE approval of tumor necrosis factor inhibitor (TNFi) therapies on the incidence of total hip replacement (THR) and total knee replacement (TKR) among rheumatoid arthritis (RA) patients in England and Wales. METHODS: Primary care data [Clinical Practice.......92 PYs, respectively. NICE guidance was associated with a significant average decrease in TKR incidence of -4.41/1000 PYs (95% C.I. -6.88 to -1.94), equating to a relative 34% reduction. Overall, no effect was seen on THR rates. CONCLUSIONS: Among incident RA patients in England and Wales, NICE guidance...

Certification Manual for Wisconsin Public Librarians. Bulletin No. 94111.

Science.gov (United States)

Lamb, Donald K.

This manual contains the guidelines and procedures for public librarian certification and certification renewal in Wisconsin. Certification is not required for library personnel other than administrators, but nonadministrators may apply for certification at the level for which they are eligible. Requirements for voluntary library certification are…

Noise-immune cavity-enhanced analytical atomic spectrometry — NICE-AAS — A technique for detection of elements down to zeptogram amounts

International Nuclear Information System (INIS)

Axner, Ove; Ehlers, Patrick; Hausmaninger, Thomas; Silander, Isak; Ma, Weiguang

2014-01-01

Noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) is a powerful technique for detection of molecular compounds in gas phase that is based on a combination of two important concepts: frequency modulation spectroscopy (FMS) for reduction of noise, and cavity enhancement, for prolongation of the interaction length between the light and the sample. Due to its unique properties, it has demonstrated unparalleled detection sensitivity when it comes to detection of molecular constituents in the gas phase. However, despite these, it has so far not been used for detection of atoms, i.e. for elemental analysis. The present work presents an assessment of the expected performance of Doppler-broadened (Db) NICE-OHMS for analytical atomic spectrometry, then referred to as noise-immune cavity-enhanced analytical atomic spectrometry (NICE-AAS). After a description of the basic principles of Db-NICE-OHMS, the modulation and detection conditions for optimum performance are identified. Based on a previous demonstrated detection sensitivity of Db-NICE-OHMS of 5 × 10 −12 cm −1 Hz −1∕2 (corresponding to a single-pass absorbance of 7 × 10 −11 over 10 s), the expected limits of detection (LODs) of Hg and Na by NICE-AAS are estimated. Hg is assumed to be detected in gas phase directly while Na is considered to be atomized in a graphite furnace (GF) prior to detection. It is shown that in the absence of spectral interferences, contaminated sample compartments, and optical saturation, it should be feasible to detect Hg down to 10 zg/cm 3 (10 fg/m 3 or 10 −5 ng/m 3 ), which corresponds to 25 atoms/cm 3 , and Na down to 0.5 zg (zg = zeptogram = 10 −21 g), representing 50 zg/mL (parts-per-sextillion, pps, 1:10 21 ) in liquid solution (assuming a sample of 10 μL) or solely 15 atoms injected into the GF, respectively. These LODs are several orders of magnitude lower (better) than any previous laser-based absorption technique previously demonstrated

Programmer`s manual for CAMCON: Compliance Assessment Methodology CONtroller

Energy Technology Data Exchange (ETDEWEB)

Rechard, R.P. [Sandia National Labs., Albuquerque, NM (United States); Gilkey, A.P.; Rudeen, D.K.; Byle, K.A. [New Mexico Engineering Research Inst., Albuquerque, NM (United States); Iuzzolino, H.J. [Geo-Centers, Inc., Albuquerque, NM (United States)

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system.

Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

Directory of Open Access Journals (Sweden)

Wohlfart Björn

2010-10-01

Full Text Available Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005 for cardiopulmonary resuscitation (CPR. The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8 or LUCAS-CPR (n = 8 was started and run for 20 minutes. Professional paramedics gave manual chest compression's alternating in 2-minute periods. Ventilation, one breath for each 10 compressions, was given to all animals. Defibrillation and, if needed, adrenaline were given to obtain a return of spontaneous circulation (ROSC. Results The mean coronary perfusion pressure was significantly (p Conclusions LUCAS-CPR gave significantly higher coronary perfusion pressure and significantly fewer rib fractures than manual CPR in this porcine model.

Guidelines for upgrading of low volume roads

CSIR Research Space (South Africa)

Division of Roads

1993-03-01

Full Text Available The purpose of this manual is to provide guidelines on the upgrading of gravel low volume roads to roads and maintenance personnel of road authorities of all sizes. Low volume is, for the purpose of this document, defined to be less than 500...

Update of the Dutch manual for costing studies in health care

NARCIS (Netherlands)

T.A. Kanters (Tim A.); C.A.M. Bouwmans-Frijters (Clazien); N. van der Linden (Naomi); S.S. Tan (Siok Swan); L. van Hakkaart-van Roijen (Leona)

2017-01-01

markdownabstract__Objectives__ Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most

Peer teaching and information retrieval: the role of the NICE Evidence search student champion scheme in enhancing students' confidence.

Science.gov (United States)

Sbaffi, Laura; Hallsworth, Elaine; Weist, Anne

2018-03-01

This research reports on the NICE Evidence search (ES) student champion scheme (SCS) first five years of activity (2011-2016) in terms of its impact on health care undergraduate students' information search skills and search confidence. A review of students' evaluation of the scheme was carried out to chart the changes in attitude towards NICE Evidence search as an online health care information source and to monitor students' approach to information seeking. This study is based on the results of questionnaires distributed to students before and after attending a training session on NICE Evidence search delivered by their own peers. The exercise was implemented in health related universities in England over a period of five consecutive academic years. (i) Students' search confidence improved considerably after the training; (ii) ES was perceived as being an increasingly useful resource of evidence based information for their studies; (iii) the training helped students develop discerning search skills and use evidence based information sources more consistently and critically. The NICE SCS improves confidence in approaching information tasks amongst health care undergraduate students. Future developments could involve offering the training at the onset of a course of study and adopting online delivery formats to expand its geographical reach. © 2018 Health Libraries Group.

Urinary tract infection in children: Diagnosis, treatment, imaging - Comparison of current guidelines.

Science.gov (United States)

Okarska-Napierała, M; Wasilewska, A; Kuchar, E

2017-12-01

Urinary tract infection (UTI) is a frequent disorder of childhood, yet the proper approach for a child with UTI is still a matter of controversy. The objective of this study was to critically compare current guidelines for the diagnosis and management of UTI in children, in light of new scientific data. An analysis was performed of the guidelines from: American Academy of Pediatrics (AAP), National Institute for Health and Care Excellence (NICE), Italian Society of Pediatric Nephrology, Canadian Paediatric Society (CPS), Polish Society of Pediatric Nephrology, and European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU). Separate aspects of the approach for a child with UTI, including diagnosis, treatment and further imaging studies, were compared, with allowance for recent research in each field. The analyzed guidelines tried to reconcile recent reports about diagnosis, treatment, and further diagnostics in pediatric UTI with prior practices and opinions, and economic capabilities. There was still a lack of sufficient data to formulate coherent, unequivocal guidelines on UTI management in children, with imaging tests remaining the main area of controversy. As a result, the authors formulated their own proposal for UTI management in children. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Manual for Accessibility: [Conference, Meeting, and Lodging Facilities]. Revised.

Science.gov (United States)

National Rehabilitation Association, Alexandria, VA.

This illustrated manual and survey forms are designed to be used by organizations, hotel and restaurant associations, interested individuals and others as a guide for selecting accessible conference, meeting, and lodging facilities. The guidelines can also be used with existing facilities to identify specific modifications and accommodations. The…

Pemberian paket gizi masyarakat proyek NICE berpengaruh terhadap kinerja posyandu, tetapi tidak meningkatkan status gizi balita di Provinsi NTB

Directory of Open Access Journals (Sweden)

Solikin Solikin

2016-08-01

Full Text Available ABSTRACTBackground: The province of NTB had the prevalence of underweight 30.5% in 2010 for children under five, this figure is above the national prevalence. A nutrition improvement through community empowerment (NICE has been developed aimed to supporting community nutrition service to overcome nutrition and health problem independently. One of the programs is CNP (community nutrition package which got the highest fund allocation compared to other NICE program.Objectives: To evaluate the effect of CNP supplementation in NTB Province to the increase of nutritional status of children under five through index of weight by age and performance of posyandu.Methods: The study was evaluative with quantitative and qualitative method and one group pre and post test design, from January to April 2012 at 4 districts/ municipalities area of NICE Project, comprising 72 villages/cities that received CNP in 533 posyandu with 7,975 of children under fives. Posyandu’s performance was measured by baseline data collection for NICE project questionairre, weight measured by scale, and indepth interview was made to individuals administering CNP before and after receiving the package. Samples were randomly selected. Data analysis used paired t-test.Results: There was significant difference in performance of posyandu (p< 0.001, 95% CI: 9.88-11.05 and nutritional status of children under five based on index of weight/age (p<0.001, 95% CI: -1.23 to -1.32 before and after CNP supplementation. CNP supplementation increased performance of posyandu, but did not increase the nutritional status of children under five (index of weight/age. There were supporting factors of community nutrition supplementation such as human resources, participation across sectors, villages and community/religious leaders and integration with other programs (PNPM-Mandiri, GSC, local budget.Conclusions: CNP supplementation affected performance of posyandu but did not increase nutritional status

Study of developing nuclear fabrication facility's integrated emergency response manual

Energy Technology Data Exchange (ETDEWEB)

Kim, Taeh Yeong; Cho, Nam Chan; Han, Seung Hoon; Moon, Jong Han; Lee, Jin Hang [KEPCO, Daejeon (Korea, Republic of); Min, Guem Young; Han, Ji Ah [Dongguk Univ., Daejeon (Korea, Republic of)

2016-05-15

Public begin to pay attention to emergency management. Thus, public's consensus on having high level of emergency management system up to advanced country's is reached. In this social atmosphere, manual is considered as key factor to prevent accident or secure business continuity. Therefore, we first define possible crisis at KEPCO Nuclear Fuel (hereinafter KNF) and also make a 'Reaction List' for each crisis situation at the view of information-design. To achieve it, we analyze several country's crisis response manual and then derive component, indicate duties and roles at the information-design point of view. From this, we suggested guideline to make 'Integrated emergency response manual(IERM)'. The manual we used before have following few problems; difficult to applicate at the site, difficult to deliver information. To complement these problems, we searched manual elements from the view of information-design. As a result, we develop administrative manual. Although, this manual could be thought as fragmentary manual because it confined specific several agency/organization and disaster type.

Training Guidelines in Non-Destructive Testing Techniques: Manual for Visual Testing at Level 2

International Nuclear Information System (INIS)

2013-01-01

The International Atomic Energy Agency (IAEA) has been active in the promotion of non-destructive testing (NDT) technology for many decades. The prime reason for this interest has been the need for stringent quality control standards for safe operation of nuclear as well as other industrial installations. The IAEA has successfully executed a number of projects, including technical cooperation projects (national and regional) and coordinated research projects, in which NDT was an important part. Through these projects, a large number of persons have been trained in numerous Member States, leading to the establishment of national certifying bodies responsible for training and certification of NDT personnel. Consequently a state of self-sufficiency in this area of technology has been achieved in many of these States. All along there has been a realization of the need to have well established training guidelines and related books, in order, first, to guide IAEA experts involved in this training programme and, second, to achieve some level of international uniformity and harmonization of training materials and consequent competence of NDT personnel. The syllabuses for training courses have been published in the form of TECDOC publications. The first was IAEA-TECDOC-407 (1987), which contained syllabuses for the five basic NDT methods: liquid penetrant testing, magnetic particle testing, eddy current testing, radiographic testing and ultrasonic testing. To accommodate advancements in NDT technology, later versions of this publication were issued in 1991, 2002 and 2008, with the current version being IAEA-TECDOC- 628/Rev.2 (2008), which includes additional and more advanced NDT methods. The next logical step was to compile textbooks and training manuals in accordance with these syllabuses. Manuals on liquid penetrant, magnetic particle, radiographic, ultrasonic and eddy current testing have already been published in the Training Course Series. These play a vital role in

Pre-test probability risk scores and their use in contemporary management of patients with chest pain: One year stress echo cohort study

Science.gov (United States)

Demarco, Daniela Cassar; Papachristidis, Alexandros; Roper, Damian; Tsironis, Ioannis; Byrne, Jonathan; Monaghan, Mark

2015-01-01

Objectives To compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation. Design We undertook a large retrospective study to investigate the outcomes of stress echocardiography. Setting A large tertiary centre in the UK in a contemporary clinical practice. Participants Two thirds of the patients in the cohort were referred from our rapid access chest pain clinics. Results We found that the NICE risk score overestimates risk by 20% compared to the ESC Risk score. We also found that based on the NICE guidelines, 44% of the patients presenting with chest pain, in this cohort, would have been investigated invasively, with diagnostic coronary angiography. Using the ESC guidelines, only 0.3% of the patients would be investigated invasively. Conclusion The large discrepancy between the two guidelines can be easily reduced if NICE adopted the ESC risk score. PMID:26673458

Canadian Treatment Guidelines on Psychosocial Treatment of Schizophrenia in Children and Youth.

Science.gov (United States)

Lecomte, Tania; Abidi, Sabina; Garcia-Ortega, Iliana; Mian, Irfan; Jackson, Kevin; Jackson, Kim; Norman, Ross

2017-09-01

A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth. New treatments were also considered when recent meta-analyses suggested their usefulness. The children and youth psychosocial guidelines include many cross-sectional recommendations in terms of clinical and interpersonal skills needed to work with this clientele, setting and collaboration issues and needed adaptations for specific subpopulations. In terms of specific treatments, the treatments most strongly recommended are family intervention and cognitive behavior therapy. Also recommended, although with different degrees of support, are supported employment/supported education programs, patient education, cognitive remediation, and social skills training. Novel and upcoming psychosocial treatments are also briefly discussed. These novel Canadian guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.

The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process.

Science.gov (United States)

Carroll, Christopher; Kaltenthaler, Eva; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

2017-06-01

As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Suggestion of the manual exposure condition guideline for reducing patient dose in digital breast tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Hong, Eun Ae [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Lee, In Ja [Dept. of Radiologic Technology, Dongnam Health University, Suwon (Korea, Republic of)

2016-12-15

The conditions after exposure to digital mammography and digital breast tomosynthesis were analyzed. The examinations for the ACR phantom were done using manual exposure, not auto exposure, to examine image discrimination and patient dose. As a result, the following results were derived: In the CC exposure , the kVp was 2kVp higher while mAs decreased to 58.6% for the 3D tomography. Such result showed an approximate decrease of 60mAs. At that time, the patients Average Glandular Dose (AGD) was 1.65mGy in 2D and 1.87mGy in 3D; thus, AGD of 3D was shown to have about 1.13 times higher. The result of the manual exposure revealed a reduced mAs of up to 80%; there was no effect in the assessment standard in terms of image discrimination, resulting in more than 10 points. When mAs was reduced to 80% in the manual exposure for ACR phantom, AGD was decreased to 0.66mGy. The diagnostic values of images were maintained and patients dose was reduced in the manual exposure in the AEC condition for 3D. Since the use of 3D has recently increased, using the manual exposure has been recommended in this study to improve the diagnostic value, while, simultaneously reducing patients dose.

Existence of solutions to differential inclusions with primal lower nice functions

Directory of Open Access Journals (Sweden)

Nora Fetouci

2016-02-01

Full Text Available We prove the existence of absolutely continuous solutions to the differential inclusion $$ \\dot{x}(t\\in F(x(t+h(t,x(t, $$ where F is an upper semi-continuous set-valued function with compact values such that $F(x(t\\subset \\partial f(x(t$ on [0,T], where f is a primal lower nice function, and h a single valued Caratheodory perturbation.

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

Science.gov (United States)

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

2013-01-01

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

Update of the Dutch manual for costing studies in health care

NARCIS (Netherlands)

T.A. Kanters (Tim A.); C.A.M. Bouwmans-Frijters (Clazien); N. van der Linden (Naomi); S.S. Tan (Siok Swan); L. van Hakkaart-van Roijen (Leona)

2017-01-01

textabstractObjectives: Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the

Hanford Environmental Information System (HEIS) Operator`s Manual. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Schreck, R.I.

1991-10-01

The Hanford Environmental Information System (HEIS) is a consolidated set of automated resources that effectively manage the data gathered during environmental monitoring and restoration of the Hanford Site. The HEIS includes an integrated database that provides consistent and current data to all users and promotes sharing of data by the entire user community. This manual describes the facilities available to the operational user who is responsible for data entry, processing, scheduling, reporting, and quality assurance. A companion manual, the HEIS User`s Manual, describes the facilities available-to the scientist, engineer, or manager who uses the system for environmental monitoring, assessment, and restoration planning; and to the regulator who is responsible for reviewing Hanford Site operations against regulatory requirements and guidelines.

Guidelines for Nonsexist Language in APA Journals: Publication Manual Change Sheet 2

Science.gov (United States)

American Psychologist, 1977

1977-01-01

This second change sheet for its publication manual states the American Psychologist Association's policy on sexist language in its journals offers some general principles for journal authors to consider, and suggests some ways to avoid sexist language. (Author)

Wastes power generation introduction manual. Material edition; Haikibutsu hatsuden donyu manual. Shiryohen

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-07-01

This paper collects and puts into order the materials used in preparing the manual. The materials were classified into the power generation system database related to discussion of the economic performance, case studies, technical materials, other referential materials and glossary. The database shows power generation efficiency, auxiliary power ratio, construction cost, utility cost and number of operators. The case studies present examples of economy calculations on the five recommended power generation systems at a wastes treatment capacity of 180 tons a day. Technical materials put into order the technological discussions on efficiency improvement, environmental measures (suppression of discharge of dioxins, measures for their removal, and the effects thereof), refuse derived fuel (RDF) and power plant operating techniques. The other referential materials collect laws, notifications, and guidelines related to the Welfare Ministry, laws, notifications, criteria and related to the Ministry of International Trade and Industry, and materials related to LCA, forms of power generation business entities, general wastes disposal business, and electric business bonds. The glossary explains terms required for operation and understanding of the manual. (NEDO)

GUIDELINES FOR THE BIOREMEDIATION OF OIL-CONTAMINATED SALT MARSHES

Science.gov (United States)

The objective of this document is to present a detailed technical guideline for use by spill responders for the cleanup of coastal wetlands contaminated with oil and oil products by using one of the least intrusive approachesbioremediation technology. This manual is a supplem...

Manual for conducting radiological surveys in support of license termination

International Nuclear Information System (INIS)

Berger, J.D.

1992-06-01

This document describes a process for conducting radiological surveys during decommissioning, to demonstrate that residual radioactive material satisfies criteria established by the U.S. Nuclear Regulatory Commission (NRC) for termination of a license. The Manual describes procedures for design and conduct of surveys in a manner which will provide a high degree of assurance that NRC guidelines and conditions have been satisfied. The Manual also describes methods for documenting the survey findings in a final report to the NRC. This Manual updates information contained in NUREG/CR-2082, Monitoring for Compliance with Decommissioning Termination Survey Criteria, (ORNL 1981). It incorporates statistical approaches to survey design and data interpretation used by the Environmental Protection Agency for evaluation of hazardous materials sites under Superfund (CERCLA). Quality assurance is emphasized throughout. (author)

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

The design process of a reading comprehension manual

Directory of Open Access Journals (Sweden)

Sergio Alonso Lopera Medina

2015-05-01

Full Text Available Material design is an important part in the teaching practices. This article describes the process of material design of a foreign language (FL reading manual for undergraduate students at Universidad de Antioquia (Medellín – Colombia. A case study was used as a research method. Four in-service English teachers based their inquiry following the reflective approach of professional development. They also took into account the guidelines to design teaching materials proposed by Howard and Major (2004.  Some of the results of their inquiry for the design of the manual involve contextualization, personalization, and students’ needs. A sample of a reading strategy is given in order to illustrate how teachers worked and designed the manual as a product of their inquiry. Conclusions suggest that this professional development practice helped teachers become more aware of their own teaching realities and also helped them to understand their beliefs and practice in teaching reading as a foreign language.

Implementation of guidelines on oxytocin use at caesarean section: a survey of practice in Great Britain and Ireland.

LENUS (Irish Health Repository)

Sheehan, Sharon R

2012-02-01

OBJECTIVE: Caesarean section is one of the most commonly performed major operations on women worldwide. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. Various clinical guidelines address oxytocin use at the time of caesarean section. We previously reported wide variation in practice amongst clinicians in the United Kingdom in the use of oxytocin at caesarean section. The aim of this current study was to determine whether the variation in approach is universal across the individual countries of Great Britain and Ireland and whether this reflects differences in interpretation and implementation of clinical practice guidelines. STUDY DESIGN: We conducted a survey of practice in the five individual countries of Great Britain and Ireland. A postal questionnaire was sent to all lead consultant obstetricians and anaesthetists with responsibility for the labour ward. We explored the use of oxytocin bolus and infusion, the measurement of blood loss at caesarean section and the rates of major haemorrhage. Existing clinical guidelines from the National Institute for Clinical Excellence (NICE), the Royal College of Obstetricians and Gynaecologists (RCOG) and ALSO (Advanced Life Support in Obstetrics) were used to benchmark reported practice against recommended practice for the management of blood loss at caesarean section. RESULTS: The response rate was 82% (391 respondents). Use of a 5 IU oxytocin bolus was reported by 346 respondents (85-95% for individual countries). In some countries, up to 14% used a 10 IU oxytocin bolus despite recommendations against this. Routine use of an oxytocin infusion varied greatly between countries (11% lowest-55% highest). Marked variations in choice of oxytocin regimens were noted with inconsistencies in the country-specific recommendations, e.g. NICE (which covers England and Wales) recommends a 30 IU oxytocin infusion over 4h, but only 122 clinicians (40%) used this. CONCLUSIONS

NASA Electronic Parts and Packaging Field Programmable Gate Array Single Event Effects Test Guideline Update

Science.gov (United States)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

The NHS: assessing new technologies, NICE and value for money.

Science.gov (United States)

Stevens, A; Chalkidou, K; Littlejohns, P

2011-06-01

The healthcare system in the UK, essentially the NHS, is an open economic system subject to the same pressures as any other economic system. The pressures concern limited resources coupled with powerful drivers for increasing spending: invention, demography and inflation. There have only ever been three types of economic system: steady state (everything, as in a feudal system, stays as it was the year before), market capitalism (supply and demand are allowed to find their own equilibrium) and some version of central planning. In healthcare, most advanced countries favour the last of the three. This is for three reasons: distribution (not only are the poor less able to pay for sickness, but sickness exacerbates poverty), information (markets operate poorly when providers can easily outsmart customers) and externalities (it is in the interest of everyone that infectious diseases and the other knock-on consequences of ill health are ameliorated). So in the UK, the state, with a good deal of cross-party consensus, directs most of health service supply. This system has become more complex over the decades since the formation of the NHS in 1948. A notable element of the complexity is the regulation of the introduction of new technologies. A key element of the regulatory system has been the National Institute for Health and Clinical Excellence (NICE), and a key aspect of NICE's decisions has been not just value, but also value for money. This has not been without controversy.

USTC & TBA Guidelines for Tennis Court & Running Track Construction.

Science.gov (United States)

United States Tennis Court & Track Builders Association.

Guidelines are presented on tennis court and track and field construction that reflect the latest developments in construction technology, methodology, and practice. Based on contributions from experienced certified tennis court and track builders, material suppliers and design professionals, this manual examines each of the critical areas of…

Derivation of uranium residual radioactive material guidelines for the Ventron site

International Nuclear Information System (INIS)

Loureiro, C.; Yu, C.; Jones, L.

1992-03-01

Residual radioactive material guidelines for uranium were derived for the Ventron site in Beverly, Massachusetts. This site has been identified for remedial action under the Formerly Utilized Sites Remedial Action Program of the US Department of Energy (DOE). The derivations for the single radionuclides and the total uranium guidelines were based on the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the Ventron site should not exceed a dose of 100 mrem/yr following remedial action. The DOE residual radioactive material guideline computer code, RESRAD, which implements the methodology described in the DOE manual for implementing residual radioactive material guidelines, was used in this evaluation

Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

Science.gov (United States)

Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H

2002-01-01

The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in

Revegetation manual for the environmental restoration contractor

International Nuclear Information System (INIS)

McLendon, T.; Redente, E.F.

1997-02-01

The purpose of this manual is to provide guidance and general guidelines for the revegetation of remediation waste sites and other disturbed areas on the Hanford Site. Specific revegetation plans will be developed using guidance from this manual. Locations, resources, and funding will dictate the specific revegetation design at each disturbed area. Disturbances have occurred to some of the ecological communities of the Hanford Site. Many of these disturbances are the result of operations of the Hanford Site, including Comprehensive Environmental Response, Compensation, and Liability Act of 1980 waste sites on small portions of the Hanford Site. There were, however, extensive disturbances to the native vegetation prior to operations of the facility. These resulted from cultivation, grazing, fire, and the introduction of exotics. Revegetation planning must take into account these early disturbances, as well as the later ones

Revegetation manual for the environmental restoration contractor

Energy Technology Data Exchange (ETDEWEB)

McLendon, T.; Redente, E.F.

1997-02-01

The purpose of this manual is to provide guidance and general guidelines for the revegetation of remediation waste sites and other disturbed areas on the Hanford Site. Specific revegetation plans will be developed using guidance from this manual. Locations, resources, and funding will dictate the specific revegetation design at each disturbed area. Disturbances have occurred to some of the ecological communities of the Hanford Site. Many of these disturbances are the result of operations of the Hanford Site, including Comprehensive Environmental Response, Compensation, and Liability Act of 1980 waste sites on small portions of the Hanford Site. There were, however, extensive disturbances to the native vegetation prior to operations of the facility. These resulted from cultivation, grazing, fire, and the introduction of exotics. Revegetation planning must take into account these early disturbances, as well as the later ones.

A Greenhouse for Tropical Lowlands (Malaysia), Training manual : Guidelines for the Planning and Organisation of Training Activities

NARCIS (Netherlands)

Elings, A.; Stijger, I.; Blomne Sopov, M.; Campen, J.B.; Runia, L.

2012-01-01

This Training Manual on tropical lowland greenhouse horticulture has been prepared as a manual for training of trainers staff of the Department of Agriculture of Malaysia, agricultural extension workers of the government, trainers of educational institutes engaged in greenhouse training and for

Strategy and Management Guideline on Preventive School Maintenance in Eritrea

DEFF Research Database (Denmark)

Vagnby, Bo Hellisen

An action-oriented and practical guideline for the planning, organisation and management of preventive school maintenance in Eritrea. The manual is the result of a participatory planning process which has involved actors at the school and community level, district levels and the national policy...

Ultrasonic boiler inspection and economic analysis guidelines

International Nuclear Information System (INIS)

Anon.

1987-01-01

Boiler tube failures cause approximately 6% availability loss of large fossil-fired power generating plants. This loss can be reduced by systematic approaches using ultrasonic examination and root cause failure analysis methods. Two projects sponsored by EPRI have provided utility engineers with guidelines for performing ultrasonic examinations and with details on 22 types of tube failure mechanisms. A manual has been published that provides descriptions of typical locations, superficial appearances, damage mechanisms, metallurgy, microstructural changes, likely root causes, and potential corrective actions. Application of the principles in the manual is being demonstrated in an EPRI-funded project at 10 electric utilities over the next two years. Guidelines have been published that prescribe the activities necessary for ultrasonic examinations of boiler tubes. Eight essential elements of a boiler examination should be performed to assure that possible economic benefits are obtained. Work was supported by EPRI under RP 1890 and RP 1865. A software package has been developed for effectively planning inspections for wall thinning in fossil-fired boiler tubing. The software assists in minimizing costs associated with maintenance, such as inspection and repair, while the life of the boiler is maximized

Sensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making.

Science.gov (United States)

Andronis, L; Barton, P; Bryan, S

2009-06-01

To determine how we define good practice in sensitivity analysis in general and probabilistic sensitivity analysis (PSA) in particular, and to what extent it has been adhered to in the independent economic evaluations undertaken for the National Institute for Health and Clinical Excellence (NICE) over recent years; to establish what policy impact sensitivity analysis has in the context of NICE, and policy-makers' views on sensitivity analysis and uncertainty, and what use is made of sensitivity analysis in policy decision-making. Three major electronic databases, MEDLINE, EMBASE and the NHS Economic Evaluation Database, were searched from inception to February 2008. The meaning of 'good practice' in the broad area of sensitivity analysis was explored through a review of the literature. An audit was undertaken of the 15 most recent NICE multiple technology appraisal judgements and their related reports to assess how sensitivity analysis has been undertaken by independent academic teams for NICE. A review of the policy and guidance documents issued by NICE aimed to assess the policy impact of the sensitivity analysis and the PSA in particular. Qualitative interview data from NICE Technology Appraisal Committee members, collected as part of an earlier study, were also analysed to assess the value attached to the sensitivity analysis components of the economic analyses conducted for NICE. All forms of sensitivity analysis, notably both deterministic and probabilistic approaches, have their supporters and their detractors. Practice in relation to univariate sensitivity analysis is highly variable, with considerable lack of clarity in relation to the methods used and the basis of the ranges employed. In relation to PSA, there is a high level of variability in the form of distribution used for similar parameters, and the justification for such choices is rarely given. Virtually all analyses failed to consider correlations within the PSA, and this is an area of concern

An evaluation of methods assessing the physical demands of manual lifting in scaffolding

NARCIS (Netherlands)

Beek, van der A.J.; Mathiassen, S.E.; Windhorst, J.; Burdorf, A.

2005-01-01

Four methods assessing the physical demands of manual lifting were compared. The scaffolding job was evaluated and three distinct scaffolding tasks were ranked using: (1) the revised NIOSH lifting equation (NIOSH method), (2) lifting guidelines for the Dutch construction industry (Arbouw method),

Manual herbicide application methods for managing vegetation in Appalachian hardwood forests

Science.gov (United States)

Jeffrey D. Kochenderfer; James N. Kochenderfer; Gary W. Miller

2012-01-01

Four manual herbicide application methods are described for use in Appalachian hardwood forests. Stem injection, basal spray, cut-stump, and foliar spray techniques can be used to control interfering vegetation and promote the development of desirable reproduction and valuable crop trees in hardwood forests. Guidelines are presented to help the user select the...

[A survey on diet manuals in Italian hospitals].

Science.gov (United States)

Donini, L M; Riti, M; Castellaneta, E; Ceccarelli, P; Civale, C; Passaretti, S; del Balzo, V; Cannella, C

2009-01-01

Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.

Comparing Whole Building Energy Implications of Sidelighting Systems with Alternate Manual Blind Control Algorithms

Directory of Open Access Journals (Sweden)

Christopher Dyke

2015-05-01

Full Text Available Currently, there is no manual blind control guideline used consistently throughout the energy modeling community. This paper identifies and compares five manual blind control algorithms with unique control patterns and reports blind occlusion, rate of change data, and annual building energy consumption. The blind control schemes detailed here represent five reasonable candidates for use in lighting and energy simulation based on difference driving factors. This study was performed on a medium-sized office building using EnergyPlus with the internal daylight harvesting engine. Results show that applying manual blind control algorithms affects the total annual consumption of the building by as much as 12.5% and 11.5% for interior and exterior blinds respectively, compared to the Always Retracted blinds algorithm. Peak demand was also compared showing blind algorithms affected zone load sizing by as much as 9.8%. The alternate algorithms were tested for their impact on American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE Guideline 14 calibration metrics and all models were found to differ from the original calibrated baseline by more than the recommended ±15% for coefficient of variance of the mean square error (CVRMSE and ±5% for normalized mean bias error (NMBE. The paper recommends that energy modelers use one or more manual blind control algorithms during design stages when making decisions about energy efficiency and other design alternatives.

Retrospective checking of compliance with practice guidelines for acute stroke care: a novel experiment using openEHR’s Guideline Definition Language

Science.gov (United States)

2014-01-01

Background Providing scalable clinical decision support (CDS) across institutions that use different electronic health record (EHR) systems has been a challenge for medical informatics researchers. The lack of commonly shared EHR models and terminology bindings has been recognised as a major barrier to sharing CDS content among different organisations. The openEHR Guideline Definition Language (GDL) expresses CDS content based on openEHR archetypes and can support any clinical terminologies or natural languages. Our aim was to explore in an experimental setting the practicability of GDL and its underlying archetype formalism. A further aim was to report on the artefacts produced by this new technological approach in this particular experiment. We modelled and automatically executed compliance checking rules from clinical practice guidelines for acute stroke care. Methods We extracted rules from the European clinical practice guidelines as well as from treatment contraindications for acute stroke care and represented them using GDL. Then we executed the rules retrospectively on 49 mock patient cases to check the cases’ compliance with the guidelines, and manually validated the execution results. We used openEHR archetypes, GDL rules, the openEHR reference information model, reference terminologies and the Data Archetype Definition Language. We utilised the open-sourced GDL Editor for authoring GDL rules, the international archetype repository for reusing archetypes, the open-sourced Ocean Archetype Editor for authoring or modifying archetypes and the CDS Workbench for executing GDL rules on patient data. Results We successfully represented clinical rules about 14 out of 19 contraindications for thrombolysis and other aspects of acute stroke care with 80 GDL rules. These rules are based on 14 reused international archetypes (one of which was modified), 2 newly created archetypes and 51 terminology bindings (to three terminologies). Our manual compliance checks for

Effectiveness of manual therapies: the UK evidence report

OpenAIRE

Bronfort, Gert; Haas, Mitch; Evans, Roni; Leininger, Brent; Triano, Jay

2010-01-01

Abstract Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet incl...

Finanční analýza sportovního střediska Loděnice Trója UK FTVS

OpenAIRE

Ocman, Josef

2010-01-01

Title: The financial analysis of sport centre Loděnice Troja FTVS UK Annotation: The main goal of the project is to detect prosperity and utilization of sport centre Loděnice Troja FTVS UK on base of evaluation of economy of the departments and his subdepartments. The goal is achived by an analyse of accouting data and with help of metod of financial analysis. . The project was firmed up on base of order of management FTVS UK. Keywords: Financial analysis, municipal firm, ratio, calculation 3

STRUCTURE, FUNCTIONING AND PROBLEMS OF NICE NATIONAL SPORT MUSEUM OF FRANCE

OpenAIRE

Neslihan Arikan; Özbay Güven

2017-01-01

Sport is an expression tool of the culture. Historical memory of sport, with its scientific and artistic side, serves as a bridge for societies to reach large masses. In this respect, cultural and sportive movements have led to the establishment of sports museums around the world. Sports museums are a form of expression and a story of a nation. They are the most meaningful bridges between past and future generations. With these aspects, the Nice National Sports Museum of France is one of the ...

Manual for IRS Coding. Joint IAEA/NEA International Reporting System for Operating Experience

International Nuclear Information System (INIS)

2011-01-01

The International Reporting System for Operating Experience (IRS) is jointly operated by the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organisation for Economic Co-operation and Development (OECD/NEA). In early 2010, the IAEA and OECD/NEA jointly issued the IRS Guidelines, which described the reporting system and process and gave users the necessary elements to enable them to produce IRS reports to a high standard of quality while retaining the effectiveness of the system expected by all Member States operating nuclear power plants. The purpose of the present Manual for IRS Coding is to provide supplementary guidance specifically on the coding element of IRS reports to ensure uniform coding of events that are reported through IRS. This Coding Manual does not supersede the IRS Guidelines, but rather, supports users and preparers in achieving a consistent and high level of quality in their IRS reports. Consistency and high quality in the IRS reports allow stakeholders to search and retrieve specific event information with ease. In addition, well-structured reports also enhance the efficient management of the IRS database. This Coding Manual will give specific guidance on the application of each section of the IRS codes, with examples where necessary, of when and how these codes are to be applied. As this reporting system is owned by the Member States, this manual has been developed and approved by the IRS National Coordinators with the assistance of the IAEA and NEA secretariats

What and How Are We Evaluating? Meta-Evaluation Study of the NASA Innovations in Climate Education (NICE) Portfolio

Science.gov (United States)

Martin, A. M.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.

2013-12-01

As part of NASA's Minority University Research and Education Program (MUREP), the NASA Innovations in Climate Education (NICE) project at Langley Research Center has funded 71 climate education initiatives since 2008. The funded initiatives span across the nation and contribute to the development of a climate-literate public and the preparation of a climate-related STEM workforce through research experiences, professional development opportunities, development of data access and modeling tools, and educational opportunities in both K-12 and higher education. Each of the funded projects proposes and carries out its own evaluation plan, in collaboration with external or internal evaluation experts. Using this portfolio as an exemplar case, NICE has undertaken a systematic meta-evaluation of these plans, focused primarily on evaluation questions, approaches, and methods. This meta-evaluation study seeks to understand the range of evaluations represented in the NICE portfolio, including descriptive information (what evaluations, questions, designs, approaches, and methods are applied?) and questions of value (do these evaluations meet the needs of projects and their staff, and of NASA/NICE?). In the current climate, as federal funders of climate change and STEM education projects seek to better understand and incorporate evaluation into their decisions, evaluators and project leaders are also seeking to build robust understanding of program effectiveness. Meta-evaluations like this provide some baseline understanding of the current status quo and the kinds of evaluations carried out within such funding portfolios. These explorations are needed to understand the common ground between evaluative best practices, limited resources, and agencies' desires, capacity, and requirements. When NASA asks for evaluation of funded projects, what happens? Which questions are asked and answered, using which tools? To what extent do the evaluations meet the needs of projects and

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

Science.gov (United States)

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

2018-02-27

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

The methodological quality of guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia: A systematic review.

Science.gov (United States)

Ambaras Khan, R; Aziz, Z

2018-05-02

Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Electronic databases including MEDLINE, CINAHL, PubMed and EMBASE were searched up to September 2017 for relevant guidelines. Other databases such as NICE, Scottish Intercollegiate Guidelines Network (SIGN) and the websites of professional societies were also searched for relevant guidelines. The quality and reporting of included guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) instrument. Six guidelines were eligible for inclusion in our review. Among 6 domains of AGREE-II, "clarity of presentation" scored the highest (80.6%), whereas "applicability" scored the lowest (11.8%). All the guidelines supported the antibiotic de-escalation strategy, whereas the majority of the guidelines (5 of 6) recommended that empirical antibiotic therapy should be implemented in accordance with local microbiological data. All the guidelines suggested that for early-onset HAP/VAP, therapy should start with a narrow spectrum empirical antibiotic such as penicillin or cephalosporins, whereas for late-onset HAP/VAP, the guidelines recommended the use of a broader spectrum empirical antibiotic such as the penicillin extended spectrum carbapenems and glycopeptides. Expert guidelines

Manual for reactor produced radioisotopes

International Nuclear Information System (INIS)

2003-01-01

numerous new developments that have taken place since then. Hence in this manual it was decided to focus only on reactor produced radioisotopes. This manual contains procedures for 48 important reactor-produced isotopes. These were contributed by major radioisotope producers from different parts of the world and are based on their practical experience. In case of widely used radioisotopes such as 131 I, 32 P and 99 Mo, information from more than one centre is included so that the users can compare the procedures. As in the earlier two versions, a general introductory write-up is included covering basic information on related aspects such as target irradiation, handling facilities, radiation protection and transportation, but in less detail. Relevant IAEA publications on such matters, particularly related to radiation protection and transportation, should be referred to for guidelines. Similarly, the nuclear data contained in the manual are only indicative and the relevant databases should be referred to for more authentic values. It is hoped that the manual will be a useful source of information for those working in radioisotope production laboratories as well as those intending to initiate such activities

Load research manual. Volume 1. Load research procedures

Energy Technology Data Exchange (ETDEWEB)

Brandenburg, L.; Clarkson, G.; Grund, Jr., C.; Leo, J.; Asbury, J.; Brandon-Brown, F.; Derderian, H.; Mueller, R.; Swaroop, R.

1980-11-01

This three-volume manual presents technical guidelines for electric utility load research. Special attention is given to issues raised by the load data reporting requirements of the Public Utility Regulatory Policies Act of 1978 and to problems faced by smaller utilities that are initiating load research programs. In Volumes 1 and 2, procedures are suggested for determining data requirements for load research, establishing the size and customer composition of a load survey sample, selecting and using equipment to record customer electricity usage, processing data tapes from the recording equipment, and analyzing the data. Statistical techniques used in customer sampling are discussed in detail. The costs of load research also are estimated, and ongoing load research programs at three utilities are described. The manual includes guides to load research literature and glossaries of load research and statistical terms.

NASA Electronic Parts and Packaging (NEPP) Field Programmable Gate Array (FPGA) Single Event Effects (SEE) Test Guideline Update

Science.gov (United States)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

Proposed quality assurance manual for the Office of Waste Isolation

International Nuclear Information System (INIS)

1977-01-01

The manual provides guidelines for assuring safe and reliable siting, design, procurement and construction, operation, and decommissioning of a radioactive waste repository. The organization of the program is given and the program itself is defined. The program includes the site evaluation, site selection, design, procurement, fabrication, installation, and testing of any system or component that is safety related. It also included all necessary documentation and auditing

[On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus].

Science.gov (United States)

Zenner, H-P; Delb, W; Kröner-Herwig, B; Jäger, B; Peroz, I; Hesse, G; Mazurek, B; Goebel, G; Gerloff, C; Trollmann, R; Biesinger, E; Seidler, H; Langguth, B

2015-06-01

Tinnitus is a frequent symptom, which, particularly in combination with comorbidities, can result in a severe disease-related burden. Chronic idiopathic tinnitus (CIT) is the most frequent type of tinnitus. A considerable number of treatment strategies are used to treat CIT-for many of which there is no evidence of efficacy. In order to enable scientific evidence-based treatment of CIT, German interdisciplinary S3 guidelines have recently been constructed for the first time. Here we present a short form of these S3 guidelines. The guidelines were constructed based on a meta-analysis of the treatment of chronic tinnitus performed by the authors. Additionally, a systematic literature search was performed in the PubMed and Cochrane Library databases. Furthermore, a systematic search for international guidelines was performed in Google, as well as in the Guidelines International Network and National Guideline Clearinghouse (USA) database. Evidence was classified according to the Oxford Centre for Evidence-Based Medicine system. According to the guidelines, alongside counselling, manualized structured tinnitus-specific cognitive behavioral therapy (tCBT) with a validated treatment manual is available as evidence-based therapy. In addition, the guidelines recommend concurrent treatment of comorbidities, including drug-based treatment, where appropriate. Particularly important is treatment of anxiety and depression. Where a psychic or psychiatric comorbidity is suspected, further diagnosis and treatment should be performed by an appropriately qualified specialist (psychiatrist, neurologist, psychosomatic medicine consultant) or psychological psychotherapist. In cases accompanied by deafness or hearing loss bordering on deafness, cochlear implants may be indicated. No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations

An observational analysis of provider adherence to AUA guidelines on the management of benign prostatic hyperplasia.

Science.gov (United States)

Auffenberg, Gregory B; Gonzalez, Chris M; Wolf, J Stuart; Clemens, J Quentin; Meeks, William; McVary, Kevin T

2014-11-01

We retrospectively evaluated urologist adherence to the AUA guidelines on the management of new patients with benign prostatic hyperplasia related lower urinary tract symptoms in a large university urology group. All first time benign prostatic hyperplasia/lower urinary tract symptom visits to the urology clinic at the Northwestern Medical Faculty Foundation between January 1, 2008 and December 31, 2012 were evaluated using an institutionally managed electronic medical record data repository. Clinical documentation and orders from each encounter were assessed to determine the rate of performance of guideline measures. Approximately 1% of all results were manually reviewed in a validation process designed to determine the reliability of the electronic medical record based system. A total of 3,494 eligible encounters were evaluated in the final analysis. Provider adherence rates with the 9 measures recommended in the guidelines varied by measure from 53.0% to 92.8%. The rate of performance of 5 not routinely recommended measures was 10.2% or less. Post-void residual and urinary flow measurement were optional measures, and were performed on 68.1% and 4.6% of new encounters respectively. Manual validation revealed the electronic medical record data extraction was concordant with manual review in 96.7% of cases (95% CI 94.8-98.5). Using electronic medical record based data extraction techniques, we reliably document a baseline adherence rate with AUA guidelines on the management of benign prostatic hyperplasia. Establishing this benchmark will be important for future investigation into patient outcomes related to guideline adherence and into methods for improving provider adherence. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

ANSI/ASHRAE/IES Standard 90.1-2010 Performance Rating Method Reference Manual

Energy Technology Data Exchange (ETDEWEB)

Goel, Supriya [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-05-01

This document is intended to be a reference manual for the Appendix G Performance Rating Method (PRM) of ANSI/ASHRAE/IES Standard 90.1- 2010 (Standard 90.1-2010).The PRM is used for rating the energy efficiency of commercial and high-rise residential buildings with designs that exceed the requirements of Standard 90.1. The procedures and processes described in this manual are designed to provide consistency and accuracy by filling in gaps and providing additional details needed by users of the PRM. It should be noted that this document is created independently from ASHRAE and SSPC 90.1 and is not sanctioned nor approved by either of those entities . Potential users of this manual include energy modelers, software developers and implementers of “beyond code” energy programs. Energy modelers using ASHRAE Standard 90.1-2010 for beyond code programs can use this document as a reference manual for interpreting requirements of the Performance Rating method. Software developers, developing tools for automated creation of the baseline model can use this reference manual as a guideline for developing the rules for the baseline model.

Substitute Care Providers: Helping Abused and Neglected Children. The User Manual Series.

Science.gov (United States)

Watson, Kenneth

This manual for child welfare staff and foster/adoptive parents is intended to provide guidelines for serving abused and neglected children who are in family foster care and adoption. The first section is on substitute care and permanency planning and offers an historical perspective on substitute care and definitions of family foster care and…

The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline.

Science.gov (United States)

Bussières, André E; Stewart, Gregory; Al-Zoubi, Fadi; Decina, Philip; Descarreaux, Martin; Hayden, Jill; Hendrickson, Brenda; Hincapié, Cesar; Pagé, Isabelle; Passmore, Steven; Srbely, John; Stupar, Maja; Weisberg, Joel; Ornelas, Joseph

2016-10-01

The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders (NADs) and whiplash-associated disorders (WADs). This guideline replaces 2 prior chiropractic guidelines on NADs and WADs. Pertinent systematic reviews on 6 topic areas (education, multimodal care, exercise, work disability, manual therapy, passive modalities) were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and data extracted from admissible randomized controlled trials. We incorporated risk of bias scores in the Grading of Recommendations Assessment, Development, and Evaluation. Evidence profiles were used to summarize judgments of the evidence quality, detail relative and absolute effects, and link recommendations to the supporting evidence. The guideline panel considered the balance of desirable and undesirable consequences. Consensus was achieved using a modified Delphi. The guideline was peer reviewed by a 10-member multidisciplinary (medical and chiropractic) external committee. For recent-onset (0-3 months) neck pain, we suggest offering multimodal care; manipulation or mobilization; range-of-motion home exercise, or multimodal manual therapy (for grades I-II NAD); supervised graded strengthening exercise (grade III NAD); and multimodal care (grade III WAD). For persistent (>3 months) neck pain, we suggest offering multimodal care or stress self-management; manipulation with soft tissue therapy; high-dose massage; supervised group exercise; supervised yoga; supervised strengthening exercises or home exercises (grades I-II NAD); multimodal care or practitioner's advice (grades I-III NAD); and supervised exercise with advice or advice alone (grades I-II WAD). For workers with persistent neck and shoulder pain, evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone (grades I-III NAD). A multimodal approach including manual therapy, self-management advice, and exercise is an

Hanford Environmental Information System (HEIS) user's manual

International Nuclear Information System (INIS)

1991-10-01

The Hanford Environmental Information System (HEIS) is a consolidated set of automated resources that effectively manage the data gathered during environmental monitoring and restoration of the Hanford Site. The HEIS includes an integrated database that provides consistent and current data to all users and promotes sharing of data by the entire user community. Data stored in the HEIS are collected under several regulatory programs. Currently these include the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA); the Resource Conservation and Recovery Act of 1976 (RCRA); and the Ground-Water Environmental Surveillance Project, managed by the Pacific Northwest Laboratory. The HEIS is an information system with an inclusive database. The manual, the HEIS User's Manual, describes the facilities available to the scientist, engineer, or manager who uses the system for environmental monitoring, assessment, and restoration planning; and to the regulator who is responsible for reviewing Hanford Site operations against regulatory requirements and guidelines

Manual on laboratory testing for uranium ore processing

International Nuclear Information System (INIS)

1990-01-01

Laboratory testing of uranium ores is an essential step in the economic evaluation of uranium occurrences and in the development of a project for the production of uranium concentrates. Although these tests represent only a small proportion of the total cost of a project, their proper planning, execution and interpretation are of crucial importance. The main purposes of this manual are to discuss the objectives of metallurgical laboratory ore testing, to show the specific role of these tests in the development of a project, and to provide practical instructions for performing the tests and for interpreting their results. Guidelines on the design of a metallurgical laboratory, on the equipment required to perform the tests and on laboratory safety are also given. This manual is part of a series of Technical Reports on uranium ore processing being prepared by the IAEA's Division of Nuclear Fuel Cycle and Waste Management. A report on the Significance of Mineralogy in the Development of Flowsheets for Processing Uranium Ores (Technical Reports Series No. 196, 1980) and an instruction manual on Methods for the Estimation of Uranium Ore Reserves (No. 255, 1985) have already been published. 17 refs, 40 figs, 17 tabs

Resource Manual for Handling Body Fluids in the School Setting To Prevent Transmission of Human Immunodeficiency Virus and Hepatitis B Virus. Revised Edition.

Science.gov (United States)

Maryland State Dept. of Health and Mental Hygiene, Baltimore.

This Maryland resource manual provides local education agencies with guidelines on how to handle body fluids to prevent the transmission of diseases, especially Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV), in the school setting. The first section summarizes the reasons for development of the manual. The second section summarizes…

Manual for the GAW Precipitation Chemistry Programme: Guidelines, Data Quality Objectives and Standard Operating Procedures

National Research Council Canada - National Science Library

Allan, Mary A

2004-01-01

This is a manual for the Global Atmosphere Watch Precipitation Chemistry (GAW-PC) Programme. Where possible, it describes standard operating procedures and otherwise provides guidance on methods and procedures...

77 FR 11199 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

Science.gov (United States)

2012-02-24

..., and Japan have all conducted valuable research that has increased the available knowledge regarding... browsing, or visual-manual social media browsing while driving. The recommendation is not intended to... Partnership CANbus Controller Area Network bus CD Compact Disc CDS Crashworthiness Data System (NASS-CDS) DFD...

Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.

Science.gov (United States)

Pearce, Alison M; Ryan, Fay; Drummond, Frances J; Thomas, Audrey Alforque; Timmons, Aileen; Sharp, Linda

2016-02-01

Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice. A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon. Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted. This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.

Radiological protection guidelines for the Formerly Utilized Sites Remedial Action Program and remote Surplus Facilities Management Program

International Nuclear Information System (INIS)

Gilbert, T.L.

1985-01-01

The need for a definitive basis for radiological guidelines and criteria for FUSRAP became apparent by 1981 and led ORO to sponsor a joint ANL/BNI/LANL/ORO effort under the chairmanship of Wayne Hansen (LANL) that resulted in a final FUSRAP radiological guidelines document in March 1983. A separate effort to develop guidelines for remedial action criteria for SFMP was in progress at PNL. The need to coordinate both efforts with impending revisions of DOE Radiological Protection Standards and impending new developments in EPA and NRC Radiological Protection Standards led to convening of the first DOE Workshop on Remedial Action Criteria in Gaithersburg, Maryland, in February 1984, followed by a second workshop in June 1984 at ANL. The major decisions were to base the criteria on dosimetry models and basic limits currently recommended by the International Commission on Radiological Protection, to emphasize the development and use of site-specific rather than generic guidelines and criteria for residual radionuclide concentrations in the ground, and to prepare a manual to accompany the guidelines that would present procedures and tables for deriving site-specific soil guidelines and criteria for the remedial action programs. A joint ANL/LANL/ORNL/PNL effort to prepare a definitive set of guidelines and a manual has been initiated. The scope, status, and current plans for this effort, and some of the key issues, are presented. 10 references, 1 table

Radiological protection guidelines for the Formerly Utilized Sites Remedial Action Program and Remote Surplus Facilities Management Program

International Nuclear Information System (INIS)

Gilbert, T.L.

1984-01-01

The need for a definitive basis for radiological guidelines and criteria for FUSRAP became apparent by 1981 and led ORO to sponsor a joint ANL/BNI/LANL/ORO effort under the chairmanship of Wayne Hansen (LANL) that resulted in a final FUSRAP radiological guidelines document in March 1983. A separate effort to develop guidelines for remedial action criteria for SFMP was in progress at PNL. The need to coordinate both efforts with impending revisions of DOE Radiological Protection Standards and impending new developments in EPA and NRC Radiological Protection Standards led to convening of the first DOE Workshop on Remedial Action Criteria in Gaithersburg, Maryland, in February 1984, followed by a second workshop in June 1984 at ANL. The major decisions were to base the criteria on dosimetry models and basic limits currently recommended by the International Commission on Radiological Protection, to emphasize the development and use of site-specific rather than generic guidelines and criteria for residual radionuclide concentrations in the ground, and to prepare a manual to accompany the guidelines that would present procedures and tables for deriving site-specific soil guidelines and criteria for the remedial action programs. A joint ANL/LANL/ORNL/PNL effort to prepare a definitive set of guidelines and a manual has been initiated. The scope, status, and current plans for this effort, and some of the key issues, are presented. 10 references, 1 table

Vehicle access and search training manual. Report for Oct 77-sep 79

International Nuclear Information System (INIS)

Obermiller, J.E.; Wait, H.J.

1979-11-01

This Vehicle Access and Search Training Manual is intended to assist NRC-licensed organizations and their security personnel in developing vehicle access, control and search operations necessary at nuclear fuel cycle facilities and at reactor facilities. The manual is based on security requirements prescribed by The Nuclear Regulatory Commission as contained in Title 10 of the Code of Federal Regulations, Part 73, 'Physical Protection of Plants and Materials.' As a condition of the licensing agreement, the licensee is required to maintain a physical protection system which includes a training program for security personnel. The manual includes lesson plans in (1) controlling vehicle entry and exit, (2) searching for contraband, and (3) protecting the facility from sabotage and/or theft of special nuclear materials. These training guidelines provide information and instruction for self-study, discussion and hands-on training. A job knowledge test reviews the entire training program

Resource Manual for Handling Body Fluids in the School Setting To Prevent the Transmission of Human Immunodeficiency Virus and Hepatitis B Virus.

Science.gov (United States)

Maryland State Dept. of Health and Mental Hygiene, Baltimore.

Guidelines to prevent the transmission of blood-borne diseases, especially those caused by the Human Immunodeficiency Virus (HIV) and the Hepatitis B Virus (HBV), in the school setting are provided in this resource manual for school staff. Sections include information on the reasons for the development of this manual; a summary of the means of HIV…

The environmental survey manual: Appendices E, F, G, H, I, J, and K

International Nuclear Information System (INIS)

1987-08-01

Appendices E, F, G, H, I, J and K of the Environmental Survey Manual address the following topics: Field Sampling Protocols and Guidance; Guidelines for Preparation of Quality Assurance Plans; Decontamination Guidance; Data Management and Analysis; Sample and Document Management; Health and Safety Guidance for Sampling and Analysis Teams; Documents for Sampling and Analysis Program

An overview of review guidelines for HDL programmable devices in nuclear safety systems

International Nuclear Information System (INIS)

Komanduri, Raghavan; Srivani, L.; Thirugnana Murthy, D.

2013-01-01

HDL programmable devices viz. CPLDs and FPGAs are increasingly being used to implement digital designs in the I and C systems performing safety functions of nuclear power plants. Synthesizable RTL descriptions manually written in HDLs are the first step in developing industry standard large scale digital designs. The reliability of the implementation is determined by the methodologies followed by the designer during development. Very few guidelines on HPD design practices, specific to nuclear industry are available. This paper presents an overview of the existing guidelines such as IEC 62566 and U.S. NRC's 'Review guidelines for FPGAs in nuclear power plant safety systems'. (author)

Critical Appraisal of International Clinical Practice Guidelines in Kidney Transplantation Using the Appraisal of Guidelines for Research and Education (AGREE) II Tool: A Systematic Review.

Science.gov (United States)

OʼDonoghue, Katriona Jane Marie; Reed, Rhiannon D; Knight, Simon R; O'Callaghan, John M; Ayaz-Shah, Anam A; Hassan, Sevda; Weissenbacher, Annemarie; Morris, Peter J; Pengel, Liset H M

2018-05-22

Whilst Clinical Practice Guidelines (CPGs) are used for the development of local protocols in kidney transplantation (Ktx), the quality of their methodology is variable. This systematic review aimed to critically appraise international CPGs in all aspects of Ktx using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. CPGs in Ktx and donation published between 2010 and 2017 were identified from MEDLINE, Embase, National Guideline Clearinghouse, NHS and NICE Evidence Searches, and the websites of transplant societies. Using AGREE II, 3 appraisers assessed the quality of CPGs. Interrater reliability was measured using the intraclass correlation coefficient (ICC). Searches identified 3,168 records and 115 CPGs were included. The highest scoring AGREE II domain was 'Scope and Purpose' (80%; Range 30-100%), followed by 'Clarity of Presentation' (77%; Range 43-98%), 'Editorial independence' (52%; Range 0-94%), 'Rigour of Development' (47%; Range 6-97%) and 'Stakeholder Involvement' (41%; Range 11-85%). The poorest scoring domain was 'Applicability' (31%; Range 3-74%). Most CPGs were recommended for future use either with (63%) or without modifications (18%). A small number were not recommended for future use (14%) or reviewers did not agree on recommending the CPG (5%). The overall mean CPG quality score was 4 out of 7 (Range 2-7). The mean ICC of 0.74 indicated substantial agreement between reviewers. The quality of international CPGs in Ktx was variable, and most CPGs lacked key aspects of methodological robustness and transparency. Improvements in methodology, patient involvement and strategies for implementation are required.

MICE or NICE? An economic evaluation of clinical decision rules in the diagnosis of heart failure in primary care.

Science.gov (United States)

Monahan, Mark; Barton, Pelham; Taylor, Clare J; Roalfe, Andrea K; Hobbs, F D Richard; Cowie, Martin; Davis, Russell; Deeks, Jon; Mant, Jonathan; McCahon, Deborah; McDonagh, Theresa; Sutton, George; Tait, Lynda

2017-08-15

Detection and treatment of heart failure (HF) can improve quality of life and reduce premature mortality. However, symptoms such as breathlessness are common in primary care, have a variety of causes and not all patients require cardiac imaging. In systems where healthcare resources are limited, ensuring those patients who are likely to have HF undergo appropriate and timely investigation is vital. A decision tree was developed to assess the cost-effectiveness of using the MICE (Male, Infarction, Crepitations, Edema) decision rule compared to other diagnostic strategies to identify HF patients presenting to primary care. Data from REFER (REFer for EchocaRdiogram), a HF diagnostic accuracy study, was used to determine which patients received the correct diagnosis decision. The model adopted a UK National Health Service (NHS) perspective. The current recommended National Institute for Health and Care Excellence (NICE) guidelines for identifying patients with HF was the most cost-effective option with a cost of £4400 per quality adjusted life year (QALY) gained compared to a "do nothing" strategy. That is, patients presenting with symptoms suggestive of HF should be referred straight for echocardiography if they had a history of myocardial infarction or if their NT-proBNP level was ≥400pg/ml. The MICE rule was more expensive and less effective than the other comparators. Base-case results were robust to sensitivity analyses. This represents the first cost-utility analysis comparing HF diagnostic strategies for symptomatic patients. Current guidelines in England were the most cost-effective option for identifying patients for confirmatory HF diagnosis. The low number of HF with Reduced Ejection Fraction patients (12%) in the REFER patient population limited the benefits of early detection. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

IZBOLJŠANJE MANAGEMENTSKEGA VODENJA V JAVNEM ZAVODU SPLOŠNE BOLNIŠNICE MURSKA SOBOTA

OpenAIRE

Maček, Ines

2015-01-01

Za magistrsko nalogo z naslovom Izboljšanje managementskega vodenja v javnem zavodu Splošne bolnišnice Murska Sobota smo se odločili, ker menimo, da uspešnost javnega zavoda ni odvisna samo od spretnega vodstva, ampak predvsem od dobrega sodelovanja in komuniciranja na različnih organizacijskih ravneh javnega zavoda. Zaposleni v javnem zavodu morajo nenehno sodelovati in komunicirati med seboj in tudi s svojimi nadrejenimi, le-ti pa morajo tesno sodelovati z vodstvom. Javni zavod brez komu...

Finding of no significant impact for the joint DOE/EPA program on national industrial competitiveness through energy efficiency and economics (NICE{sup 3})

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

The Department of Energy (DOE) has prepared a Programmatic Environmental Assessment (PEA), to assess the environment impacts associated with a joint DOE/EPA cost-sharing grant program named National Industrial Competitiveness through Energy Efficiency, Environment and Economics (NICE{sup 3}). The purpose of the NICE{sup 3} Program is to encourage waste minimization technology in industry by funding projects that develop activities and process improvements to conserve energy and reduce pollution. The proposed action would provide Federal financial assistance in the form of grants to industry in order to promote pollution prevention, energy efficiency, and cost competitiveness. Based on the analysis presented in the PEA, DOE has determined that the proposed action (providing NICE{sup 3} grants for projects which are consistent with the goals of the PPA and EPACT) does not constitute a major Federal action significantly affecting the quality of the human environment within the meaning of NEPA. Therefore, the preparation of an Environmental Impact Statement is not needed and the Department is issuing this Finding of No Significant Impact.

A SCAT manual for Arctic regions and cold climates

International Nuclear Information System (INIS)

Owens, E.H.; Sergy, G.A.

2004-01-01

The Shoreline Cleanup Assessment Technique (SCAT) has been used on many oil spills in a variety of ways to meet a broad range of specific spill conditions. SCAT was created in response to the Exxon Valdez oil spill in Prince William Sound Alaska. Environment Canada developed generic second-generation SCAT protocols to standardize the documentation and description of oiled shorelines. As the SCAT process becomes more widely accepted and used during spill response operations, the need for flexibility and modifications has grown. For that reason, the Arctic SCAT Manual was created to address the need for guidelines, standardized definitions, standardized terminology and forms that can be applied for oiled shorelines or riverbanks in Arctic environments and cold climates. Unique Arctic shoreline types such as tundra cliffs, inundated low-lying tundra and peat shorelines are included in the manual along with a new set of shoreline oiling forms for marine coasts, tidal flats, wetlands, lake shores, riverbanks, and stream banks. A First Responders guide has been included with the manual to help local inhabitants during the initial phases of an oiled shoreline assessment. 5 refs., 2 tabs., 20 figs

MELCOR computer code manuals

Energy Technology Data Exchange (ETDEWEB)

Summers, R.M.; Cole, R.K. Jr.; Smith, R.C.; Stuart, D.S.; Thompson, S.L. [Sandia National Labs., Albuquerque, NM (United States); Hodge, S.A.; Hyman, C.R.; Sanders, R.L. [Oak Ridge National Lab., TN (United States)

1995-03-01

MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the U.S. Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, and combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR`s phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package.

MELCOR computer code manuals

International Nuclear Information System (INIS)

Summers, R.M.; Cole, R.K. Jr.; Smith, R.C.; Stuart, D.S.; Thompson, S.L.; Hodge, S.A.; Hyman, C.R.; Sanders, R.L.

1995-03-01

MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the U.S. Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, and combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR's phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package

HRS Clinical Document Development Methodology Manual and Policies: Executive summary.

Science.gov (United States)

Indik, Julia H; Patton, Kristen K; Beardsall, Marianne; Chen-Scarabelli, Carol A; Cohen, Mitchell I; Dickfeld, Timm-Michael L; Haines, David E; Helm, Robert H; Krishnan, Kousik; Nielsen, Jens Cosedis; Rickard, John; Sapp, John L; Chung, Mina

2017-10-01

The Heart Rhythm Society (HRS) has been developing clinical practice documents in collaboration and partnership with other professional medical societies since 1996. The HRS formed a Scientific and Clinical Documents Committee (SCDC) with the sole purpose of managing the development of these documents from conception through publication. The SCDC oversees the process for developing clinical practice documents, with input and approval from the HRS Executive Committee and the Board of Trustees. As of May 2017, the HRS has produced more than 80 publications with other professional organizations. This process manual is produced to publicly and transparently declare the standards by which the HRS develops clinical practice documents, which include clinical practice guidelines, expert consensus statements, scientific statements, clinical competency statements, task force policy statements, and proceedings statements. The foundation for this process is informed by the Institute of Medicine's standards for developing trustworthy clinical practice guidelines; the new criteria from the National Guidelines Clearinghouse, effective June 2014; SCDC member discussions; and a review of guideline policies and methodologies used by other professional organizations. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Do children go for the nice guys? The influence of speaker benevolence and certainty on selective word learning.

Science.gov (United States)

Bergstra, Myrthe; DE Mulder, Hannah N M; Coopmans, Peter

2018-04-06

This study investigated how speaker certainty (a rational cue) and speaker benevolence (an emotional cue) influence children's willingness to learn words in a selective learning paradigm. In two experiments four- to six-year-olds learnt novel labels from two speakers and, after a week, their memory for these labels was reassessed. Results demonstrated that children retained the label-object pairings for at least a week. Furthermore, children preferred to learn from certain over uncertain speakers, but they had no significant preference for nice over nasty speakers. When the cues were combined, children followed certain speakers, even if they were nasty. However, children did prefer to learn from nice and certain speakers over nasty and certain speakers. These results suggest that rational cues regarding a speaker's linguistic competence trump emotional cues regarding a speaker's affective status in word learning. However, emotional cues were found to have a subtle influence on this process.

Regulations and guidelines from the manufacturers' point of view

International Nuclear Information System (INIS)

Orth, K.H.

1977-01-01

Work on regulations and guidelines is a prerequisite for a better utilization of capacities, for improvements with regard to the licensing procedure and for a more efficient use of the available potential of engineers at the manufacturers' side who, freed from routine tasks, might be charged with further improving the safety of plants. Regulations and guidelines enable a shortening of the planning and building time, an employment of well-tried techniques and directions, multiple use of manufacturing documents, a reduction of the risks to be met in the planning, construction and start-up phases. They enable mass-production of components to be finished at a fixed date, a standardized operation manual and standardized staff training. Cooperation of nuclear power plant manufacturers in drawing up regulations and guidelines is thus not only an issue for the present, but also an investment for the future. (orig./HP) [de

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

Nice Guys Finish Last: Are People with Higher Tax Morale Taxed more Heavily?

OpenAIRE

Philipp Doerrenberg; Denvil Duncan; Clemens Fuest; Andreas Peichl

2012-01-01

This paper is the first to provide evidence of efficient taxation of groups with heterogeneous levels of 'tax morale'. We set up an optimal income tax model where high tax morale implies a high subjective cost of evading taxes. The model predicts that 'nice guys finish last': groups with higher tax morale will be taxed more heavily, simply because taxing them is less costly. Based on unique cross-country micro data and an IV approach to rule out reverse causality, we find empirical support fo...

Radiologic measurement of extraocular muscle volumes in patients with Graves' orbitopathy: a review and guideline

NARCIS (Netherlands)

Bijlsma, Ward R.; Mourits, Maarten Ph

2006-01-01

OBJECTIVE: To evaluate and compare techniques for extraocular muscle (EOM) volume measurement and to provide guidelines for future measurements. DESIGN: Systematic review. RESULTS: Existing techniques used to measure extraocular muscle volumes on radiologic scans can be divided into manual

NICeSim: an open-source simulator based on machine learning techniques to support medical research on prenatal and perinatal care decision making.

Science.gov (United States)

Cerqueira, Fabio Ribeiro; Ferreira, Tiago Geraldo; de Paiva Oliveira, Alcione; Augusto, Douglas Adriano; Krempser, Eduardo; Corrêa Barbosa, Helio José; do Carmo Castro Franceschini, Sylvia; de Freitas, Brunnella Alcantara Chagas; Gomes, Andreia Patricia; Siqueira-Batista, Rodrigo

2014-11-01

This paper describes NICeSim, an open-source simulator that uses machine learning (ML) techniques to aid health professionals to better understand the treatment and prognosis of premature newborns. The application was developed and tested using data collected in a Brazilian hospital. The available data were used to feed an ML pipeline that was designed to create a simulator capable of predicting the outcome (death probability) for newborns admitted to neonatal intensive care units. However, unlike previous scoring systems, our computational tool is not intended to be used at the patients bedside, although it is possible. Our primary goal is to deliver a computational system to aid medical research in understanding the correlation of key variables with the studied outcome so that new standards can be established for future clinical decisions. In the implemented simulation environment, the values of key attributes can be changed using a user-friendly interface, where the impact of each change on the outcome is immediately reported, allowing a quantitative analysis, in addition to a qualitative investigation, and delivering a totally interactive computational tool that facilitates hypothesis construction and testing. Our statistical experiments showed that the resulting model for death prediction could achieve an accuracy of 86.7% and an area under the receiver operating characteristic curve of 0.84 for the positive class. Using this model, three physicians and a neonatal nutritionist performed simulations with key variables correlated with chance of death. The results indicated important tendencies for the effect of each variable and the combination of variables on prognosis. We could also observe values of gestational age and birth weight for which a low Apgar score and the occurrence of respiratory distress syndrome (RDS) could be less or more severe. For instance, we have noticed that for a newborn with 2000 g or more the occurrence of RDS is far less problematic

Peace Corps Aquaculture Training Manual. Training Manual T0057.

Science.gov (United States)

Peace Corps, Washington, DC. Information Collection and Exchange Div.

This Peace Corps training manual was developed from two existing manuals to provide a comprehensive training program in fish production for Peace Corps volunteers. The manual encompasses the essential elements of the University of Oklahoma program that has been training volunteers in aquaculture for 25 years. The 22 chapters of the manual are…

No Ifs, No Butts: Compliance with Smoking Cessation in Secondary Care Guidance (NICE PH48 by Providers of Cancer Therapies (Radiotherapy and Chemotherapy in the UK

Directory of Open Access Journals (Sweden)

Daniel Hutton

2016-12-01

Full Text Available Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE guidance (PH48 in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance.

Critical Imperative for the Reform of British Interpretation of Fetal Heart Rate Decelerations: Analysis of FIGO and NICE Guidelines, Post-Truth Foundations, Cognitive Fallacies, Myths and Occam's Razor.

Science.gov (United States)

Sholapurkar, Shashikant L

2017-04-01

Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends. Unfortunately, the discrimination of FHR decelerations seems to be muddled since the British obstetrics adopted the concept of vast majority of FHR decelerations being "variable" (cord-compression). With proliferation of confusing waveform criteria, "atypical variables" became the commonest cause of suspicious/pathological CTG. However, National Institute for Health and Care Excellence (NICE) (2014) had to disband the "typical" and "atypical" terminology because of flawed classifying criteria. This analytical review makes a strong case that there are major and fundamental framing and confirmation fallacies (not just biases) in interpretation of FHR decelerations by NICE (2014) and International Federation of Gynecology and Obstetrics (FIGO) (2015), probably the biggest in modern medicine. This "post-truth" approach is incompatible with scientific practice. Moreover, it amounts to setting oneself for failure. The inertia to change could be best described as "backfire effect". There is abundant evidence that head-compression (and other non-hypoxic mediators) causes rapid rather than shallow/gradual decelerations. Currently, the vast majority of decelerations are attributed to unproven cord compression underpinned by flawed disproven pathophysiological hypotheses. Their further discrimination based on abstract, random, trial and error criteria remains unresolved suggesting a

A method for studying decision-making by guideline development groups.

Science.gov (United States)

Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

2009-08-05

Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

A method for studying decision-making by guideline development groups

Directory of Open Access Journals (Sweden)

Michie Susan

2009-08-01

Full Text Available Abstract Background Multidisciplinary guideline development groups (GDGs have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. Methods A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Results Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE acute physical health GDG. Conclusion This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision

EARLY DYNAMICAL EVOLUTION OF THE SOLAR SYSTEM: PINNING DOWN THE INITIAL CONDITIONS OF THE NICE MODEL

International Nuclear Information System (INIS)

Batygin, Konstantin; Brown, Michael E.

2010-01-01

In the recent years, the 'Nice' model of solar system formation has attained an unprecedented level of success in reproducing much of the observed orbital architecture of the solar system by evolving the planets to their current locations from a more compact configuration. Within the context of this model, the formation of the classical Kuiper Belt requires a phase during which the ice giants have a high eccentricity. An outstanding question of this model is the initial configuration from which the solar system started out. Recent work has shown that multi-resonant initial conditions can serve as good candidates, as they naturally prevent vigorous type-II migration. In this paper, we use analytical arguments, as well as self-consistent numerical N-body simulations to identify fully resonant initial conditions, whose dynamical evolution is characterized by an eccentric phase of the ice giants, as well as planetary scattering. We find a total of eight such initial conditions. Four of these primordial states are compatible with the canonical 'Nice' model, while the others imply slightly different evolutions. The results presented here should prove useful in further development of a comprehensive model for solar system formation.

An Administrator's Manual for Planning, Developing, and Implementing Mainstream, Self-Contained, or Co-op Programs for the Disadvantaged.

Science.gov (United States)

Pennsylvania State Univ., University Park. Div. of Occupational and Vocational Studies.

This administrator's manual contains guidelines for planning, developing, and implementing mainstream, self-contained, or cooperative work experience programs for the disadvantaged. Outlined in the introductory section are the philosophy underlying programs for the disadvantaged, procedures to determine student eligibility, signals indicating the…

Risk assessment of manual material handling activities (case study: PT BRS Standard Industry)

Science.gov (United States)

Deviani; Triyanti, V.

2017-12-01

The process of moving material manually has the potential for injury to workers. The risk of injury will increase if we do not pay attention to the working conditions. The purpose of this study is to assess and analyze the injury risk level in manual handling material activity, as well as to improve the condition. The observed manual material handling activities is pole lifting and goods loading. These activities were analyzed using Job Strain Index method, Rapid Entire Body Assessment, and Chaffin’s 2D Planar Static Model. The results show that most workers who perform almost all activities have a high level of risk level with the score of JSI and REBA exceeds 9 points. For some activities, the estimated compression forces in the lumbar area also exceed the standard limits of 3400 N. Concerning this condition, several suggestions for improvement were made, improving the composition of packing, improving body posture, and making guideline posters.

Katimavik Participant's Manual, Book VII, Socio-Cultural Activities = Katimavik manuel du participant, cahier VII, activites socio-culturelles.

Science.gov (United States)

OPCAN, Montreal (Quebec).

The bilingual student manual, devoted to the socio-cultural learning activity portion of Katimavik (a nine-month volunteer community service and experiential learning program for 17 to 21 year old Canadians), contains sections on learning program objectives and trimester guidelines, optional activities, resume recordkeeping, general topic…

Fiscal 1999 technological survey report. Part 1. Applied technology for measuring human sense (Human sense measuring manual - human sense evaluation index guideline); Ningen kankaku keisoku manual. 1. Ningen kankaku hyoka shihyo guide line

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

A method of measuring/evaluating a mental and physical state by means of physiological information developed by a project was compiled into a 'guide book', as was a method of evaluating adaptability to the environment or products; and, this manual was prepared for the purpose of improving the adaptability of human beings to products by making use of the guide book widely in the field of industrial manufacturing. Described in the part 1 are a method of evaluating human mind and body by the measurement of physiological quantity, a method of evaluating mental and physical adaptability from the element of environmental physics such as vision, sound and warmth, and a method of evaluating adaptability concerning utilization of machines and equipment, as 'human sense evaluation indexes'. The chapter 1 is the index of physiological/psychological state (stress evaluation index, fatigue/awakening evaluation index), the chapter 2 is an environmental/psychological index (overall environmental evaluation index, visual environmental effect index, sound/vibration environmental evaluation index, thermal environmental evaluation index), the chapter 3 is an adaptability evaluation index of products and the like (adaptability evaluation index by form and movement, evaluation index for operability of equipment for example), and the chapter 4 is the guideline (of environmental design and of product design). (NEDO)

Rapid sampling of BTEX in air by SPME in the city of Nice and at the Nice-Cote d'Azur airport

International Nuclear Information System (INIS)

Tumbiolo, S.; Gal, J.F.; Maria, P.Ch.; Laborde, P.; Teton, S.

2006-01-01

This article presents the results of a tentative application of Solid Phase Micro Extraction (SPME) to the analysis of BTEX (benzene, toluene, ethyl-benzene and xylenes) at the μg/m 3 level in indoor and outdoor air. The salient features of the method validation are reported. Sampling by QUALITAIR using Radiello passive samplers, was carried out from 2001 to 2004 in the city of Nice and its airport. Urban traffic impact was proved, but a link between BTX concentrations and the variations of airport activities was not clearly established. During the same period, several samplings were performed using SPME. Taking into account the short (30 minutes) sampling time, rapid changes of BTEX concentrations were evidenced, as for example the start of airplane engines. As field studies have shown, SPME technique appears as a method of choice for fast qualitative analysis and quantitative determination of Volatile Organic Compounds (VOC). The small dimensions of the SPME sampling system and the short sampling time let envisage its utilisation for the rapid diagnostic and the monitoring of indoor air quality. (author)

New Oxford style manual

CERN Document Server

2012-01-01

The New Oxford Style Manual brings together two essential reference works in a single volume: New Hart's Rules and the New Oxford Dictionary for Writers and Editors. New Hart's Rules, Oxford's definitive guide to style, consists of 20 chapters that provide authoritative and expert advice on how to prepare copy for publication. Topics covered include how to use italic, roman, and other type treatments, numbers and dates, law and legal references, illustrations, notes and references, and bibliographies. The guidelines are complemented by the New Oxford Dictionary for Writers and Editors, which features 25,000 alphabetically arranged entries giving authoritative advice on those words and names which raise questions time and time again because of spelling, capitalization, hyphenation, or cultural and historical context. Entries give full coverage of recommended spellings, variant forms, confusable words, hyphenation, capitalization, foreign and specialist terms, proper names, and abbreviations. The dictionary a...

Bivalirudin for the treatment of ST-segment elevation myocardial infarction: a NICE single technology appraisal.

Science.gov (United States)

Simpson, E L; Fitzgerald, P; Evans, P; Tappenden, P; Kalita, N; Reckless, J P D; Bakhai, A

2013-04-01

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer (The Medicines Company) of bivalirudin to submit evidence for its clinical and cost effectiveness within its licensed indication for the treatment of adults with ST-segment elevation myocardial infarction (STEMI) intended for primary percutaneous coronary intervention (PPCI), as part of NICE's single technology appraisal (STA) process. The School of Health and Related Research (ScHARR) at the University of Sheffield was commissioned to act as the Evidence Review Group (ERG), which produced a review of the evidence within the manufacturer's submission to NICE. This article describes the manufacturer's submission, the ERG review and NICE's subsequent decisions. The main evidence was derived from one randomized controlled trial (RCT) of STEMI patients intended for PPCI, comparing bivalirudin with unfractionated heparin plus glycoprotein IIb/IIIa inhibitors (GPIs). Bivalirudin was associated with a significant reduction in cardiac mortality at 30 days (p = 0.03) and at 1-year follow-up (p = 0.005), and a significant reduction in major bleeding at 30 days (p plus GPI. Stent thrombosis up to 24 hours following PPCI was significantly (p target vessel for ischaemia (p = 0.18 and p = 0.12, respectively). There were two decision-analytic models: the base-case scenario used 1-year follow-up data from the RCT; and a sensitivity analysis used 3-year follow-up data. Resource use was primarily drawn from this RCT. Health-related quality-of-life (HR-QOL) estimates were drawn from a UK cohort study. Both models evaluated the incremental costs and outcomes of bivalirudin compared with heparin plus GPI for patients with STEMI intended for PPCI. The analysis adopted a UK NHS perspective over a lifetime horizon. Unit costs were based on year 2009-2010 prices. The model adopted a decision-tree structure to reflect initial events for the initial period (stroke, repeat MI, minor

Concrete containment integrity software: Procedure manual and guidelines

International Nuclear Information System (INIS)

Dameron, R.A.; Dunham, R.S.; Rashid, Y.R.

1990-06-01

This report is an executive summary describing the concrete containment analysis methodology and software that was developed in the EPRI-sponsored research to predict the overpressure behavior and leakage of concrete containments. A set of guidelines has been developed for performing reliable 2D axisymmetric concrete containment analysis with a cracking concrete constitutive model developed by ANATECH. The software package developed during this research phase is designed for use in conjunction with ABAQUS-EPGEN; it provides the concrete model and automates axisymmetric grid preparation, and rebar generation for 2D and 3D grids. The software offers the option of generating pre-programmed axisymmetric grids that can be tailored to a specific containment by input of a few geometry parameters. The goal of simplified axisymmetric analysis within the framework of the containment leakage prediction methodology is to compute global liner strain histories at various locations within the containment. A simplified approach for generating peak liner strains at structural discontinuities as function of the global liner strains has been presented in a separate leakage criteria document; the curves for strain magnification factors and liner stress triaxiality factors found in that document are intended to be applied to the global liner strain histories developed through global 2D analysis. This report summarizes the procedures for global 2D analysis and gives an overview of the constitutive model and the special purpose concrete containment analysis software developed in this research phase. 8 refs., 10 figs

Materials selection guidelines for geothermal energy utilization systems

Energy Technology Data Exchange (ETDEWEB)

Ellis, P.F. II; Conover, M.F.

1981-01-01

This manual includes geothermal fluid chemistry, corrosion test data, and materials operating experience. Systems using geothermal energy in El Salvador, Iceland, Italy, Japan, Mexico, New Zealand, and the United States are described. The manual provides materials selection guidelines for surface equipment of future geothermal energy systems. The key chemical species that are significant in determining corrosiveness of geothermal fluids are identified. The utilization modes of geothermal energy are defined as well as the various physical fluid parameters that affect corrosiveness. Both detailed and summarized results of materials performance tests and applicable operating experiences from forty sites throughout the world are presented. The application of various non-metal materials in geothermal environments are discussed. Included in appendices are: corrosion behavior of specific alloy classes in geothermal fluids, corrosion in seawater desalination plants, worldwide geothermal power production, DOE-sponsored utilization projects, plant availability, relative costs of alloys, and composition of alloys. (MHR)

Load research manual. Volume 2. Fundamentals of implementing load research procedures

Energy Technology Data Exchange (ETDEWEB)

Brandenburg, L.; Clarkson, G.; Grund, Jr., C.; Leo, J.; Asbury, J.; Brandon-Brown, F.; Derderian, H.; Mueller, R.; Swaroop, R.

1980-11-01

This three-volume manual presents technical guidelines for electric utility load research. Special attention is given to issues raised by the load data reporting requirements of the Public Utility Regulatory Policies Act of 1978 and to problems faced by smaller utilities that are initiating load research programs. In Volumes 1 and 2, procedures are suggested for determining data requirements for load research, establishing the size and customer composition of a load survey sample, selecting and using equipment to record customer electricity usage, processing data tapes from the recording equipment, and analyzing the data. Statistical techniques used in customer sampling are discussed in detail. The costs of load research also are estimated, and ongoing load research programs at three utilities are described. The manual includes guides to load research literature and glossaries of load research and statistical terms.

77 FR 15452 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

Science.gov (United States)

2012-03-15

... proposed NHTSA Guidelines are meant to promote safety by discouraging the introduction of excessively... your statement or other material (e.g., film clips and slides) so that it can be placed into the docket...

Profession. Gas triumph celebrated in Nice. Globalization at all levels; Profession. Le triomphe du gaz celebre a Nice. Globalisation a tous les etages

Energy Technology Data Exchange (ETDEWEB)

Robert, J.

2000-08-01

These columns comprise two articles. The first article presents a status of the conclusions of the 21. world gas congress held in Nice (France) in June 6-9, 2000. Natural gas has been promoted 'energy of the 21. century' and presented as a vector of economic development and environment protection. The deregulation of markets, the new forms of competition and partnership and the new technologies were in the center of debates and presentations. The second article concerns the 16. world oil congress, held in Calgary (Canada) in June 2000. Durable economic development, environment and Internet were the three main topics of the congress. In front of the globalization of economies and the development of Internet, oil companies need to change their working procedures which will lead to the acceptance of the durable development concept. The objective is to take into consideration the environment and the social dimension in any new project. (J.S.)

Installation Guidelines for Solar DHW Systems in One- and Two-Family Dwellings. Second Edition.

Science.gov (United States)

Hollander, Peter; And Others

Described are some of the better techniques for installing solar domestic hot water (DHW) systems. By using these guidelines, along with the manufacturer's manual, professional installation contractors and skilled homeowners should be able to install and fill a solar DHW system. Among the topics considered are system layouts, siting, mounting…

Evaluation of the Swedish version of the Child Drawing: Hospital Manual.

Science.gov (United States)

Wennström, Berith; Nasic, Salmir; Hedelin, Hans; Bergh, Ingrid

2011-05-01

This paper is a report of psychometric testing of the Swedish version of the Child Drawing: Hospital Manual. Drawings have shown to be useful in assessing emotional status and anxiety in children because they generally speak to us more clearly and openly through their drawings than they are willing or able to verbally. The Child Drawing: Hospital Manual was translated into Swedish according to World Health Organization guidelines (a routine procedure for translation of English instruments) in order to assess anxiety by analysing the drawings of 59 children (5-11 years), of whom nine were girls and 50 boys undergoing day surgery during 2007-2009. Inter-rater reliability (five independent scorers) was high and internal consistency reliability was good (coefficient alpha =0·77). Parts A and C, as well as the total scale score of the Child Drawing: Hospital Manual, discriminated anxiety significantly between the group of children undergoing day surgery and a comparison group of school children, indicating adequate construct validity. For the Swedish version of the Child Drawing: Hospital Manual, our study demonstrates evidence for adequate construct validity in Parts A and C (and total scale score), high inter-rater reliability and acceptable internal consistency reliability. However, some improvements are needed before the instrument will be a clinically useful assessment of anxiety in children undergoing day surgery. © 2011 Blackwell Publishing Ltd.

Guidelines for the preparation of a quality manual for external audit groups on dosimetry in radiotherapy

International Nuclear Information System (INIS)

Izewska, Joanna; Arib, M.; Saravi, M.

2002-01-01

This document has been prepared within the framework of a Co-ordinated Research Programme (CRP) on Development of Quality Assurance Programme for Radiation Therapy Dosimetry in Developing Countries, during two Meetings at the IAEA Headquarters in Vienna (11-14 November 1996 and 6-10 October 1997). It is based on the recommendations of ISO 9000 series and ISO/IEC guide No. 25. The document can be used as a guide on how to prepare a quality manual for national External Audit Groups (EAG), i.e., a nationally recognised group in charge of operating external quality audits for radiotherapy dosimetry. The EAG of a given country includes the SSDL, a Measuring Group and a Medical Physics Group, who work in close co-operation at all steps of the audit. The content herein should be considered as a suggestion and additions or deletions can be made in accordance with the specific conditions in each country. It is preferable that the manual itself be as concise as possible, limiting it to the core scope. Detailed working sheets describing the procedures should be included in Appendices together with data sheets, questionnaires and reporting forms. The quality manual of each country should be carefully reviewed by all members of the EAG and, as far as possible, should be approved by relevant professional bodies and supported by health authorities. It has long been recognised that accurate knowledge of the dose in radiotherapy is vital to ensure safe and effective radiation treatments. To achieve this goal, comprehensive quality assurance programmes should be established to cover all steps from dose prescription to dose delivery. These programmes should include internal checks performed by the radiotherapy centres and external audits made by independent external bodies. It is estimated that not more than 50% of radiotherapy facilities world-wide have participated in some level of dose quality audit by an independent expert. Genuine concern exists that some, or even many

Implementation of a manual for working with wobbler mice and criteria for discontinuation of the experiment

DEFF Research Database (Denmark)

Ott, Bastian; Dahlke, Carolin; Meller, Karl

2015-01-01

. This article is designed to summarize conscientious work with the wobbler mouse, a model for the sporadic form of amyotrophic lateral sclerosis. This mouse model is characterized by a degeneration of α-motor-neurons leading to head tremor, loss of body weight and rapidly progressive paralysis. Although...... this mouse model has been known since 1956, there are no guidelines for breeding wobbler mice. Due to the lack of such guidelines the present study tries to close this gap and implements a manual for further studies. It includes the whole workflow in regard to wobbler mice from breeding and animal care...

Quality manual for the Danish greenhouse gas inventory

DEFF Research Database (Denmark)

Nielsen, Ole-Kenneth; Plejdrup, Marlene Schmidt; Winther, Morten

The report outlines the quality work undertaken by the emission inventory group at the Department of Environmental Science, Aarhus University in connection with the preparation and reporting of the Danish greenhouse gas inventory. The report updates and expands on the first version of the quality...... manual published in 2005. The report fulfils the mandatory requirements for a quality assurance/quality control (QA/QC) plan as lined out in the UNFCCC reporting guidelines and the specifications related to reporting under the Kyoto Protocol. The report describes all elements of the internal QC...... procedures as well as the QA and verification activities carried out in connection with the Danish greenhouse gas inventory....

Att utforma en teknisk manual : Med tillhörande riktlinjer

OpenAIRE

Runvall, Linda; Parantainen, Satu

2007-01-01

Vi, Linda Runvall och Satu Parantainen, har gjort vårt examensarbete för företaget Leine & Linde i Strängnäs. De tillverkar pulsgivare som används inom industrin. Examensarbetet bestod av att göra om en befintlig manual och skriva guidelines (riktlinjer) till Leine & Lindes personal. Under vårt examensarbete har vi använt oss av våra kunskaper inom informationsdesign. Rune Pettersson, professor i informationsdesign vid Mälardalens högskola, beskriver ämnet informationsdesign såhär: ”I...

Automated Detection of HONcode Website Conformity Compared to Manual Detection: An Evaluation

OpenAIRE

Boyer, Célia; Dolamic, Ljiljana

2015-01-01

Background To earn HONcode certification, a website must conform to the 8 principles of the HONcode of Conduct In the current manual process of certification, a HONcode expert assesses the candidate website using precise guidelines for each principle. In the scope of the European project KHRESMOI, the Health on the Net (HON) Foundation has developed an automated system to assist in detecting a website?s HONcode conformity. Automated assistance in conducting HONcode reviews can expedite the cu...

RELAP/MOD3 code manual: User's guidelines. Volume 5, Revision 1

International Nuclear Information System (INIS)

Fletcher, C.D.; Schultz, R.R.

1995-08-01

The RELAP5 code has been developed for best estimate transient simulation of light water reactor coolant systems during postulated accidents. The code models the coupled behavior of the reactor coolant system and the core for loss-of-coolant accidents, and operational transients, such as anticipated transient without scram, loss of offsite power, loss of feedwater, and loss of flow. A generic modeling approach is used that permits simulating a variety of thermal hydraulic systems. Control system and secondary system components are included to permit modeling of plant controls, turbines, condensers, and secondary feedwater systems. Volume V contains guidelines that have solved over the past several years through the use of the RELAP5 code

A cost-effectiveness analysis of celecoxib compared with diclofenac in the treatment of pain in osteoarthritis (OA) within the Swedish health system using an adaptation of the NICE OA model.

Science.gov (United States)

Brereton, Nicholas; Pennington, Becky; Ekelund, Mats; Akehurst, Ronald

2014-09-01

Celecoxib for the treatment of pain resulting from osteoarthritis (OA) was reviewed by the Tandvårds- och läkemedelsförmånsverket-Dental and Pharmaceutical Benefits Board (TLV) in Sweden in late 2010. This study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus a PPI in a Swedish setting. The National Institute for Health and Care Excellence (NICE) in the UK developed a health economic model as part of their 2008 assessment of treatments for OA. In this analysis, the model was reconstructed and adapted to a Swedish perspective. Drug costs were updated using the TLV database. Adverse event costs were calculated using the regional price list of Southern Sweden and the standard treatment guidelines from the county council of Stockholm. Costs for treating cardiovascular (CV) events were taken from the Swedish DRG codes and the literature. Over a patient's lifetime treatment with celecoxib plus a PPI was associated with a quality-adjusted life year (QALY) gain of 0.006 per patient when compared to diclofenac plus a PPI. There was an increase in discounted costs of 529 kr per patient, which resulted in an incremental cost-effectiveness ratio (ICER) of 82,313 kr ($12,141). Sensitivity analysis showed that treatment was more cost effective in patients with an increased risk of bleeding or gastrointestinal (GI) complications. The results suggest that celecoxib plus a PPI is a cost effective treatment for OA when compared to diclofenac plus a PPI. Treatment is shown to be more cost effective in Sweden for patients with a high risk of bleeding or GI complications. It was in this population that the TLV gave a positive recommendation. There are known limitations on efficacy in the original NICE model.

Audit of Helicobacter pylori Testing in Microbiology Laboratories in England: To Inform Compliance with NICE Guidance and the Feasibility of Routine Antimicrobial Resistance Surveillance

Directory of Open Access Journals (Sweden)

Rosalie Allison

2016-01-01

Full Text Available Introduction. The National Institute for Health and Clinical Excellence (NICE guidance recommends that dyspeptic patients are tested for Helicobacter pylori using a urea breath test, stool antigen test, or serology. Antibiotic resistance in H. pylori is globally increasing, but treatment in England is rarely guided by susceptibility testing or surveillance. Aims. To determine compliance of microbiology laboratories in England with NICE guidance and whether laboratories perform culture and antibiotic susceptibility testing (AST. Methods. In 2015, 170 accredited English microbiology laboratories were surveyed, by email. Results. 121/170 (71% laboratories responded; 96% provided H. pylori testing (78% on site. 94% provided H. pylori diagnosis using stool antigen; only four provided serology as their noninvasive test; 3/4 of these encouraged urea breath tests in their acute trusts. Only 22/94 (23% of the laboratories performed H. pylori cultures from gastric biopsies on site; 9/22 performed AST, but the vast majority processed less than one specimen/week. Conclusions. Only five laboratories in England do not comply with NICE guidance; these will need the guidance reinforced. National surveillance needs to be implemented; culture-based AST would need to be centralised. Moving forward, detection of resistance in H. pylori from stool specimens using molecular methods (PCR needs to be explored.

The logic of surveillance guidelines: an analysis of vaccine adverse event reports from an ontological perspective.

Directory of Open Access Journals (Sweden)

Mélanie Courtot

Full Text Available BACKGROUND: When increased rates of adverse events following immunization are detected, regulatory action can be taken by public health agencies. However to be interpreted reports of adverse events must be encoded in a consistent way. Regulatory agencies rely on guidelines to help determine the diagnosis of the adverse events. Manual application of these guidelines is expensive, time consuming, and open to logical errors. Representing these guidelines in a format amenable to automated processing can make this process more efficient. METHODS AND FINDINGS: Using the Brighton anaphylaxis case definition, we show that existing clinical guidelines used as standards in pharmacovigilance can be logically encoded using a formal representation such as the Adverse Event Reporting Ontology we developed. We validated the classification of vaccine adverse event reports using the ontology against existing rule-based systems and a manually curated subset of the Vaccine Adverse Event Reporting System. However, we encountered a number of critical issues in the formulation and application of the clinical guidelines. We report these issues and the steps being taken to address them in current surveillance systems, and in the terminological standards in use. CONCLUSIONS: By standardizing and improving the reporting process, we were able to automate diagnosis confirmation. By allowing medical experts to prioritize reports such a system can accelerate the identification of adverse reactions to vaccines and the response of regulatory agencies. This approach of combining ontology and semantic technologies can be used to improve other areas of vaccine adverse event reports analysis and should inform both the design of clinical guidelines and how they are used in the future. AVAILABILITY: Sufficient material to reproduce our results is available, including documentation, ontology, code and datasets, at http://purl.obolibrary.org/obo/aero.

Effectiveness of manual therapies: the UK evidence report.

Science.gov (United States)

Bronfort, Gert; Haas, Mitch; Evans, Roni; Leininger, Brent; Triano, Jay

2010-02-25

The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1

Effectiveness of manual therapies: the UK evidence report

Directory of Open Access Journals (Sweden)

Leininger Brent

2010-02-01

Full Text Available Abstract Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs, widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. Results By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines. Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Conclusions Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and

Cost-effectiveness modeling for neuropathic pain treatments: investigating the relative importance of parameters using an open-source model.

Science.gov (United States)

Hirst, Matthew; Bending, Matthew W; Baio, Gianluca; Yesufu-Udechuku, Amina; Dunlop, William C N

2018-06-08

The study objective was to develop an open-source replicate of a cost-effectiveness model developed by National Institute for Health and Care (NICE) in order to explore uncertainties in health economic modeling of novel pharmacological neuropathic pain treatments. The NICE model, consisting of a decision tree with branches for discrete levels of pain relief and adverse event (AE) severities, was replicated using R and used to compare a hypothetical neuropathic pain drug to pregabalin. Model parameters were sourced from NICE's clinical guidelines and associated with probability distributions to account for underlying uncertainty. A simulation-based scenario analysis was conducted to assess how uncertainty in efficacy and AEs affected the net monetary benefit (NMB) for the hypothetical treatment at a cost-effectiveness threshold of £20,000 per QALY. Relative to pregabalin, an increase in efficacy was associated with greater NMB than an improvement in tolerability. A greater NMB was observed when efficacy was marginally higher than that of pregabalin while maintaining the same level of AEs than when efficacy was equivalent to pregabalin but with a more substantial reduction in AEs. In the latter scenario, the NMB was only positive at a low cost-effectiveness threshold. The replicate model shares the limitations described in the NICE guidelines. There is a lack of support in scientific literature for the assumption that increased efficacy is associated with a greater reduction in tolerability. The replicate model also included a single comparator, unlike the NICE model. Pain relief is a stronger driver of NMB than tolerability at a cost-effectiveness threshold of £20,000 per QALY. Health technology assessment decisions which are influenced by NICE's model may reward efficacy gains even if they are associated with more severe AEs. This contrasts with recommendations from clinical guidelines for neuropathic pain which place more equal weighting on improvements in

An approach to standardization of urine sediment analysis via suggestion of a common manual protocol.

Science.gov (United States)

Ko, Dae-Hyun; Ji, Misuk; Kim, Sollip; Cho, Eun-Jung; Lee, Woochang; Yun, Yeo-Min; Chun, Sail; Min, Won-Ki

2016-01-01

The results of urine sediment analysis have been reported semiquantitatively. However, as recent guidelines recommend quantitative reporting of urine sediment, and with the development of automated urine sediment analyzers, there is an increasing need for quantitative analysis of urine sediment. Here, we developed a protocol for urine sediment analysis and quantified the results. Based on questionnaires, various reports, guidelines, and experimental results, we developed a protocol for urine sediment analysis. The results of this new protocol were compared with those obtained with a standardized chamber and an automated sediment analyzer. Reference intervals were also estimated using new protocol. We developed a protocol with centrifugation at 400 g for 5 min, with the average concentration factor of 30. The correlation between quantitative results of urine sediment analysis, the standardized chamber, and the automated sediment analyzer were generally good. The conversion factor derived from the new protocol showed a better fit with the results of manual count than the default conversion factor in the automated sediment analyzer. We developed a protocol for manual urine sediment analysis to quantitatively report the results. This protocol may provide a mean for standardization of urine sediment analysis.

Manual Therapy

OpenAIRE

Hakgüder, Aral; Kokino, Siranuş

2002-01-01

Manual therapy has been used in the treatment of pain and dysfunction of spinal and peripheral joints for more than a hundred years. Manual medicine includes manipulation, mobilization, and postisometric relaxation techniques. The aim of manual therapy is to enhance restricted movement caused by blockage of joints keeping postural balance, restore function and maintain optimal body mechanics. Anatomic, biomechanical, and neurophysiological evaluations of the leucomotor system is essential for...

Design/CPN. A Reference Manual

DEFF Research Database (Denmark)

Jensen et. al, Kurt

/CPN WWW pages. To speed up the access to the Design/CPN manuals we recommend to keep a local copy - which may be shared by all users in your organisation. In this way you do not need to go via our WWW server each time you need to look in a manual. For some of the largest manuals, we also supply files......Note: The manuals are available as PDF files . There are two sets of manuals - one for the Unix platform and another for the Mac platform. Each set of manual consists of: Tutorial (for the Design/CPN editor and simulator) Reference Manual (for the Design/CPN editor and simulator) Programmer......'s Manual (with Design/OA functions and Charts) Occurrence Graph Manual (integrated tutorial and reference manual) OE/OS Graph Manual (integrated tutorial and reference manual) Other Manuals (e.g. a short overview of CPN ML).   The Tutorial, Reference Manual and Programmer's Manual are made for Design...

How did the ball of rock we live on get so nice?

Science.gov (United States)

Armstrong, K.

2017-12-01

We want to understand how the big ball of rock, water, and air we live on got to be as nice as it is. Some of the things that made our world so nice are what it's made of, and what happened to those things after they were all put together. When our home ball of rock was little, it got bigger by grabbing some of the other stuff that was close by in space. So our world is made of all that space stuff, which was rocks, and that stuff that turns red if you let it get wet. Most of that red stuff is deep down in the middle of the world, covered up by a lot of rocks. But there is a lot of it inside the rocks, too. That red stuff does a lot of cool stuff when it touches other things, especially the kind of air we like to breathe- that is what makes it turn red. Just one very tiny piece of the red stuff can join up with the breathing air in different ways: it can team up with none at all, or a little bit, or a lot, or even more. If we look at how much of the breathing air is teamed up with the red stuff inside the rocks, we can learn about how the rocks got there and what happened to them a long time ago. In the rocks that we can look at, there is more of the breathing air teamed up with the red stuff than we might have thought. We think that maybe that is because when more and more stuff tries to fit in the same small space, and gets pressed down, like it does deep down in our world, it can change in ways we do not expect. When our world was almost as big as it is now, it probably grabbed some space stuff that was almost as big as it was. The space stuff would have run into our world really hard, and that would have made everything really hot, hot enough to make all the rocks in the world move like water. We have an idea that maybe, when all the rocks on the world were really hot and moved around like water, deep down the red stuff and the breathing air might have got all pressed together very hard, so that more of the breathing air would team up with the red stuff than it

Wearable Sensors for eLearning of Manual Tasks: Using Forearm EMG in Hand Hygiene Training.

Science.gov (United States)

Kutafina, Ekaterina; Laukamp, David; Bettermann, Ralf; Schroeder, Ulrik; Jonas, Stephan M

2016-08-03

In this paper, we propose a novel approach to eLearning that makes use of smart wearable sensors. Traditional eLearning supports the remote and mobile learning of mostly theoretical knowledge. Here we discuss the possibilities of eLearning to support the training of manual skills. We employ forearm armbands with inertial measurement units and surface electromyography sensors to detect and analyse the user's hand motions and evaluate their performance. Hand hygiene is chosen as the example activity, as it is a highly standardized manual task that is often not properly executed. The World Health Organization guidelines on hand hygiene are taken as a model of the optimal hygiene procedure, due to their algorithmic structure. Gesture recognition procedures based on artificial neural networks and hidden Markov modeling were developed, achieving recognition rates of 98 . 30 % ( ± 1 . 26 % ) for individual gestures. Our approach is shown to be promising for further research and application in the mobile eLearning of manual skills.

Caltrans : construction manual

Science.gov (United States)

2009-08-01

Caltrans intends this manual as a resource for all personnel engaged in contract administration. The manual establishes policies and procedures for the construction phase of Caltrans projects. However, this manual is not a contract document. It impos...

Comparative Study between Sequential Automatic and Manual Home Respiratory Polygraphy Scoring Using a Three-Channel Device: Impact of the Manual Editing of Events to Identify Severe Obstructive Sleep Apnea

Directory of Open Access Journals (Sweden)

Glenda Ernst

2015-01-01

Full Text Available Objective. According to current guidelines, autoscoring of respiratory events in respiratory polygraphy requires manual scoring. The aim of this study was to evaluate the agreement between automatic analysis and manual scoring to identify patients with suspected OSA. Methods. This retrospective study analyzed 791 records from respiratory polygraphy (RP performed at home. The association grade between automatic scoring and manual scoring was evaluated using Kappa coefficient and the agreement using Bland and Altman test and intraclass correlation coefficient (CCI. To determine the accuracy in the identification of AHI≥30 eV/h, the ROC curve analysis was used. Results. The population analyzed consisted of 493 male (62.3% and 298 female patients, with an average age of 54.7±14.20 years and BMI of 32.7±8.21 kg/m2. There was no significant difference between automatic and manual apnea/hypopnea indexes (aAHI, mAHI: aAHI 17.25 (SD: 17.42 versus mAHI 21.20±7.96 (p; NS. The agreement between mAHI and aAHI to AHI≥30 was 94%, with a Kappa coefficient of 0.83 (p<0.001 and a CCI of 0.83. The AUC-ROC, sensitivity, and specificity were 0.99 (CI 95%: 0.98-0.99, p<0.001, 86% (CI 95%: 78.7–91.4, and 97% (CI 95%: 96–98.3, respectively. Conclusions. We observed good agreement between automatic scoring and sequential manual scoring to identify subjects with AHI≥30 eV/h.

The Role of Nice and Nasty Theory of Mind in Teacher-Selected Peer Models for Adolescents with Autism Spectrum Disorders

Science.gov (United States)

Laghi, Fiorenzo; Lonigro, Antonia; Levanto, Simona; Ferraro, Maurizio; Baumgartner, Emma; Baiocco, Roberto

2016-01-01

The study aimed at verifying if nice and nasty theory of mind behaviors, in association with teachers' peer buddy nomination, could be used to correctly select peer models for adolescents with autism spectrum disorder. Mentalizing abilities and emotional and behavioral characteristics of 601 adolescents were assessed. Results suggest that teachers…

Systematic review of efficacy for manual lymphatic drainage techniques in sports medicine and rehabilitation: an evidence-based practice approach.

Science.gov (United States)

Vairo, Giampietro L; Miller, Sayers John; McBrier, Nicole M; Buckley, William E

2009-01-01

Manual therapists question integrating manual lymphatic drainage techniques (MLDTs) into conventional treatments for athletic injuries due to the scarcity of literature concerning musculoskeletal applications and established orthopaedic clinical practice guidelines. The purpose of this systematic review is to provide manual therapy clinicians with pertinent information regarding progression of MLDTs as well as to critique the evidence for efficacy of this method in sports medicine. We surveyed English-language publications from 1998 to 2008 by searching PubMed, PEDro, CINAHL, the Cochrane Library, and SPORTDiscus databases using the terms lymphatic system, lymph drainage, lymphatic therapy, manual lymph drainage, and lymphatic pump techniques. We selected articles investigating the effects of MLDTs on orthopaedic and athletic injury outcomes. Nine articles met inclusion criteria, of which 3 were randomized controlled trials (RCTs). We evaluated the 3 RCTs using a validity score (PEDro scale). Due to differences in experimental design, data could not be collapsed for meta-analysis. Animal model experiments reinforce theoretical principles for application of MLDTs. When combined with concomitant musculoskeletal therapy, pilot and case studies demonstrate MLDT effectiveness. The best evidence suggests that efficacy of MLDT in sports medicine and rehabilitation is specific to resolution of enzyme serum levels associated with acute skeletal muscle cell damage as well as reduction of edema following acute ankle joint sprain and radial wrist fracture. Currently, there is limited high-ranking evidence available. Well-designed RCTs assessing outcome variables following implementation of MLDTs in treating athletic injuries may provide conclusive evidence for establishing applicable clinical practice guidelines in sports medicine and rehabilitation.

Critical Imperative for the Reform of British Interpretation of Fetal Heart Rate Decelerations: Analysis of FIGO and NICE Guidelines, Post-Truth Foundations, Cognitive Fallacies, Myths and Occam’s Razor

Science.gov (United States)

Sholapurkar, Shashikant L.

2017-01-01

Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex “pattern recognition” of CTG interpretation by clinicians depends. Unfortunately, the discrimination of FHR decelerations seems to be muddled since the British obstetrics adopted the concept of vast majority of FHR decelerations being “variable” (cord-compression). With proliferation of confusing waveform criteria, “atypical variables” became the commonest cause of suspicious/pathological CTG. However, National Institute for Health and Care Excellence (NICE) (2014) had to disband the “typical” and “atypical” terminology because of flawed classifying criteria. This analytical review makes a strong case that there are major and fundamental framing and confirmation fallacies (not just biases) in interpretation of FHR decelerations by NICE (2014) and International Federation of Gynecology and Obstetrics (FIGO) (2015), probably the biggest in modern medicine. This “post-truth” approach is incompatible with scientific practice. Moreover, it amounts to setting oneself for failure. The inertia to change could be best described as “backfire effect”. There is abundant evidence that head-compression (and other non-hypoxic mediators) causes rapid rather than shallow/gradual decelerations. Currently, the vast majority of decelerations are attributed to unproven cord compression underpinned by flawed disproven pathophysiological hypotheses. Their further discrimination based on abstract, random, trial and error criteria remains

Guidelines for Management Consulting Programs for Small-Scale Enterprise. Appropriate Technologies for Development. Manual M-14.

Science.gov (United States)

Vaughan, Gary L.

This manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are: the role of the SSE in third world development, problems of SSEs, and target firms. The second chapter deals with various forms of management assistance to…

National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy

DEFF Research Database (Denmark)

Stochkendahl, Mette Jensen; Kjær, Per; Hartvigsen, Jan

2018-01-01

based on the GRADE approach. RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active. If treatment is needed, the guidelines suggest using patient education, different...... types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids. CONCLUSION: Recommendations are based on low to moderate quality evidence or on consensus...

External cavity diode laser-based detection of trace gases with NICE-OHMS using current modulation.

Science.gov (United States)

Centeno, R; Mandon, J; Cristescu, S M; Axner, O; Harren, F J M

2015-03-09

We combine an external cavity diode laser with noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) using current modulation. With a finesse of 1600, we demonstrate noise equivalent absorption sensitivities of 4.1 x 10(-10) cm(-1) Hz(-1/2), resulting in sub-ppbv detection limits for Doppler-broadened transitions of CH(4) at 6132.3 cm(-1), C(2)H(2) at 6578.5 cm(-1) and HCN at 6541.7 cm(-1). The system is used for hydrogen cyanide detection from sweet almonds.

Manual on internal dose computation and reporting

International Nuclear Information System (INIS)

Sawant, Pramilla D.; Sawant, Jyoti V.; Gurg, R.P.; Rudran, Kamala; Gupta, V.K.; Abani, M.C.

1999-05-01

Whole body counting and bioassay measurement are carried out for estimation of radioactivity content in the whole body or in a particular organ/tissue of interest. These measurements are routinely carried out for occupational workers at nuclear power plants, reprocessing plants, radiochemical laboratories, radioisotope laboratories and radioactive waste management facilities to evaluate individual internal dose due to 3 H, 60 Co, 90 Sr, 137 Cs, transuranics and other isotopes of interest. This manual is prepared to provide guidelines for computation of intake, committed equivalent dose and committed effective dose from direct measurement of tissue and/or body content of radioactivity for 60 Co, 131 I, and 137 Cs employing in-vivo monitoring procedures and/or bioassay measurements only. Bioassay measurements are used for determination of 90 Sr in the body since it is a pure beta emitter. This manual can be used as a ready reckoner for assessment of radiation dose due to internal contamination of occupational workers as estimated using above techniques in the middle and back-end of the nuclear fuel cycle operations. The methodology used in computation of dose is based on the principles and biokinetic models given by ICRP. Recording level recommended in the manual is 0.6 mSv for both, routine as well as special monitoring, which is lower than 1 mSv recommended by ICRP (ICRP-75, 1997) for individual routine monitoring and 0.66 mSv for special monitoring. The Annual Limit on Intake is taken equivalent to Annual Effective Dose Limit of 20 mSv as prescribed by the Atomic Energy Regulatory Board (AERB), India. (author)

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.

Nice module. Apollon Solar present their new line of solar modules; Nettes Modul. Apollon Solar stellt Linie fuer neuartige Modultechnologie vor

Energy Technology Data Exchange (ETDEWEB)

Podewils, C.

2008-06-15

Solar modules, TGV engines and perfume Zerstaeuber seem to have nothing in common. The new solar module developed by French producer Apollon Solar makes use of both technologies in the construction process. The contribution presents the 'Nice' module which has many new features. (orig.)

CSTEM User Manual

Science.gov (United States)

Hartle, M.; McKnight, R. L.

2000-01-01

This manual is a combination of a user manual, theory manual, and programmer manual. The reader is assumed to have some previous exposure to the finite element method. This manual is written with the idea that the CSTEM (Coupled Structural Thermal Electromagnetic-Computer Code) user needs to have a basic understanding of what the code is actually doing in order to properly use the code. For that reason, the underlying theory and methods used in the code are described to a basic level of detail. The manual gives an overview of the CSTEM code: how the code came into existence, a basic description of what the code does, and the order in which it happens (a flowchart). Appendices provide a listing and very brief description of every file used by the CSTEM code, including the type of file it is, what routine regularly accesses the file, and what routine opens the file, as well as special features included in CSTEM.

HIFK soccer the game book : - guidelines for junior coaching

OpenAIRE

Laurila, Eero

2010-01-01

This thesis is based on the fact that HIFK (Idrottsförening Kamraterna i Helsingfors) Soccer has not had any guidelines or a manual on how the club wants to develop the players. The basic idea and aim of the game book is to collect all the important information about coaching and football in one book. Today there is a huge mass of information around football which makes it difficult for a football coach to find essential know-how from that flood of informa-tion. The game book is a practical t...

Laboratory training manual on the use of nuclear and associated techniques in pesticide research

International Nuclear Information System (INIS)

1991-01-01

Most laboratories studying pesticide metabolism or other aspects of pesticides use isotope techniques. This manual is aimed at scientists who use or intended to use radioisotopes in pesticide research. It contains a theoretical introduction on the properties of radionuclides and radiation, a description of radioactivity measuring instruments, guidelines for radiation protection and general recommendations on experimental design and performance. A large part of the manual is devoted to laboratory exercises in which detailed protocols for applications of isotope techniques in pesticide research are presented. These are intended to demonstrate concepts or denote representative means of conducting particular types of experiment, and it is hoped that the information gained through the performance of the exercises will serve as a basis for modifications to suit other specialized needs. 36 figs

A manual of recommended practices for hydrogen energy systems

Energy Technology Data Exchange (ETDEWEB)

Hoagland, W.; Leach, S. [W. Hoagland and Associates, Boulder, CO (United States)

1997-12-31

Technologies for the production, distribution, and use of hydrogen are rapidly maturing and the number and size of demonstration programs designed to showcase emerging hydrogen energy systems is expanding. The success of these programs is key to hydrogen commercialization. Currently there is no comprehensive set of widely-accepted codes or standards covering the installation and operation of hydrogen energy systems. This lack of codes or standards is a major obstacle to future hydrogen demonstrations in obtaining the requisite licenses, permits, insurance, and public acceptance. In a project begun in late 1996 to address this problem, W. Hoagland and Associates has been developing a Manual of Recommended Practices for Hydrogen Systems intended to serve as an interim document for the design and operation of hydrogen demonstration projects. It will also serve as a starting point for some of the needed standard-setting processes. The Manual will include design guidelines for hydrogen procedures, case studies of experience at existing hydrogen demonstration projects, a bibliography of information sources, and a compilation of suppliers of hydrogen equipment and hardware. Following extensive professional review, final publication will occur later in 1997. The primary goal is to develop a draft document in the shortest possible time frame. To accomplish this, the input and guidance of technology developers, industrial organizations, government R and D and regulatory organizations and others will be sought to define the organization and content of the draft Manual, gather and evaluate available information, develop a draft document, coordinate reviews and revisions, and develop recommendations for publication, distribution, and update of the final document. The workshop, Development of a Manual of Recommended Practices for Hydrogen Energy Systems, conducted on March 11, 1997 in Alexandria, Virginia, was a first step.

EMSL Operations Manual

Energy Technology Data Exchange (ETDEWEB)

Foster, Nancy S.

2009-06-18

This manual is a general resource tool to assist EMSL users and Laboratory staff within EMSL locate official policy, practice and subject matter experts. It is not intended to replace or amend any formal Battelle policy or practice. Users of this manual should rely only on Battelle’s Standard Based Management System (SBMS) for official policy. No contractual commitment or right of any kind is created by this manual. Battelle management reserves the right to alter, change, or delete any information contained within this manual without prior notice.

EMSL Operations Manual

Energy Technology Data Exchange (ETDEWEB)

Foster, Nancy S.

2009-03-25

This manual is a general resource tool to assist EMSL users and Laboratory staff within EMSL locate official policy, practice and subject matter experts. It is not intended to replace or amend any formal Battelle policy or practice. Users of this manual should rely only on Battelle’s Standard Based Management System (SBMS) for official policy. No contractual commitment or right of any kind is created by this manual. Battelle management reserves the right to alter, change, or delete any information contained within this manual without prior notice.

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

International Nuclear Information System (INIS)

Ghayur, S.; Tariq, H.

2013-01-01

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

Guidelines for the presentation of emergency operating procedures using advanced information technology

International Nuclear Information System (INIS)

Green, M.; Hollnagel, E.; Niwa, Yuji

1994-01-01

New methods of information presentation and interface design are changing the conditions for work in the modern NPP control room. One area receiving considerable attention is that of Emergency Operating Procedures (EOP). Conventionally such procedures are presented using hard copy manuals; however, development in IT means that there are new opportunities for the computerization of such procedures. This paper reports on the development of human factors guidelines for the computerized presentation of EOPs. After identifying the principle stages in the transition from procedures as documents to fully automated procedures, computerised procedure presentation is briefly discussed. Guidelines for the presentation of such procedures are outlined starting with the high level goals for guidelines themselves. Such goals also constitute the criteria against which the computerized procedures are measured during implementation. Six dimensions describing computerized procedure presentation are presented and two are explore in more detail by identifying points along each dimension that characterize different levels of IT sophistication. (author). 8 refs, 1 tab

Guidelines for normalising Early Modern English corpora: Decisions and justifications

Directory of Open Access Journals (Sweden)

Archer Dawn

2015-03-01

Full Text Available Corpora of Early Modern English have been collected and released for research for a number of years. With large scale digitisation activities gathering pace in the last decade, much more historical textual data is now available for research on numerous topics including historical linguistics and conceptual history. We summarise previous research which has shown that it is necessary to map historical spelling variants to modern equivalents in order to successfully apply natural language processing and corpus linguistics methods. Manual and semiautomatic methods have been devised to support this normalisation and standardisation process. We argue that it is important to develop a linguistically meaningful rationale to achieve good results from this process. In order to do so, we propose a number of guidelines for normalising corpora and show how these guidelines have been applied in the Corpus of English Dialogues.

INTRA/Mod3.2. Manual and code description. Volume 2 - User's manual

International Nuclear Information System (INIS)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User's Manual is an input description. This document, the User's Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Derivation of uranium residual radioactive material guidelines for the former Alba Craft Laboratory site, Oxford, Ohio

International Nuclear Information System (INIS)

Nimmagadda, M.; Faillace, E.; Yu, C.

1994-01-01

Residual radioactive material guidelines for uranium were derived for the former Alba Craft Laboratory site in Oxford, Ohio. This site has been identified for remedial action under the Formerly Utilized Sites Remedial Action Program (FUSRAP) of the US Department of Energy (DOE). Single nuclide and total uranium guidelines were derived on the basis of the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the former Alba Craft Laboratory site should not exceed a dose of 30 mrem/yr following remedial action for the current use and likely future use scenarios or a dose of 100 mrem/yr for less likely future use scenarios (Yu et al. 1993). The DOE residual radioactive material guideline computer code, RESRAD, which implements the methodology described in the DOE manual for implementing residual radioactive material guidelines, was used in this evaluation

Structures manual

Science.gov (United States)

2001-01-01

This manual was written as a guide for use by design personnel in the Vermont Agency of Transportation Structures Section. This manual covers the design responsibilities of the Section. It does not cover other functions that are a part of the Structu...

Ciencias 2. Manual do Professor (Science Teacher's Manual).

Science.gov (United States)

Raposo, Lucilia

This is the teacher's manual for Ciencias 2, the second in a series of elementary science textbooks for Portuguese-speaking students. The student textbook contains 10 chapters and 57 activities. The teacher's manual presents an explanation of the educational goals and the organization of the content, Topics included are environment, the human,…

Radiological Control Manual

Energy Technology Data Exchange (ETDEWEB)

1993-04-01

This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

Radiological Control Manual

International Nuclear Information System (INIS)

1993-04-01

This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records

Egyptian Mythological Manuals

DEFF Research Database (Denmark)

Jørgensen, Jens Kristoffer Blach

From the hands of Greek mythographers a great number of myths have survived along with philosophical discussions of their meaning and relevance for the Greeks. It is little known that something similar existed in ancient Egypt where temple libraries and archives held scholarly literature used...... by the native priesthood, much of which has only been published in recent years. As part of this corpus of texts, the ancient Egyptian mythological manuals offer a unique perspective on how the Egyptian priesthood structured and interpreted Egyptian myths. The thesis looks at the different interpretative...... techniques used in the Tebtunis Mythological Manual (Second century CE) and the Mythological Manual of the Delta (Sixth century BCE) and the place of these manuals within the larger corpus of priestly scholarly literature from ancient Egypt. To organize the wealth of local myths the manuals use model...

Have a Nice Conflict How to Find Success and Satisfaction in the Most Unlikely Places

CERN Document Server

Scudder, Tim; Mitchell, Kent

2011-01-01

How to successfully navigate and prevent conflict From the publishers of the popular Strength Deployment Inventory, Have a Nice Conflict follows one man's fight to rescue his sinking career. Sales manager John Doyle would consider his career a success-he's his company's top revenue driver, and his take-charge attitude gets the job done. However, when he is passed over for promotion-again-after losing two direct reports, who cite his abrasive style as their reason for leaving, John is forced to reassess how he approaches his relationships. With the help of Mac, an expert in the art of Relations

Laboratory training manual on the use of nuclear techniques in animal parasitology

International Nuclear Information System (INIS)

1982-01-01

The Manual is designed for specialist training in the use of nuclear techniques in animal parasitology. The theoretical part contains a general introduction to experimental work in this field. Laboratory exercises are divided into Basic Exercises (17) and Applied Exercises (25) oriented to research in the immunology and pathogenesis of host-parasite interactions using radioisotopic methods and to disease management through the use of radiation-attenuated vaccines. The closing part contains a number of practical guidelines and data for work with radioisotopes in general and for the use of radioisotopic methods in animal parasitology

RELAP/MOD3 code manual: User`s guidelines. Volume 5, Revision 1

Energy Technology Data Exchange (ETDEWEB)

Fletcher, C.D.; Schultz, R.R. [Lockheed Idaho Technologies Co., Idaho Falls, ID (United States)

1995-08-01

The RELAP5 code has been developed for best estimate transient simulation of light water reactor coolant systems during postulated accidents. The code models the coupled behavior of the reactor coolant system and the core for loss-of-coolant accidents, and operational transients, such as anticipated transient without scram, loss of offsite power, loss of feedwater, and loss of flow. A generic modeling approach is used that permits simulating a variety of thermal hydraulic systems. Control system and secondary system components are included to permit modeling of plant controls, turbines, condensers, and secondary feedwater systems. Volume V contains guidelines that have solved over the past several years through the use of the RELAP5 code.

Deliberating Tarceva: A case study of how British NHS managers decide whether to purchase a high-cost drug in the shadow of NICE guidance.

Science.gov (United States)

Hughes, David; Doheny, Shane

2011-11-01

This paper examines audio-recorded data from meetings in which NHS managers decide whether to fund high-cost drugs for individual patients. It investigates the work of a Welsh individual patient commissioning (IPC) panel responsible for sanctioning the purchase of 'un-commissioned' treatments for exceptional cases. The case study presented highlights the changing rationales used for approving or denying a cancer drug, Tarceva, during a period when NICE first suggested it was not cost effective, but then changed its position in a final technology appraisal recommending use when the cost did not exceed that of an alternative product. Our data show how decisions taken in the shadow of NICE guidance remain complex and subject to local discretion. Guidance that takes time to prepare, is released in stages, and relates to particular disease stages, must be interpreted in the context of particular cases. The case-based IPC panel discourse stands in tension with the standardised population-based recommendations in guidance. Panel members, who based their decisions on the central notions of 'efficacy' and 'exceptionality', often struggled to apply NICE information on cost-effectiveness to their deliberations on efficacy (clinical effectiveness). The case study suggests that the complex nature of decision making makes standardization of outcomes very difficult to achieve, so that local professional judgement is likely to remain central to health care rationing at this level. Copyright © 2011 Elsevier Ltd. All rights reserved.

PRIS-STATISTICS: Power Reactor Information System Statistical Reports. User's Manual

International Nuclear Information System (INIS)

2013-01-01

The IAEA developed the Power Reactor Information System (PRIS)-Statistics application to assist PRIS end users with generating statistical reports from PRIS data. Statistical reports provide an overview of the status, specification and performance results of every nuclear power reactor in the world. This user's manual was prepared to facilitate the use of the PRIS-Statistics application and to provide guidelines and detailed information for each report in the application. Statistical reports support analyses of nuclear power development and strategies, and the evaluation of nuclear power plant performance. The PRIS database can be used for comprehensive trend analyses and benchmarking against best performers and industrial standards.

Quality manual for the Danish greenhouse gas inventory. Version 2

Energy Technology Data Exchange (ETDEWEB)

Nielsen, O.-K.; Plejdrup, M.S.; Winther, M. [and others

2013-02-15

This report outlines the quality work undertaken by the emission inventory group at the Department of Environmental Science, Aarhus University in connection with the preparation and reporting of the Danish greenhouse gas inventory. This report updates and expands on the first version of the quality manual published in 2005. The report fulfils the mandatory requirements for a quality assurance/quality control (QA/QC) plan as lined out in the UNFCCC reporting guidelines and the specifications related to reporting under the Kyoto Protocol. The report describes all elements of the internal QC procedures as well as the QA and verification activities carried out in connection with the Danish greenhouse gas inventory. (Author)

A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. Seminar planned for this week is: Make Office documents with Windows Word 2003 and Excel 2003 (EN), Thursday 17 June, 14:00 (special time). The seminars will take place in the IT Auditorium (bldg. 31, 3-005) and last for about one hour plus questions. No registration is necessary. More information is available at http://cern.ch/Win/Seminars/Tutorials. Interested users can also have a look to courses offered by CERN Technical Training, at http://cern.ch/humanresources/external/training/tech/office/te_office.asp.

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-07-01

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

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

Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual.

Science.gov (United States)

Morisada, S; Nosaka, N; Tsukahara, K; Ugawa, T; Sato, K; Ujike, Y

2015-09-30

The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive burns (SEB) treated before and after implementation of these new guidelines at this institution. The patients included in this study had a burn index (BI) ≥30 or a prognostic burn index (PBI = BI + patient's age) ≥100. The survival rate of the patients with BI ≥30 was 65.2% with the traditional treatment and 100% with the new guidelines. Likewise, the survival rate of the patients with PBI ≥100 was 61.1% with the traditional treatment compared to 100% with the new guidelines. Together, these data demonstrate that the new treatment guidelines dramatically improved the treatment outcome and survival of SEB patients.

INTRA/Mod3.2. Manual and code description. Volume 2 - User`s manual

Energy Technology Data Exchange (ETDEWEB)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User`s Manual is an input description. This document, the User`s Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Camp Health Aide Manual = Manual para trabajadores de salud.

Science.gov (United States)

Robinson, June Grube; And Others

This bilingual manual serves as a textbook for migrant Camp Health Aides. Camp Health Aides are members of migrant labor camps enlisted to provide information about health and social services to migrant workers and their families. The manual is divided into 12 tabbed sections representing lessons. Teaching notes printed on contrasting paper…

Abiraterone Acetate for the Treatment of Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer : An Evidence Review Group Perspective of an NICE Single Technology Appraisal

NARCIS (Netherlands)

Ramaekers, Bram L. T.; Riemsma, Rob; Tomini, Florian; van Asselt, Thea; Deshpande, Sohan; Duffy, Steven; Armstrong, Nigel; Severens, Johan L.; Kleijnen, Jos; Joore, Manuela A.

The National Institute for Health and Care Excellence (NICE) invited Janssen, the company manufacturing abiraterone acetate (AA; tradename Zytiga(A (R))), to submit evidence for the clinical and cost effectiveness of AA in combination with prednisone/prednisolone (AAP) compared with watchful waiting

HVAC system operation manual of IMEF

International Nuclear Information System (INIS)

Baek, Sang Yeol; Park, Dae Kyu; Ahn, Sang Bok; Ju, Yong Sun.

1997-06-01

This manual is operation procedures of the IMEF(Irradiated Material Examination Facility) HVAC(Heating, Ventilation and Air Conditioning) System. General operation procedures and test method of the IMEF HVAC system are described. The manual is as follows; 1. HVAC system operation manual 2. HVAC system management guide 3. HVAC system maintenance manual 4. HVAC system air velocity and flowrate measurement manual 5. HVAC system HEPA filter leak test manual 6. HVAC system charcoal filter leak test manual 7. HVAC system HEPA and charcoal filter exchange manual. (author). 8 tabs

Crizotinib for Untreated Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

Science.gov (United States)

Morgan, Philip; Woolacott, Nerys; Biswas, Mousumi; Mebrahtu, Teumzghi; Harden, Melissa; Hodgson, Robert

2017-09-01

As part of the National Institute for Health and Care Excellence (NICE) single technology appraisal process, the manufacturer of crizotinib submitted evidence on the clinical and cost effectiveness of crizotinib in untreated anaplastic lymphoma kinase-positive (ALK-positive) non-small-cell lung cancer (NSCLC). Crizotinib has previously been assessed by NICE for patients with previously treated ALK-positive NSCLC (TA 296). It was not approved in this previous appraisal, but had been made available through the cancer drugs fund. As part of this new appraisal, the company included a price discount patient access scheme (PAS). The Centre for Reviews and Dissemination and Centre for Health Economics Technology Appraisal Group at the University of York was commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company's submission and the ERG's review and summarises the resulting NICE guidance issued in August 2016. The main clinical-effectiveness data were derived from a multicentre randomised controlled trial-PROFILE 1014-that compared crizotinib with pemetrexed chemotherapy in combination with carboplatin or cisplatin in patients with untreated non-squamous ALK-positive NSCLC. In the trial, crizotinib demonstrated improvements in progression-free survival (PFS) and overall survival (OS). The company's economic model was a three-state 'area under the curve' Markov model. The base-case incremental cost-effectiveness ratio (ICER) was estimated to be greater than £50,000 per quality-adjusted life-year (QALY) gained (excluding the PAS discount). The ERG assessment of the evidence submitted by the company raised a number of concerns. In terms of the clinical evidence, the OS benefit was highly uncertain due to the cross-over permitted in the trial and the immaturity of the data; only 26% of events had occurred by the data cut-off point. In the economic modelling, the most significant concerns related to the analysis

State of Arctic Sea Ice North of Svalbard during N-ICE2015

Science.gov (United States)

Rösel, Anja; King, Jennifer; Gerland, Sebastian

2016-04-01

The N-ICE2015 cruise, led by the Norwegian Polar Institute, was a drift experiment with the research vessel R/V Lance from January to June 2015, where the ship started the drift North of Svalbard at 83°14.45' N, 21°31.41' E. The drift was repeated as soon as the vessel drifted free. Altogether, 4 ice stations where installed and the complex ocean-sea ice-atmosphere system was studied with an interdisciplinary Approach. During the N-ICE2015 cruise, extensive ice thickness and snow depth measurements were performed during both, winter and summer conditions. Total ice and snow thickness was measured with ground-based and airborne electromagnetic instruments; snow depth was measured with a GPS snow depth probe. Additionally, ice mass balance and snow buoys were deployed. Snow and ice thickness measurements were performed on repeated transects to quantify the ice growth or loss as well as the snow accumulation and melt rate. Additionally, we collected independent values on surveys to determine the general ice thickness distribution. Average snow depths of 32 cm on first year ice, and 52 cm on multi-year ice were measured in January, the mean snow depth on all ice types even increased until end of March to 49 cm. The average total ice and snow thickness in winter conditions was 1.92 m. During winter we found a small growth rate on multi-year ice of about 15 cm in 2 months, due to above-average snow depths and some extraordinary storm events that came along with mild temperatures. In contrast thereto, we also were able to study new ice formation and thin ice on newly formed leads. In summer conditions an enormous melt rate, mainly driven by a warm Atlantic water inflow in the marginal ice zone, was observed during two ice stations with melt rates of up to 20 cm per 24 hours. To reinforce the local measurements around the ship and to confirm their significance on a larger scale, we compare them to airborne thickness measurements and classified SAR-satellite scenes. The

A Manual of Style.

Science.gov (United States)

Nebraska State Dept. of Education, Lincoln.

This "Manual of Style" is offered as a guide to assist Nebraska State employees in producing quality written communications and in presenting a consistently professional image of government documents. The manual is not designed to be all-inclusive. Sections of the manual discuss formatting documents, memorandums, letters, mailing…

Migrant Education, Interstate Secondary Credit Accrual and Acceptance Manual: Practical Guidelines for School Personnel Serving Migrant Secondary Students.

Science.gov (United States)

Villarreal, Gay Callaway

Migrant students graduation rates, although improving, are still significantly lower than those of their non-migrant peers. This manual is a comprehensive reference guide for Chapter 1 Migrant Program personnel counselors and teachers serving migrant students at the secondary level. Migrant students are those who move across school district…

MARS CODE MANUAL VOLUME III - Programmer's Manual

International Nuclear Information System (INIS)

Chung, Bub Dong; Hwang, Moon Kyu; Jeong, Jae Jun; Kim, Kyung Doo; Bae, Sung Won; Lee, Young Jin; Lee, Won Jae

2010-02-01

Korea Advanced Energy Research Institute (KAERI) conceived and started the development of MARS code with the main objective of producing a state-of-the-art realistic thermal hydraulic systems analysis code with multi-dimensional analysis capability. MARS achieves this objective by very tightly integrating the one dimensional RELAP5/MOD3 with the multi-dimensional COBRA-TF codes. The method of integration of the two codes is based on the dynamic link library techniques, and the system pressure equation matrices of both codes are implicitly integrated and solved simultaneously. In addition, the Equation-Of-State (EOS) for the light water was unified by replacing the EOS of COBRA-TF by that of the RELAP5. This programmer's manual provides a complete list of overall information of code structure and input/output function of MARS. In addition, brief descriptions for each subroutine and major variables used in MARS are also included in this report, so that this report would be very useful for the code maintenance. The overall structure of the manual is modeled on the structure of the RELAP5 and as such the layout of the manual is very similar to that of the RELAP. This similitude to RELAP5 input is intentional as this input scheme will allow minimum modification between the inputs of RELAP5 and MARS3.1. MARS3.1 development team would like to express its appreciation to the RELAP5 Development Team and the USNRC for making this manual possible

Manual to radioactive waste management produced in hospitals, research and education centers

International Nuclear Information System (INIS)

Villasenor N, L.F.; Mejia L, M.

1996-01-01

This manual collects the experience on the disposal and management of the wastes produced in the preparation and application of radioactive material. Although the content is not so extensive, the authors have tried to provide the necessary guidelines and adequate information for the management of the wastes produced in hospitals and research and education centers. The objective of this work is to describe the basis and principles for the establishment of a minimization program, a segregation program and a provisional waste storage, in order to reduce the generation of wastes, personal exposure and the environmental impact. (authors). 5 refs

Quality Manual

Science.gov (United States)

Koch, Michael

The quality manual is the “heart” of every management system related to quality. Quality assurance in analytical laboratories is most frequently linked with ISO/IEC 17025, which lists the standard requirements for a quality manual. In this chapter examples are used to demonstrate, how these requirements can be met. But, certainly, there are many other ways to do this.

Le Nouveau Manuel de Formation sur l'Elaboration et la Gestion des Projets. (The New Project Design and Management Workshop Training Manual).

Science.gov (United States)

Peace Corps, Washington, DC. Information Collection and Exchange Div.

A french language version of a training manual that presents guidelines for planning and conducting a project design and management (PDM) workshop to teach Peace Corps volunteers to involve local community members in the process of using participatory analysis tools and planning and implementing projects meeting local desires and needs. The first…

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis.

Science.gov (United States)

Stautz, Kaidy; Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-02-28

In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

To What Extent do Clinical Practice Guidelines Respond to the Needs and Preferences of Patients Diagnosed with Obsessive-Compulsive Disorder?

Science.gov (United States)

Villena-Jimena, Amelia; Gómez-Ocaña, Clara; Amor-Mercado, Gisela; Núñez-Vega, Amanda; Morales-Asencio, José Miguel; Hurtado, María Magdalena

The number of Clinical Practice Guidelines (CPG) to help in making clinical decisions is increasing. However, there is currently a lack of CPG for Obsessive-Compulsive Disorder that take into account the requirements and expectations of the patients. The aim of the present study was to determine whether recommendations of the NICE guideline, "Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder" agrees with the needs and preferences of patients diagnosed with OCD in the mental health service. Two focal groups were formed with a total of 12 participants. They were asked about the impact of the disorder in their lives, their experiences with the mental health services, their satisfaction with treatments, and about their psychological resources. Preferences and needs were compared with the recommendations of the guidelines, and to facilitate their analysis, they were classified into four topics: information, accessibility, treatments, and therapeutic relationship. The results showed a high agreement between recommendations and patients preferences, particularly as regards high-intensity psychological interventions. Some discrepancies included the lack of prior low-intensity psychological interventions in mental health service, and the difficulty of rapid access the professionals. There is significant concordance between recommendations and patients preferences and demands, which are only partially responded to by the health services. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

SHARP User Manual

Energy Technology Data Exchange (ETDEWEB)

Yu, Y. Q. [Argonne National Lab. (ANL), Argonne, IL (United States); Shemon, E. R. [Argonne National Lab. (ANL), Argonne, IL (United States); Thomas, J. W. [Argonne National Lab. (ANL), Argonne, IL (United States); Mahadevan, Vijay S. [Argonne National Lab. (ANL), Argonne, IL (United States); Rahaman, Ronald O. [Argonne National Lab. (ANL), Argonne, IL (United States); Solberg, Jerome [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2016-03-31

SHARP is an advanced modeling and simulation toolkit for the analysis of nuclear reactors. It is comprised of several components including physical modeling tools, tools to integrate the physics codes for multi-physics analyses, and a set of tools to couple the codes within the MOAB framework. Physics modules currently include the neutronics code PROTEUS, the thermal-hydraulics code Nek5000, and the structural mechanics code Diablo. This manual focuses on performing multi-physics calculations with the SHARP ToolKit. Manuals for the three individual physics modules are available with the SHARP distribution to help the user to either carry out the primary multi-physics calculation with basic knowledge or perform further advanced development with in-depth knowledge of these codes. This manual provides step-by-step instructions on employing SHARP, including how to download and install the code, how to build the drivers for a test case, how to perform a calculation and how to visualize the results. Since SHARP has some specific library and environment dependencies, it is highly recommended that the user read this manual prior to installing SHARP. Verification tests cases are included to check proper installation of each module. It is suggested that the new user should first follow the step-by-step instructions provided for a test problem in this manual to understand the basic procedure of using SHARP before using SHARP for his/her own analysis. Both reference output and scripts are provided along with the test cases in order to verify correct installation and execution of the SHARP package. At the end of this manual, detailed instructions are provided on how to create a new test case so that user can perform novel multi-physics calculations with SHARP. Frequently asked questions are listed at the end of this manual to help the user to troubleshoot issues.

SHARP User Manual

International Nuclear Information System (INIS)

Yu, Y. Q.; Shemon, E. R.; Thomas, J. W.; Mahadevan, Vijay S.; Rahaman, Ronald O.; Solberg, Jerome

2016-01-01

SHARP is an advanced modeling and simulation toolkit for the analysis of nuclear reactors. It is comprised of several components including physical modeling tools, tools to integrate the physics codes for multi-physics analyses, and a set of tools to couple the codes within the MOAB framework. Physics modules currently include the neutronics code PROTEUS, the thermal-hydraulics code Nek5000, and the structural mechanics code Diablo. This manual focuses on performing multi-physics calculations with the SHARP ToolKit. Manuals for the three individual physics modules are available with the SHARP distribution to help the user to either carry out the primary multi-physics calculation with basic knowledge or perform further advanced development with in-depth knowledge of these codes. This manual provides step-by-step instructions on employing SHARP, including how to download and install the code, how to build the drivers for a test case, how to perform a calculation and how to visualize the results. Since SHARP has some specific library and environment dependencies, it is highly recommended that the user read this manual prior to installing SHARP. Verification tests cases are included to check proper installation of each module. It is suggested that the new user should first follow the step-by-step instructions provided for a test problem in this manual to understand the basic procedure of using SHARP before using SHARP for his/her own analysis. Both reference output and scripts are provided along with the test cases in order to verify correct installation and execution of the SHARP package. At the end of this manual, detailed instructions are provided on how to create a new test case so that user can perform novel multi-physics calculations with SHARP. Frequently asked questions are listed at the end of this manual to help the user to troubleshoot issues.

Dabigatran for the prevention of stroke and systemic embolism in atrial fibrillation: A NICE single technology appraisal.

Science.gov (United States)

Faria, Rita; Spackman, Eldon; Burch, Jane; Corbacho, Belen; Todd, Derick; Pepper, Chris; Woolacott, Nerys; Palmer, Stephen

2013-07-01

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of dabigatran etexilate (Boehringer Ingelheim Ltd, UK) to submit evidence for the clinical and cost-effectiveness of this drug for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF) as part of the NICE single technology appraisal process. The Centre for Reviews and Dissemination and the Centre for Health Economics at the University of York were commissioned to act as the evidence review group (ERG). This article presents a summary of the manufacturer's submission, the ERG report and the subsequent development of NICE guidance for the use of dabigatran within the UK National Health Service. Dabigatran was granted marketing authorisation by the European Medicines Agency for a sequential dosing regimen (DBG sequential), in which patients under 80 years are treated with dabigatran 150 mg twice daily (DBG150) and patients 80 years and over are given dabigatran 110 mg twice daily (DBG110). NICE decisions are bound by the marketing authorisation; therefore, the decision problem faced by the committee was whether the DBG sequential regimen was effective and cost-effective compared with warfarin or aspirin for patients with non-valvular AF and one or more risk factors. The RE-LY trial, a large multi-centre non-inferiority randomised clinical trial, was the primary source of clinical evidence. DBG150 was shown to be non-inferior, and subsequently superior to warfarin, for the primary outcome of all stroke/systemic embolism. DBG110 was found to be non-inferior to warfarin. Results were presented for a post hoc subgroup analysis for patients under and over 80 years of age, where DBG110 showed a statistically significant reduction of haemorrhagic stroke and intracranial haemorrhage in comparison to warfarin in patients over 80 years of age. This post hoc subgroup analysis by age was the basis for the licensed DBG sequential regimen

Development of instructional manual encouraging student active learning for high school teaching on fluid mechanics through Torricelli's tank experiment

Science.gov (United States)

Apiwan, Suttinee; Puttharugsa, Chokchai; Khemmani, Supitch

2018-01-01

The purposes of this research were to help students to perform Physics laboratory by themselves and to provide guidelines for high school teacher to develop active learning on fluid mechanics by using Torricelli's tank experiment. The research was conducted as follows: 1) constructed an appropriate Torricelli's tank experiment for high school teaching and investigated the condition for maximum water falling distance. As a consequence, it was found that the distance of the falling water measured from the experiment was shorter than that obtained from the theory of ideal fluid because of the energy loss during a flow, 2) developed instructional manual for high school teaching that encourages active learning by using problem based learning (PBL) approach, which is consistent with the trend of teaching and learning in 21st century. The content validity of our instructional manual using Index of Item-objective Congruence (IOC) as evaluated by three experts was over 0.67. The manual developed was therefore qualified for classroom practice.

Manual licensing procedure co-fermentation of manure. Guideline for the initiator; Handboek vergunningverlening co-vergisting van mest. Wegwijzer voor de initiatiefnemer

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-11-15

This manual helps licensers assess the opportunities and possible bottlenecks in applying for a license for a co-digester. The manual contains elaborate information on the safety of the co-digester, the influence on the environment, the smell, the noise and the transport movements. Moreover, the licensing procedure is explained [Dutch] Dit handboek helpt vergunningverleners bij het inschatten van de kansen en mogelijke knelpunten bij de aanvraag voor een co-vergister. Het handboek bevat uitgebreide informatie over de veiligheid van de co-vergister, de invloed op de omgeving, de geur, het geluid en transportbewegingen. Daarnaast komt de procedure rond de vergunningverlening aan bod.

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service.

Science.gov (United States)

Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M

2015-01-01

The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the 'Guidelines on prevention & management of foot problems in Type 2 Diabetes' by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

Directory of Open Access Journals (Sweden)

Alexandra Ryan

2015-06-01

Full Text Available Objective: The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods: An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE. Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results: An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot. Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion: During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

Model for Analysis of Energy Demand (MAED-2). User's manual

International Nuclear Information System (INIS)

2007-01-01

The IAEA has been supporting its Member States in the area of energy planning for sustainable development. Development and dissemination of appropriate methodologies and their computer codes are important parts of this support. This manual has been produced to facilitate the use of the MAED model: Model for Analysis of Energy Demand. The methodology of the MAED model was originally developed by. B. Chateau and B. Lapillonne of the Institute Economique et Juridique de l'Energie (IEJE) of the University of Grenoble, France, and was presented as the MEDEE model. Since then the MEDEE model has been developed and adopted to be appropriate for modelling of various energy demand system. The IAEA adopted MEDEE-2 model and incorporated important modifications to make it more suitable for application in the developing countries, and it was named as the MAED model. The first version of the MAED model was designed for the DOS based system, which was later on converted for the Windows system. This manual presents the latest version of the MAED model. The most prominent feature of this version is its flexibility for representing structure of energy consumption. The model now allows country-specific representations of energy consumption patterns using the MAED methodology. The user can now disaggregate energy consumption according to the needs and/or data availability in her/his country. As such, MAED has now become a powerful tool for modelling widely diverse energy consumption patterns. This manual presents the model in details and provides guidelines for its application

Model for Analysis of Energy Demand (MAED-2). User's manual

International Nuclear Information System (INIS)

2006-01-01

The IAEA has been supporting its Member States in the area of energy planning for sustainable development. Development and dissemination of appropriate methodologies and their computer codes are important parts of this support. This manual has been produced to facilitate the use of the MAED model: Model for Analysis of Energy Demand. The methodology of the MAED model was originally developed by. B. Chateau and B. Lapillonne of the Institute Economique et Juridique de l'Energie (IEJE) of the University of Grenoble, France, and was presented as the MEDEE model. Since then the MEDEE model has been developed and adopted to be appropriate for modelling of various energy demand system. The IAEA adopted MEDEE-2 model and incorporated important modifications to make it more suitable for application in the developing countries, and it was named as the MAED model. The first version of the MAED model was designed for the DOS based system, which was later on converted for the Windows system. This manual presents the latest version of the MAED model. The most prominent feature of this version is its flexibility for representing structure of energy consumption. The model now allows country-specific representations of energy consumption patterns using the MAED methodology. The user can now disaggregate energy consumption according to the needs and/or data availability in her/his country. As such, MAED has now become a powerful tool for modelling widely diverse energy consumption patterns. This manual presents the model in details and provides guidelines for its application

Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit.

Science.gov (United States)

Audit, National Prospective Tonsillectomy

2008-08-01

The National Institute for Health and Clinical Excellence (NICE) issued guidance on surgical techniques for tonsillectomy during a national audit of surgical practice and postoperative complications. To assess the impact of the guidance on tonsillectomy practice and outcomes. An interrupted time-series analysis of routinely collected Hospital Episodes Statistics data, and an analysis of longitudinal trends in surgical technique using data from the National Prospective Tonsillectomy Audit. Patients undergoing tonsillectomy in English NHS hospitals between January 2002 and December 2004. Postoperative haemorrhage within 28 days. The rate of haemorrhage increased by 0.5% per year from 2002, reaching 6.4% when the guidance was published. After publication, the rate of haemorrhage fell immediately to 5.7% (difference 0.7%: 95% CI -1.3% to 0.0%) and the rate of increase appeared to have stopped. Data from the National Prospective Tonsillectomy Audit showed that the fall coincided with a shift in surgical techniques, which was consistent with the guidance. NICE guidance influenced surgical tonsillectomy technique and in turn produced an immediate fall in postoperative haemorrhage. The ongoing national audit and strong support from the surgical specialist association may have aided its implementation.

Fuel Element Technical Manual

Energy Technology Data Exchange (ETDEWEB)

Burley, H.H. [ed.

1956-08-01

It is the purpose of the Fuel Element Technical Manual to Provide a single document describing the fabrication processes used in the manufacture of the fuel element as well as the technical bases for these processes. The manual will be instrumental in the indoctrination of personnel new to the field and will provide a single data reference for all personnel involved in the design or manufacture of the fuel element. The material contained in this manual was assembled by members of the Engineering Department and the Manufacturing Department at the Hanford Atomic Products Operation between the dates October, 1955 and June, 1956. Arrangement of the manual. The manual is divided into six parts: Part I--introduction; Part II--technical bases; Part III--process; Part IV--plant and equipment; Part V--process control and improvement; and VI--safety.

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.

Guidelines for children's work in agriculture: implications for the future.

Science.gov (United States)

Marlenga, Barbara; Lee, Barbara C; Pickett, William

2012-01-01

The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to assist parents in assigning developmentally appropriate and safe farm work to their children aged 7-16 years. Since their release in 1999, a growing body of evidence has accumulated regarding the content and application of these guidelines to populations of working children on farms. The purpose of this paper is to review the scientific and programmatic evidence about the content, efficacy, application, and uptake of NAGCAT and propose key recommendations for the future. The methods for this review included a synthesis of the peer-reviewed literature and programmatic evidence gathered from safety professionals. From the review, it is clear that the NAGCAT tractor guidelines and the manual material handling guidelines need to be updated based upon the latest empirical evidence. While NAGCAT do have the potential to prevent serious injuries to working children in the correct age range (7-16 years), the highest incidence of farm related injuries and fatalities occur to children aged 1-6 years and NAGCAT are unlikely to have any direct effect on this leading injury problem. It is also clear that NAGCAT, as a voluntary educational strategy, is not sufficient by itself to protect children working on farms. Uptake of NAGCAT has been sporadic, despite being geographically widespread and has depended, almost solely, on a few interested and committed professionals. Key recommendations for the future are provided based upon this review.

Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

Science.gov (United States)

Merriweather, Judith; Smith, Pam; Walsh, Timothy

2014-03-01

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

Incidence of infective endocarditis in England, 2000-13: a secular trend, interrupted time-series analysis.

Science.gov (United States)

Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M; Lockhart, Peter B; Thornhill, Martin H

2015-03-28

Antibiotic prophylaxis given before invasive dental procedures in patients at risk of developing infective endocarditis has historically been the focus of infective endocarditis prevention. Recent changes in antibiotic prophylaxis guidelines in the USA and Europe have substantially reduced the number of patients for whom antibiotic prophylaxis is recommended. In the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of infective endocarditis in March, 2008. We aimed to investigate changes in the prescribing of antibiotic prophylaxis and the incidence of infective endocarditis since the introduction of these guidelines. We did a retrospective secular trend study, analysed as an interrupted time series, to investigate the effect of antibiotic prophylaxis versus no prophylaxis on the incidence of infective endocarditis in England. We analysed data for the prescription of antibiotic prophylaxis from Jan 1, 2004, to March 31, 2013, and hospital discharge episode statistics for patients with a primary diagnosis of infective endocarditis from Jan 1, 2000, to March 31, 2013. We compared the incidence of infective endocarditis before and after the introduction of the NICE guidelines using segmented regression analysis of the interrupted time series. Prescriptions of antibiotic prophylaxis for the prevention of infective endocarditis fell substantially after introduction of the NICE guidance (mean 10,900 prescriptions per month [Jan 1, 2004, to March 31, 2008] vs 2236 prescriptions per month [April 1, 2008, to March 31, 2013], pinfective endocarditis increased significantly above the projected historical trend, by 0·11 cases per 10 million people per month (95% CI 0·05-0·16, pinfective endocarditis was significant for both individuals at high risk of infective endocarditis and those at lower risk. Although our data do not establish a causal association, prescriptions

Radiological control manual. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Kloepping, R.

1996-05-01

This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.

Radiological control manual. Revision 1

International Nuclear Information System (INIS)

Kloepping, R.

1996-05-01

This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP

CRISP instrument manual

International Nuclear Information System (INIS)

Bucknall, D.G.; Langridge, Sean

1997-05-01

This document is a user manual for CRISP, one of the two neutron reflectomers at ISIS. CRISP is highly automated allowing precision reproducible measurements. The manual provides detailed instructions for the setting-up and running of the instrument and advice on data analysis. (UK)

Calculations of Financial Incentives for Providers in a Pay-for-Performance Program: Manual Review Versus Data From Structured Fields in Electronic Health Records.

Science.gov (United States)

Urech, Tracy H; Woodard, LeChauncy D; Virani, Salim S; Dudley, R Adams; Lutschg, Meghan Z; Petersen, Laura A

2015-10-01

Hospital report cards and financial incentives linked to performance require clinical data that are reliable, appropriate, timely, and cost-effective to process. Pay-for-performance plans are transitioning to automated electronic health record (EHR) data as an efficient method to generate data needed for these programs. To determine how well data from automated processing of structured fields in the electronic health record (AP-EHR) reflect data from manual chart review and the impact of these data on performance rewards. Cross-sectional analysis of performance measures used in a cluster randomized trial assessing the impact of financial incentives on guideline-recommended care for hypertension. A total of 2840 patients with hypertension assigned to participating physicians at 12 Veterans Affairs hospital-based outpatient clinics. Fifty-two physicians and 33 primary care personnel received incentive payments. Overall, positive and negative agreement indices and Cohen's kappa were calculated for assessments of guideline-recommended antihypertensive medication use, blood pressure (BP) control, and appropriate response to uncontrolled BP. Pearson's correlation coefficient was used to assess how similar participants' calculated earnings were between the data sources. By manual chart review data, 72.3% of patients were considered to have received guideline-recommended antihypertensive medications compared with 65.0% by AP-EHR review (κ=0.51). Manual review indicated 69.5% of patients had controlled BP compared with 66.8% by AP-EHR review (κ=0.87). Compared with 52.2% of patients per the manual review, 39.8% received an appropriate response by AP-EHR review (κ=0.28). Participants' incentive payments calculated using the 2 methods were highly correlated (r≥0.98). Using the AP-EHR data to calculate earnings, participants' payment changes ranged from a decrease of $91.00 (-30.3%) to an increase of $18.20 (+7.4%) for medication use (interquartile range, -14.4% to 0

Salinas : theory manual.

Energy Technology Data Exchange (ETDEWEB)

Walsh, Timothy Francis; Reese, Garth M.; Bhardwaj, Manoj Kumar

2004-08-01

This manual describes the theory behind many of the constructs in Salinas. For a more detailed description of how to use Salinas , we refer the reader to Salinas, User's Notes. Many of the constructs in Salinas are pulled directly from published material. Where possible, these materials are referenced herein. However, certain functions in Salinas are specific to our implementation. We try to be far more complete in those areas. The theory manual was developed from several sources including general notes, a programer-notes manual, the user's notes and of course the material in the open literature.

PCs The Missing Manual

CERN Document Server

Karp, David

2005-01-01

Your vacuum comes with one. Even your blender comes with one. But your PC--something that costs a whole lot more and is likely to be used daily and for tasks of far greater importance and complexity--doesn't come with a printed manual. Thankfully, that's not a problem any longer: PCs: The Missing Manual explains everything you need to know about PCs, both inside and out, and how to keep them running smoothly and working the way you want them to work. A complete PC manual for both beginners and power users, PCs: The Missing Manual has something for everyone. PC novices will appreciate the una

Canadian Schizophrenia Guidelines: Schizophrenia and Other Psychotic Disorders with Coexisting Substance Use Disorders.

Science.gov (United States)

Crockford, David; Addington, Donald

2017-09-01

Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders. We reviewed guidelines that were published in the last 5 years and that included systematic reviews or meta-analyses. Most of our recommendations came from 2 publications from the National Institute for Health and Care Excellence (NICE): the 2011 guidance titled Coexisting Severe Mental Illness (Psychosis) and Substance Misuse: Assessment and Management in Healthcare Settings and the 2014 guidance titled Psychosis and Schizophrenia in Adults: Prevention and Management. We placed these recommendations into the Canadian context to create this guideline. Evidence supports the inclusion of individuals with coexisting substance use disorders in first-episode psychosis programs. The programs should integrate psychosis and substance use treatments, emphasizing ongoing monitoring of both substance use and patterns and symptoms. The best outcomes are achieved with combined use of antipsychotic medications and addiction-based psychosocial interventions. However, limited evidence is available to recommend using one antipsychotic medication over another or one psychosocial intervention over another for persons with schizophrenia and other psychotic disorders with coexisting substance use disorders. Treating persons who have schizophrenia and other psychotic disorders with coexisting substance use disorders can present clinical challenges, but modifications in practice can help engage and retain people in treatment, where significant improvements over time can be expected.

Guidelines for the verification and validation of expert system software and conventional software: Rationale and description of V ampersand V guideline packages and procedures. Volume 5

International Nuclear Information System (INIS)

Mirsky, S.M.; Hayes, J.E.; Miller, L.A.

1995-03-01

This report is the fifth volume in a series of reports describing the results of the Expert System Verification C, and Validation (V ampersand V) project which is jointly funded by the U.S. Nuclear Regulatory Commission and the Electric Power Research Institute toward the objective of formulating Guidelines for the V ampersand V of expert systems for use in nuclear power applications. This report provides the rationale for and description of those guidelines. The actual guidelines themselves are presented in Volume 7, open-quotes User's Manual.close quotes Three factors determine what V ampersand V is needed: (1) the stage of the development life cycle (requirements, design, or implementation); (2) whether the overall system or a specialized component needs to be tested (knowledge base component, inference engine or other highly reusable element, or a component involving conventional software); and (3) the stringency of V ampersand V that is needed (as judged from an assessment of the system's complexity and the requirement for its integrity to form three Classes). A V ampersand V Guideline package is provided for each of the combinations of these three variables. The package specifies the V ampersand V methods recommended and the order in which they should be administered, the assurances each method provides, the qualifications needed by the V ampersand V team to employ each particular method, the degree to which the methods should be applied, the performance measures that should be taken, and the decision criteria for accepting, conditionally accepting, or rejecting an evaluated system. In addition to the Guideline packages, highly detailed step-by-step procedures are provided for 11 of the more important methods, to ensure that they can be implemented correctly. The Guidelines can apply to conventional procedural software systems as well as all kinds of Al systems

International co-operation and the future of nuclear power. European Nuclear Congress '98, Nice, 26 October 1998

International Nuclear Information System (INIS)

ElBaradei, M.

1998-01-01

The document reproduces the text of the conference given by the Director General of the IAEA at the joint Opening Session of the European Nuclear Congress'98 (ENC) and RECOD in Nice, France, on 26 october 1998. The conference emphasized the importance of strengthened international co-operation in all areas relevant to the safe and peaceful use of nuclear energy, especially for power generation. As the only intergovernmental global organization dedicated to nuclear science and technology, the role of the IAEA is to serve as the international focal point for standard setting, independent analysis, technology transfer and oversight and verification

Rivaroxaban for Preventing Atherothrombotic Events in People with Acute Coronary Syndrome and Elevated Cardiac Biomarkers: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

Science.gov (United States)

Pandor, Abdullah; Pollard, Daniel; Chico, Tim; Henderson, Robert; Stevenson, Matt

2016-05-01

As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures rivaroxaban (Xarelto, Bayer) to submit evidence of the clinical and cost effectiveness of rivaroxaban for the prevention of adverse outcomes in patients after the acute management of acute coronary syndrome (ACS). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology, based upon the company's submission to NICE. The evidence was derived mainly from a randomised, double-blind, phase III, placebo-controlled trial of rivaroxaban (either 2.5 or 5 mg twice daily) in patients with recent ACS [unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation myocardial infarction (STEMI)]. In addition, all patients received antiplatelet therapy [aspirin alone or aspirin and a thienopyridine either as clopidogrel (approximately 99 %) or ticlopidine (approximately 1 %) according to national or local guidelines]. The higher dose of rivaroxaban (5 mg twice daily) did not form part of the marketing authorisation. A post hoc subgroup analysis of the licensed patients who had ACS with elevated cardiac biomarkers (that is, patients with STEMI and NSTEMI) without prior stroke or transient ischaemic stroke showed that compared with standard care, the addition of rivaroxaban (2.5 mg twice daily) to existing antiplatelet therapy reduced the composite endpoint of cardiovascular mortality, myocardial infarction or stroke, but increased the risk of major bleeding and intracranial haemorrhage. However, there were a number of limitations in the evidence base that warrant caution in its interpretation. In particular, the evidence may be confounded because of the post hoc subgroup

Efficacy of a self-help manual in increasing resilience in carers of adults with depression in Thailand

OpenAIRE

McCann, Terence V.; Songprakun, Wallapa; Stephenson, John

2016-01-01

Caring for a person with a mental illness can have adverse effects on caregivers; however, little is known about how best to help such caregivers. The aim of the present study was to examine the efficacy of a cognitive behaviour therapy-guided self-help manual in increasing resilience in caregivers of individuals with depression, in comparison to caregivers who receive routine support only. A randomized, controlled trial was conducted, following CONSORT guidelines, with 54 caregivers allocate...

Ramucirumab for Treating Advanced Gastric Cancer or Gastro-Oesophageal Junction Adenocarcinoma Previously Treated with Chemotherapy : An Evidence Review Group Perspective of a NICE Single Technology Appraisal

NARCIS (Netherlands)

Büyükkaramikli, N.; H.M. Blommestein (Hedwig); R. Riemsma (Rob); N. Armstrong (Nigel); F.J. Clay (Fiona); J. Ross (Janine); G. Worthy (Gill); J.L. Severens (Hans); J. Kleijnen (Jos); M.J. Al (Maiwenn)

2017-01-01

textabstractThe National Institute for Health and Care Excellence (NICE) invited the company that manufactures ramucirumab (Cyramza®, Eli Lilly and Company) to submit evidence of the clinical and cost effectiveness of the drug administered alone (monotherapy) or with paclitaxel (combination therapy)

Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual

OpenAIRE

Morisada, S.; Nosaka, N.; Tsukahara, K.; Ugawa, T.; Sato, K.; Ujike, Y.

2015-01-01

The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive b...

Eco-Innovation Manual

DEFF Research Database (Denmark)

O'Hare, Jamie Alexander; McAloone, Tim C.; Pigosso, Daniela Cristina Antelmi

Aim of this manual is to introduce a methodology for the implementation of eco‐innovation within small and medium sized companies in developing and emerging economies. The intended audience of this manual is organizations that provide professional services to guide and support manufacturing compa...... companies to improve their sustainability performance....

Safety handling manual for high dose rate remote afterloading system

International Nuclear Information System (INIS)

1999-01-01

This manual is mainly for safety handling of 192 Ir-RALS (remote afterloading system) of high dose rate and followings were presented: Procedure and document format for the RALS therapy and for handling of its radiation source with the purpose of prevention of human errors and unexpected accidents, Procedure for preventing errors occurring in the treatment schedule and operation, and Procedure and format necessary for newly introducing the system into a facility. Consistency was intended in the description with the quality assurance guideline for therapy with small sealed radiation sources made by JASTRO (Japan Society for Therapeutic Radiology and Oncology). Use of the old type 60 Co-RALS was pointed out to be a serious problem remained and its safety handling procedure was also presented. (K.H.)

Does GEM-Encoding Clinical Practice Guidelines Improve the Quality of Knowledge Bases? A Study with the Rule-Based Formalism

Science.gov (United States)

Georg, Gersende; Séroussi, Brigitte; Bouaud, Jacques

2003-01-01

The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results. PMID:14728173

Does GEM-encoding clinical practice guidelines improve the quality of knowledge bases? A study with the rule-based formalism.

Science.gov (United States)

Georg, Georg; Séroussi, Brigitte; Bouaud, Jacques

2003-01-01

The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results.

The influence of standards and clinical guidelines on prosthetic and orthotic service quality: a scoping review.

Science.gov (United States)

Sadeghi-Demneh, Ebrahim; Forghany, Saeed; Onmanee, Pornsuree; Trinler, Ursula; Dillon, Michael P; Baker, Richard

2017-06-20

Standards and guidelines are an integral part of prosthetic and orthotic service delivery in the developed world underpinned by an assumption that they lead to improved services. Implementing them has a cost, however, and that cost needs to be justified, particularly in resource-limited environments. This scoping review thus asks the question, "What is the evidence of the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics?" A structured search of three electronic databases (Medline, Scopus and Web of Science) followed by manual searching of title, abstract and full text, yielded 29 articles. Four categories of papers were identified: Descriptions and Commentaries (17 papers), Guideline Development (7), Guideline Testing (2) and Standards implementation (3). No articles were explicitly designed to assess the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics. Studies tended to be commentaries on or descriptions of guideline development, testing or implementation of standards. The literature is not sufficiently well developed to warrant the cost and effort of a systematic review. Future primary research should seek to demonstrate whether and how guidelines and standards improve the outcomes for people that require prostheses, orthoses and other assistive devices. Implications for Rehabilitation International Standards and Clinical Guidelines are now an integral part of clinical service provision in prosthetics and orthotics in the developed world. Complying with standards and guidelines has a cost and, particularly in resource-limited environments, it should be possible to justify this in terms of the resulting benefits. This scoping review concludes that there have been no previous studies designed to directly quantify the effects of implementing standards and guidelines on service delivery.

A methodological survey identified eight proposed frameworks for the adaptation of health related guidelines.

Science.gov (United States)

Darzi, Andrea; Abou-Jaoude, Elias A; Agarwal, Arnav; Lakis, Chantal; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; El-Jardali, Fadi; Schünemann, Holger J; Akl, Elie A

2017-06-01

Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines. We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines. We followed standard systematic review methodology. Our search captured 12,021 citations, out of which we identified eight proposed methods of guidelines adaptation: ADAPTE, Adapted ADAPTE, Alberta Ambassador Program adaptation phase, GRADE-ADOLOPMENT, MAGIC, RAPADAPTE, Royal College of Nursing (RCN), and Systematic Guideline Review (SGR). The ADAPTE framework consists of a 24-step process to adapt guidelines to a local context taking into consideration the needs, priorities, legislation, policies, and resources. The Alexandria Center for Evidence-Based Clinical Practice Guidelines updated one of ADAPTE's tools, modified three tools, and added three new ones. In addition, they proposed optionally using three other tools. The Alberta Ambassador Program adaptation phase consists of 11 steps and focused on adapting good-quality guidelines for nonspecific low back pain into local context. GRADE-ADOLOPMENT is an eight-step process based on the GRADE Working Group's Evidence to Decision frameworks and applied in 22 guidelines in the context of national guideline development program. The MAGIC research program developed a five-step adaptation process, informed by ADAPTE and the GRADE approach in the context of adapting thrombosis guidelines. The RAPADAPTE framework consists of 12 steps based on ADAPTE and using synthesized evidence databases, retrospectively derived from the experience of producing a high-quality guideline for the treatment of breast cancer with limited resources in Costa Rica. The RCN outlines

FINAS. Example manual. 2

International Nuclear Information System (INIS)

Iwata, Koji; Tsukimori, Kazuyuki; Ueno, Mutsuo

2003-12-01

FINAS is a general purpose structural analysis computer program which was developed by Japan Nuclear Cycle Development Institute for the analysis of static, dynamic and thermal responses of elastic and inelastic structures by the finite element method. This manual contains typical analysis examples that illustrate applications of FINAS to a variety of structural engineering problems. The first part of this manual presents fundamental examples in which numerical solutions by FINAS are compared with some analytical reference solutions, and the second part of this manual presents more complex examples intended for practical application. All the input data images and principal results for each problem are included in this manual for beginners' convenience. All the analyses are performed by using the FINAS Version 13.0. (author)

Biosafety Manual

Energy Technology Data Exchange (ETDEWEB)

King, Bruce W.

2010-05-18

Work with or potential exposure to biological materials in the course of performing research or other work activities at Lawrence Berkeley National Laboratory (LBNL) must be conducted in a safe, ethical, environmentally sound, and compliant manner. Work must be conducted in accordance with established biosafety standards, the principles and functions of Integrated Safety Management (ISM), this Biosafety Manual, Chapter 26 (Biosafety) of the Health and Safety Manual (PUB-3000), and applicable standards and LBNL policies. The purpose of the Biosafety Program is to protect workers, the public, agriculture, and the environment from exposure to biological agents or materials that may cause disease or other detrimental effects in humans, animals, or plants. This manual provides workers; line management; Environment, Health, and Safety (EH&S) Division staff; Institutional Biosafety Committee (IBC) members; and others with a comprehensive overview of biosafety principles, requirements from biosafety standards, and measures needed to control biological risks in work activities and facilities at LBNL.

Guideline for safe and eco-friendly biomass gasification

Energy Technology Data Exchange (ETDEWEB)

Vos, J.; Knoef, H. (BTG biomass technology group, Enschede (Netherlands)); Hauth, M. (Graz Univ. of Technology. Institute of Thermal Engineering, Graz (Austria)) (and others)

2009-11-15

The objective of the Gasification Guide project is to accelerate the market penetration of small-scale biomass gasification systems (< 5 MW fuel power) by the development of a Guideline and Software Tool to facilitate risk assessment of HSE aspects. The Guideline may also be applied in retrofitting or converting old thermal plants in the Eastern European countries - with rich biomass recourses - to new gasification plants. The objective of this document is to guide key target groups identifying potential hazards and make a proper risk assessment. The software tool is an additional aid in the risk assessment. This guideline is intended to be a training tool and a resource for workers and employers to safely design, fabricate, construct, operate and maintain small-scale biomass gasification facilities. The Guideline is applicable with the following constraints: 1) The maximum scale of the gasification plant was agreed to be about 1 MW{sub e}. The reason is that large companies do have normally their safety rules in place; 2) This means in principle only fixed bed gasifier designs. However, most parts are also valid to other designs and even other thermal conversion processes; 3) The use of contaminated biomass is beyond the scope of this Guideline. The Guideline contains five major chapters; Chapter 2 briefly describes the gasification technology in general. Chapter 3 gives an overview of major legal framework issues on plant permission and operation. The legal frame is changing and the description is based on the situation by the end of 2007. Chapter 4 explains the theory behind the risk assessment method and risk reduction measures. Chapter 5 is the heart of the Guideline and gives practical examples of good design, operation and maintenance principles. The practical examples and feedback have been received throughout the project and the description is based on mid-2009. Chapter 6 describes the best techniques currently available for emission abatement which are

ACT Plan: Technical Manual. 2013/2014

Science.gov (United States)

ACT, Inc., 2013

2013-01-01

This manual contains information about the American College Test (ACT) Plan® program. The principal focus of this manual is to document the Plan program's technical adequacy in light of its intended purposes. This manual supersedes the 2011 edition. The content of this manual responds to requirements of the testing industry as established in the…

Winter snow conditions on Arctic sea ice north of Svalbard during the Norwegian young sea ICE (N-ICE2015) expedition

Science.gov (United States)

Merkouriadi, Ioanna; Gallet, Jean-Charles; Graham, Robert M.; Liston, Glen E.; Polashenski, Chris; Rösel, Anja; Gerland, Sebastian

2017-10-01

Snow is a crucial component of the Arctic sea ice system. Its thickness and thermal properties control heat conduction and radiative fluxes across the ocean, ice, and atmosphere interfaces. Hence, observations of the evolution of snow depth, density, thermal conductivity, and stratigraphy are crucial for the development of detailed snow numerical models predicting energy transfer through the snow pack. Snow depth is also a major uncertainty in predicting ice thickness using remote sensing algorithms. Here we examine the winter spatial and temporal evolution of snow physical properties on first-year (FYI) and second-year ice (SYI) in the Atlantic sector of the Arctic Ocean, during the Norwegian young sea ICE (N-ICE2015) expedition (January to March 2015). During N-ICE2015, the snow pack consisted of faceted grains (47%), depth hoar (28%), and wind slab (13%), indicating very different snow stratigraphy compared to what was observed in the Pacific sector of the Arctic Ocean during the SHEBA campaign (1997-1998). Average snow bulk density was 345 kg m-3 and it varied with ice type. Snow depth was 41 ± 19 cm in January and 56 ± 17 cm in February, which is significantly greater than earlier suggestions for this region. The snow water equivalent was 14.5 ± 5.3 cm over first-year ice and 19 ± 5.4 cm over second-year ice.

National Survey of Neurosurgeons and Stroke Physicians on Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarction.

Science.gov (United States)

Basu, Pallavi; Jenkins, Harri; Tsang, Kevin; Vakharia, Vejay N

2017-06-01

Several studies have evaluated the use of decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMCAI). In the United Kingdom, the National Institute for Health and Care Excellence (NICE) has set criteria for selection of patients for DHC in MMCAI. We set out to survey the attitudes and practice of neurosurgeons and stroke physicians within the United Kingdom towards DHC in MMCAI. An electronic survey of questions on management of MMCAI in various clinical scenarios was submitted to the academic committees of the Society of British Neurological Surgeons and the British Association of Stroke Physicians for approval before dissemination through the consultant members. Responses were collected over 2 months. A total of 78 responses, from 51 neurosurgeons and 27 stroke physicians, were included in final analysis. A total of 54% and 24% of all respondents would recommend DHC in patients aged 60-70 and 70-80 years, respectively; 60% would advocate surgery between 48 and 72 hours and 27% beyond 72 hours. A total of 36% indicated DHC with preoperative Glasgow Coma Scale 15/15. These findings do not conform to current NICE guidelines. Stroke physicians were statistically more likely to recommend DHC in patients older than 60 years (P = 0.032) and in those with dominant multiterritorial infarcts (P = 0.042) and accept a greater postoperative modified Rankin Scale (P = 0.034) compared with neurosurgeons. In view of evidence from recent trials and differences in NICE guidelines and current clinical practice within the United Kingdom, based on our survey results, it is important to reevaluate NICE guidelines. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Guidelines for the verification and validation of expert system software and conventional software: Volume 5, Rationale and description of verification and validation guideline packages and procedures. Final report

International Nuclear Information System (INIS)

Miller, L.A.; Hayes, J.E.; Mirsky, S.M.

1995-05-01

This report is the fifth volume in a series of reports describing the results of the Expert System Verification and Validation (V ampersand V) project which is jointly funded by US NRC and EPRI toward formulating guidelines for V ampersand V of expert systems for use in nuclear power applications. This report provides the rationale for and description of those guidelines. The actual guidelines themselves (and the accompanying 11 step by step Procedures) are presented in Volume 7, User's Manual. Three factors determine what V ampersand V is needed: (1) the stage, of the development life cycle (requirements, design, or implementation), (2) whether the overall system or a specialized component needs be tested (knowledge base component, inference engine or other highly reusable element, or a component involving conventional software), and (3) the stringency of V ampersand V that is needed (as judged from an assessment of the system's complexity and the requirement for its integrity to form three Classes). A V ampersand V guideline package is provided for each of the combinations of these three variables. The package specifies the V ampersand V methods recommended and the order in which they should be administered, the assurances each method provides, the qualifications needed by the V ampersand V team to employ each Particular method, the degree to which the methods should be applied, the performance measures that should be taken, and the decision criteria for accepting, conditionally accepting, or rejecting an evaluated system. In addition to the guideline packages, highly detailed step-by-step procedures are provided for 11 of the more important methods, to ensure that they Can be implemented correctly. The guidelines can apply to conventional procedural software systems as well as all kinds of AI systems

GRACE manual

International Nuclear Information System (INIS)

Ishikawa, T.; Kawabata, S.; Shimizu, Y.; Kaneko, T.; Kato, K.; Tanaka, H.

1993-02-01

This manual is composed of three kinds of objects, theoretical background for calculating the cross section of elementary process, usage and technical details of the GRACE system. Throughout this manual we take the tree level process e + e - → W + W - γ as an example, including the e ± -scalar boson interactions. The real FORTRAN source code for this process is attached in the relevant sections as well as the results of calculation, which might be a great help for understanding the practical use of the system. (J.P.N.)

EML procedures manual

International Nuclear Information System (INIS)

Volchok, H.L.; de Planque, G.

1982-01-01

This manual contains the procedures that are used currently by the Environmental Measurements Laboratory of the US Department of Energy. In addition a number of analytical methods from other laboratories have been included. These were tested for reliability at the Battelle, Pacific Northwest Laboratory under contract with the Division of Biomedical and Environmental Research of the AEC. These methods are clearly distinguished. The manual is prepared in loose leaf form to facilitate revision of the procedures and inclusion of additional procedures or data sheets. Anyone receiving the manual through EML should receive this additional material automatically. The contents are as follows: (1) general; (2) sampling; (3) field measurements; (4) general analytical chemistry; (5) chemical procedures; (6) data section; (7) specifications

NASA Nice Climate Change Education

Science.gov (United States)

Frink, K.; Crocker, S.; Jones, W., III; Marshall, S. S.; Anuradha, D.; Stewart-Gurley, K.; Howard, E. M.; Hill, E.; Merriweather, E.

2013-12-01

Authors: 1 Kaiem Frink, 4 Sherry Crocker, 5 Willie Jones, III, 7 Sophia S.L. Marshall, 6 Anuadha Dujari 3 Ervin Howard 1 Kalota Stewart-Gurley 8 Edwinta Merriweathe Affiliation: 1. Mathematics & Computer Science, Virginia Union University, Richmond, VA, United States. 2. Mathematics & Computer Science, Elizabeth City State Univ, Elizabeth City, NC, United States. 3. Education, Elizabeth City State University, Elizabeth City, NC, United States. 4. College of Education, Fort Valley State University , Fort Valley, GA, United States. 5. Education, Tougaloo College, Jackson, MS, United States. 6. Mathematics, Delaware State University, Dover, DE, United States. 7. Education, Jackson State University, Jackson, MS, United States. 8. Education, Alabama Agricultural and Mechanical University, Huntsville, AL, United States. ABSTRACT: In this research initiative, the 2013-2014 NASA NICE workshop participants will present best educational practices for incorporating climate change pedagogy. The presentation will identify strategies to enhance instruction of pre-service teachers to aligned with K-12 Science, Technology, Engineering and Mathematics (STEM) standards. The presentation of best practices should serve as a direct indicator to address pedagogical needs to include climate education within a K-12 curriculum Some of the strategies will include inquiry, direct instructions, and cooperative learning . At this particular workshop, we have learned about global climate change in regards to how this is going to impact our life. Participants have been charged to increase the scientific understanding of pre-service teachers education programs nationally to incorporate climate education lessons. These recommended practices will provide feasible instructional strategies that can be easily implemented and used to clarify possible misconceptions and ambiguities in scientific knowledge. Additionally, the presentation will promote an awareness to the many facets in which climate

Partners Plus: Families and Caregivers in Partnerships. A Family-Centered Guide to Respite Care. Trainer's Workshop Manual [and] Community Planning Manual [and] A Family Manual [and] Caregiver Manual.

Science.gov (United States)

Ownby, Lisa L.; Hooke, Amanda C.; Moore, Dee Wylie; Garland, Corinne W.; Frank, Adrienne

Four manuals on implementing the Partners Respite Model, which provides respite care for children with disabilities or chronic illnesses, comprise this document. The Community Planning Manual offers a step-by-step guide to replication of the Partners Respite Model and is divided into sections on developing the Partners program, implementing the…

Exercise and manual physiotherapy arthritis research trial (EMPART: a multicentre randomised controlled trial

Directory of Open Access Journals (Sweden)

O'Connell Paul

2009-01-01

Full Text Available Abstract Background Osteoarthritis (OA of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy. Methods and design An assessor-blind multicentre RCT will be undertaken to compare the effect of a combination of manual therapy and exercise therapy, exercise therapy only, and a waiting-list control on physical function in hip OA. One hundred and fifty people with a diagnosis of hip OA will be recruited and randomly allocated to one of 3 groups: exercise therapy, exercise therapy with manual therapy and a waiting-list control. Subjects in the intervention groups will attend physiotherapy for 6–8 sessions over 8 weeks. Those in the control group will remain on the waiting list until after this time and will then be re-randomised to one of the two intervention groups. Outcome measures will include physical function (WOMAC, pain severity (numerical rating scale, patient perceived change (7-point Likert scale, quality of life (SF-36, mood (hospital anxiety and depression scale, patient satisfaction, physical activity (IPAQ and physical measures of range of motion, 50-foot walk and repeated sit-to stand tests. Discussion This RCT will compare the effectiveness of the addition of manual therapy to exercise therapy to exercise therapy only and a waiting-list control in hip OA. A high quality methodology will be used in keeping with CONSORT guidelines. The

The Structure of the Distant Kuiper Belt in a Nice Model Scenario

Energy Technology Data Exchange (ETDEWEB)

Pike, R. E.; Shankman, C. J.; Kavelaars, J. J. [Department of Physics and Astronomy, University of Victoria, Victoria, BC (Canada); Lawler, S. [National Research Council of Canada, Victoria, BC (Canada); Brasser, R. [Earth Life Science Institute, Tokyo Institute of Technology, Meguro, Tokyo 152-8550 (Japan); Alexandersen, M. [Institute of Astronomy and Astrophysics, Academia Sinica, Taipei 10617, Taiwan (China)

2017-03-01

This work explores the orbital distribution of minor bodies in the outer Solar System emplaced as a result of a Nice model migration from the simulations of Brasser and Morbidelli. This planetary migration scatters a planetesimal disk from between 29 and 34 au and emplaces a population of objects into the Kuiper Belt region. From the 2:1 Neptune resonance and outward, the test particles analyzed populate the outer resonances with orbital distributions consistent with trans-Neptunian object (TNO) detections in semimajor axis, inclination, and eccentricity, while capture into the closest resonances is too efficient. The relative populations of the simulated scattering objects and resonant objects in the 3:1 and 4:1 resonances are also consistent with observed populations based on debiased TNO surveys, but the 5:1 resonance is severely underpopulated compared to population estimates from survey results. Scattering emplacement results in the expected orbital distribution for the majority of the TNO populations; however, the origin of the large observed population in the 5:1 resonance remains unexplained.

Revised guidelines for good practice in IVF laboratories (2015).

Science.gov (United States)

De los Santos, Maria José; Apter, Susanna; Coticchio, Giovanni; Debrock, Sophie; Lundin, Kersti; Plancha, Carlos E; Prados, Fernando; Rienzi, Laura; Verheyen, Greta; Woodward, Bryan; Vermeulen, Nathalie

2016-04-01

Which recommendations can be provided by the European Society of Human Reproduction and Embryology Special Interest Group (ESHRE SIG) Embryology to support laboratory specialists in the organization and management of IVF laboratories and the optimization of IVF patient care? Structured in 13 sections, the guideline development group formulated recommendations for good practice in the organization and management of IVF laboratories, and for good practice of the specific procedures performed within the IVF laboratory. NA. The guideline was produced by a group of 10 embryologists representing different European countries, settings and levels of expertise. The group evaluated the document of 2008, and based on this assessment, each group member rewrote one or more sections. Two 2-day meetings were organized during which each of the recommendations was discussed and rewritten until consensus within the guideline group was reached. After finalizing the draft, the members of the ESHRE SIG embryology were invited to review the guideline. NA. The guideline provides recommendations on the general organization of an IVF laboratory (staffing and direction, quality management, laboratory safety), and on the specific aspects of the procedures performed in IVF laboratories (Identification of patients and traceability of their reproductive cells, consumables, handling of biological material, oocyte retrieval, sperm preparation, insemination of oocytes, scoring for fertilization, embryo culture and transfer, and cryopreservation). A last section provides recommendations regarding an Emergency plan for IVF laboratories. Evidence on most of the issues described is scarce, and therefore it was decided not to perform a formal search for and assessment of scientific evidence. However, recommendations published in the EUTCD and relevant and recent documents, manuals and consensus papers were taken into account when formulating the recommendations. Despite the limitations, the guideline

For information: A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. The last seminar will be about: Making presentations with Powerpoint 2003 (FR), Tuesday 22nd of June, 14:30. The seminars will take place in the IT Auditorium (bldg. 31, 3-005) and last for about one hour plus questions. No registration is necessary. More information is available at http://cern.ch/Win/Seminars/Tutorials. Interested users can also have a look to courses offered by CERN Technical Training, at http://cern.ch/humanresources/external/training/tech/office/te_office.asp.

The ISIS Open GENIE user manual

International Nuclear Information System (INIS)

Akeroyd, F.A.; Ashworth, R.L.; Campbell, S.I.; Johnston, S.D.; Martin, J.M.; Moreton-Smith, C.M.; Sivia, D.S.

2000-01-01

This manual should enable you to become familiar with Open GENIE quickly and easily. It therefore complements the Open GENIE Reference Manual which should be used to understand the full meaning of Open GENIE commands. The reference manual is accessible on the ISIS web server at: http://www.isis.rl.ac.uk/GENIEReferenceManual/ and the user manual is planned to be accessible by January '98 at http://www.isis.rl.ac.ukIGENIEUserManual/. The Open GENIE User Manual is separated into two parts: Part A. The User Manual. An introduction to the use of Open GENIE. Part B. The Installation Guide. General information on how to install and run Open GENIE. Assuming that you are new to Open GENIE and have just downloaded a copy you will need to consult the Installation Guide to get Open GENIE installed on your machine. After this we recommend you experiment with some of the example files to get an idea of the capabilities of Open GENIE. For further information, comments, additions of routines that you feel should be included, please contact us at genie at isise.rl.ac.uk

The operation and maintenance manual

International Nuclear Information System (INIS)

Stoll, A.; Krotil, H.; Klein, W.

1976-01-01

The operating manual is one of many technical documents which the nuclear power plant operator needs for ensuring safe operation. For the operating staff, however, there is only one document, namely the operating manual. The operating manual is an essential element in bringing man and machine in harmony. This is necessary for safe and, as far as possible, uninterrupted operation of the power plant. The operating manual is the only document containing binding instructions for plant operation. All the tasks of plant operation which are carried out by plant staff are described in the operating manual in a form which is as clear and comprehensible as possible. A considerable number of these tasks can only be carried out by man, namely: 1) tasks concerning operational organization, 2) all non-automated areas of plant operation. (orig./TK) [de

Fire Protection Program Manual

Energy Technology Data Exchange (ETDEWEB)

Sharry, J A

2012-05-18

This manual documents the Lawrence Livermore National Laboratory (LLNL) Fire Protection Program. Department of Energy (DOE) Orders 420.1B, Facility Safety, requires LLNL to have a comprehensive and effective fire protection program that protects LLNL personnel and property, the public and the environment. The manual provides LLNL and its facilities with general information and guidance for meeting DOE 420.1B requirements. The recommended readers for this manual are: fire protection officers, fire protection engineers, fire fighters, facility managers, directorage assurance managers, facility coordinators, and ES and H team members.

Lenalidomide for the Treatment of Low- or Intermediate-1-Risk Myelodysplastic Syndromes Associated with Deletion 5q Cytogenetic Abnormality: An Evidence Review of the NICE Submission from Celgene

NARCIS (Netherlands)

H.M. Blommestein (Hedwig); N. Armstrong (Nigel); S. Ryder; S. Deshpande (Sohan); G. Worthy (Gill); C. Noake; R. Riemsma (Rob); J. Kleijnen (Jos); J.L. Severens (Hans); M.J. Al (Maiwenn)

2016-01-01

textabstractThe National Institute for Health and Care Excellence (NICE) invited the manufacturer of lenalidomide (Celgene) to submit evidence of the clinical and cost effectiveness of the drug for treating adults with myelodysplastic syndromes (MDS) associated with deletion 5q cytogenetic

Emergency preparedness in Germany. Development of manuals for emergency exercises

International Nuclear Information System (INIS)

Bath, N.; Berg, H.P.

2001-01-01

Extensive technical and administrative measures are taken in the German nuclear power plants in order to be able to perform effective on-site accident management in case that an event actually occurs. Because of the 'beyond-design-basis' character of these accidents, there are no detailed regulations and guidelines for the development of emergency preparedness in Germany. However, it has become common practice to perform at least one emergency exercise per year in every German nuclear plant. Bundesamt fuer Strahlenschutz has launched a project for the development of a manual for planning, co-ordination, and assessment of on-site accident management exercises. The objective is to establish an approach with a sound technical basis harmonized on federal level. The current status of this project and further activities are described.(author)

ARS-Media for excel instruction manual

Science.gov (United States)

ARS-Media for Excel Instruction Manual is the instruction manual that explains how to use the Excel spreadsheet ARS-Media for Excel application. ARS-Media for Excel Instruction Manual is provided as a pdf file....

Radiologic measurement of extraocular muscle volumes in patients with Graves' orbitopathy: a review and guideline.

Science.gov (United States)

Bijlsma, Ward R; Mourits, Maarten Ph

2006-06-01

To evaluate and compare techniques for extraocular muscle (EOM) volume measurement and to provide guidelines for future measurements. Systematic review. Existing techniques used to measure extraocular muscle volumes on radiologic scans can be divided into manual outlining, computer assisted and automated segmentation. Both computed tomography (CT) and magnetic resonance (MR) image datasets can be used. On CT scans, one best measures muscle volume using region grow segmentation, accepting an overestimation of true volume by inevitable inclusion of non-muscular tissue. On high resolution MRI scans, single muscles can be outlined manually, but measurements include only part of the muscle due to poor tissue contrast at the orbital apex. Measurement errors can be reduced 3.5% by exact horizontal repositioning. A measured volume change of at least 6-17% is required to demonstrate a significant difference. Currently the best choice for EOM volume measurements on CT images is computer assisted grey value segmentation and on MRI images is manual outlining of individual muscles. Because of the time required and the complexity of the measurements, present EOM volume measurement is as yet only suitable for research purposes.

Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines.

Science.gov (United States)

Buszewicz, Marta; Cape, John; Serfaty, Marc; Shafran, Roz; Kabir, Thomas; Tyrer, Peter; Clarke, Caroline S; Nazareth, Irwin

2017-08-01

Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing

Salinas : theory manual.

Energy Technology Data Exchange (ETDEWEB)

Walsh, Timothy Francis; Reese, Garth M.; Bhardwaj, Manoj Kumar

2011-11-01

Salinas provides a massively parallel implementation of structural dynamics finite element analysis, required for high fidelity, validated models used in modal, vibration, static and shock analysis of structural systems. This manual describes the theory behind many of the constructs in Salinas. For a more detailed description of how to use Salinas, we refer the reader to Salinas, User's Notes. Many of the constructs in Salinas are pulled directly from published material. Where possible, these materials are referenced herein. However, certain functions in Salinas are specific to our implementation. We try to be far more complete in those areas. The theory manual was developed from several sources including general notes, a programmer notes manual, the user's notes and of course the material in the open literature.

ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff.

Science.gov (United States)

Gameiro, S; Boivin, J; Dancet, E; de Klerk, C; Emery, M; Lewis-Jones, C; Thorn, P; Van den Broeck, U; Venetis, C; Verhaak, C M; Wischmann, T; Vermeulen, N

2015-11-01

Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial

Improving artificial breeding of cattle in Africa. Guidelines and recommendations. A manual prepared under the framework of an IAEA technical cooperation regional AFRA project on increasing and improving milk and meat production

International Nuclear Information System (INIS)

2005-04-01

cattle farmers and to arrive at a consensus on what can be considered 'best practice' in the countries represented. It was concluded that: (a) methods of keeping records, their analysis and use for evaluating genetic merit and fertility of AI bulls require improvement in most AFRA Member States; (b) the technical aspects of providing N-PD and related services to farmers based on progesterone assay have been clarified in many Member States; (c) the modalities and logistics of practical application under the different conditions in countries need to be further developed; and (d) there is a clear need for guidelines that can be used for improvement and harmonization of currently used technical procedures for AI in the Member States. Participants of the meeting developed a framework for the guidelines, formulated the first draft of the manual and identified the additional work necessary for its completion. The manual was subsequently compiled and the second draft was circulated to all AFRA national project coordinators for comments and suggestions for improvement. It was finally discussed at a Project Review, Coordination and Planning Meeting held in Addis Ababa in March 2002 and further material incorporated as required. This manual combines the outputs from the three meetings referred to above, and is the result of collaboration between the contributors listed at the end of the publication

TJ-II Library Manual (Version 2)

International Nuclear Information System (INIS)

Tribaldos, V.; Milligen, B. Ph. van; Lopez-Fraguas, A.

2001-01-01

This is a manual of use of the TJ2 Numerical Library that has been developed for making numerical computations of different TJ-II configurations. This manual is a new version of the earlier manual CIEMAT report 806. (Author)

Derivation of guidelines for uranium residual radioactive material in soil at the New Brunswick Site, Middlesex County, New Jersey

International Nuclear Information System (INIS)

Dunning, D.; Kamboj, S.; Nimmagadda, M.; Yu, C.

1996-02-01

Residual radioactive material guidelines for uranium in soil were derived for the New Brunswick Site, located in Middlesex County, New Jersey. This site has been designated for remedial action under the Formerly Utilized Sites Remedial Action Program of the US Department of Energy (DOE). Residual radioactive material guidelines for individual radionuclides of concern and total uranium were derived on the basis of the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the New Brunswick Site should not exceed a dose of 30 mrem/yr following remedial action for the current-use and likely future-use scenarios or a dose of 100 mrem/yr for less likely future-use scenarios. The DOE residual radioactive material guideline computer code, RESRAD, was used in this evaluation; RESRAD implements the methodology described in the DOE manual for establishing residual radioactive material guidelines. The guidelines derived in this report are intended to apply to the remediation of these remaining residual radioactive materials at the site. The primary radionuclides of concern in these remaining materials are expected to be radium-226 and, to a lesser extent, natural uranium and thorium. The DOE has established generic cleanup guidelines for radium and thorium in soil; however, cleanup guidelines for other radionuclides must be derived on a site-specific basis

GERTS GQ User's Manual.

Science.gov (United States)

Akiba, Y.; And Others

This user's manual for the simulation program Graphical Evaluation and Review Technique (GERT) GQ contains sections on nodes, branches, program input description and format, and program output, as well as examples. Also included is a programmer's manual which contains information on scheduling, subroutine descriptions, COMMON Variables, and…

The Impact of Cloud Properties on Young Sea Ice during Three Winter Storms at N-ICE2015

Science.gov (United States)

Murphy, S. Y.; Walden, V. P.; Cohen, L.; Hudson, S. R.

2017-12-01

The impact of clouds on sea ice varies significantly as cloud properties change. Instruments deployed during the Norwegian Young Sea Ice field campaign (N-ICE2015) are used to study how differing cloud properties influence the cloud radiative forcing at the sea ice surface. N-ICE2015 was the first campaign in the Arctic winter since SHEBA (1997/1998) to study the surface energy budget of sea ice and the associated effects of cloud properties. Cloud characteristics, surface radiative and turbulent fluxes, and meteorological properties were measured throughout the field campaign. Here we explore how cloud macrophysical and microphysical properties affect young, thin sea ice during three winter storms from 31 January to 15 February 2015. This time period is of interest due to the varying surface and atmospheric conditions, which showcase the variety of conditions the newly-formed sea ice can experience during the winter. This period was characterized by large variations in the ice surface and near-surface air temperatures, with highs near 0°C when warm, moist air was advected into the area and lows reaching -40°C during clear, calm periods between storms. The advection of warm, moist air into the area influenced the cloud properties and enhanced the downwelling longwave flux. For most of the period, downwelling longwave flux correlates closely with the air temperature. However, at the end of the first storm, a drop in downwelling longwave flux of about 50 Wm-2 was observed, independent of any change in surface or air temperature or cloud fraction, indicating a change in cloud properties. Lidar data show an increase in cloud height during this period and a potential shift in cloud phase from ice to mixed-phase. This study will describe the cloud properties during the three winter storms and discuss their impacts on surface energy budget.

Nuclear electronics laboratory manual

International Nuclear Information System (INIS)

1984-05-01

The Nuclear Electronics Laboratory Manual is a joint product of several electronics experts who have been associated with IAEA activity in this field for many years. The manual does not include experiments of a basic nature, such as characteristics of different active electronics components. It starts by introducing small electronics blocks, employing one or more active components. The most demanding exercises instruct a student in the design and construction of complete circuits, as used in commercial nuclear instruments. It is expected that a student who completes all the experiments in the manual should be in a position to design nuclear electronics units and also to understand the functions of advanced commercial instruments which need to be repaired or maintained. The future tasks of nuclear electronics engineers will be increasingly oriented towards designing and building the interfaces between a nuclear experiment and a computer. The manual pays tribute to this development by introducing a number of experiments which illustrate the principles and the technology of interfacing

Decrease in use of manual vacuum aspiration in postabortion care in Malawi: a cross-sectional study from three public hospitals, 2008-2012.

Directory of Open Access Journals (Sweden)

Maria L Odland

Full Text Available OBJECTIVES: To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012. METHODS: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March 2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum aspiration versus sharp curettage was analysed. RESULTS: Altogether, 5121 women were included. One third (34.2% of first trimester abortions were treated with manual vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7% to 2009 (31.0%, with a rapid decline after 2010 (28.5% ending at only 4.9% in 2012. Conversely there was an increase in use of sharp curettage in all hospitals from 2010 to 2012. CONCLUSION: Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from 2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international guidelines.

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

Science.gov (United States)

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

2012-07-04

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

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

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

2018-02-01

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

Derivation of residual radioactive material guidelines for the Laboratory for Energy-Related Health Research site

International Nuclear Information System (INIS)

Chapman, T.E.

1993-11-01

Residual radioactive material guidelines were derived for the Laboratory for Energy-Related Health Research (LEHR) Environmental Restoration (ER) site in Davis, California. The guideline derivation was based on a dose limit of 100 mrem/yr. The US Department of Energy (DOE) residual radioactive material guideline computer code was used in this evaluation. This code implements the methodology described in the DOE manual for implementing residual radioactive material guidelines. Three potential site utilization scenarios were considered with the assumption that following ER action, the site will be used without radiological restrictions. The defined scenarios vary with regard to use of the site, time spent at the site, and sources of food consumed. The results of the evaluation indicate that the basic dose limit of 100 mrem/yr will not be exceeded, provided that the soil concentrations of these radionuclides at the LEHR site do not exceed the scenario-specific values calculated by this study. Except for the extent of the contaminated zone (which is very conservative), assumptions used are as site-specific as possible, given available information. The derived guidelines are single- radionuclide guidelines and are linearly proportional to the dose limit used in the calculations. In setting the actual residual soil contamination guides for the LEHR site, DOE will apply the as low as reasonably achievable policy to the decision-making process, along with other factors such as whether a particular scenario is reasonable and appropriate, as well as using site-specific inputs to computer models based on data not yet fully determined

14 CFR 121.141 - Airplane flight manual.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane flight manual. 121.141 Section 121... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Manual Requirements § 121.141 Airplane flight manual. (a) Each certificate holder shall keep a current approved airplane flight manual for each type of...

Derivation of uranium residual radioactive material guidelines for the Shpack site

International Nuclear Information System (INIS)

Cheng, J.J.; Yu, C.; Monette, F.; Jones, L.

1991-08-01

Residual radioactive material guidelines for uranium were derived for the Shpack site in Norton, Massachusetts. This site has been identified for remedial action under the Formerly Utilized Sites Remedial Action Program (FUSRAP) of the US Department of Energy (DOE). The uranium guidelines were derived on the basis of the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the Shpack site should not exceed a dose of 100 mrem/yr following decontamination. The DOE residual radioactive material guideline computer code, RESRAD, which implements the methodology described in the DOE manual for implementing residual radioactive material guidelines, was used in this evaluation. Three potential scenarios were considered for the site; the scenarios vary with regard to time spent at the site, sources of water used, and sources of food consumed. The results of the evaluation indicate that the basic dose limit of 100 mrem/yr will not be exceeded for uranium (including uranium-234, uranium-235, and uranium-238) within 1000 years, provided that the soil concentration of combined uranium (uranium-234 and uranium-238) at the Shpack site does not exceed the following levels: 2500 pCi/g for Scenario A (recreationist: the expected scenario); 1100 pCi/g for Scenario B (industrial worker: a plausible scenario); and 53 pCi/g for Scenario C (resident farmer using a well water as the only water source: a possible but unlikely scenario). The uranium guidelines derived in this report apply to the combined activity concentration of uranium-234 and uranium-238 and were calculated on the basis of a dose of 100 mrem/yr. In setting the actual uranium guidelines for the Shpack site, DOE will apply the as low as reasonably achievable (ALARA) policy to the decision-making process, along with other factors, such as whether a particular scenario is reasonable and appropriate. 8 refs., 2 figs., 8 tabs

A Pilot Study on Developing a Standardized and Sensitive School Violence Risk Assessment with Manual Annotation.

Science.gov (United States)

Barzman, Drew H; Ni, Yizhao; Griffey, Marcus; Patel, Bianca; Warren, Ashaki; Latessa, Edward; Sorter, Michael

2017-09-01

School violence has increased over the past decade and innovative, sensitive, and standardized approaches to assess school violence risk are needed. In our current feasibility study, we initialized a standardized, sensitive, and rapid school violence risk approach with manual annotation. Manual annotation is the process of analyzing a student's transcribed interview to extract relevant information (e.g., key words) to school violence risk levels that are associated with students' behaviors, attitudes, feelings, use of technology (social media and video games), and other activities. In this feasibility study, we first implemented school violence risk assessments to evaluate risk levels by interviewing the student and parent separately at the school or the hospital to complete our novel school safety scales. We completed 25 risk assessments, resulting in 25 transcribed interviews of 12-18 year olds from 15 schools in Ohio and Kentucky. We then analyzed structured professional judgments, language, and patterns associated with school violence risk levels by using manual annotation and statistical methodology. To analyze the student interviews, we initiated the development of an annotation guideline to extract key information that is associated with students' behaviors, attitudes, feelings, use of technology and other activities. Statistical analysis was applied to associate the significant categories with students' risk levels to identify key factors which will help with developing action steps to reduce risk. In a future study, we plan to recruit more subjects in order to fully develop the manual annotation which will result in a more standardized and sensitive approach to school violence assessments.

Oil Spill Response Manual

NARCIS (Netherlands)

Marieke Zeinstra; Sandra Heins; Wierd Koops

2014-01-01

A two year programme has been carried out by the NHL University of Applied Sciences together with private companies in the field of oil and chemical spill response to finalize these manuals on oil and chemical spill response. These manuals give a good overview of all aspects of oil and chemical

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.

46 CFR 160.176-21 - User manuals.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false User manuals. 160.176-21 Section 160.176-21 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-21 User manuals. (a) The manufacturer must develop a user's manual for each model of inflatable lifejacket. The content of the manual...

US Department of Energy radiological control manual

International Nuclear Information System (INIS)

1994-04-01

This manual establishes practices for the conduct of Department of Energy radiological control activities. The Manual states DOE's positions and views on the best courses of action currently available in the area of radiological controls. Accordingly, the provisions in the Manual should be viewed by contractors as an acceptable technique, method or solution for fulfilling their duties and responsibilities. This Manual shall be used by DOE in evaluating the performance of its contractors. This Manual is not a substitute for Regulations; it is intended to be consistent with all relevant statutory and regulatory requirements and shall be revised whenever necessary to ensure such consistency. Some of the Manual provisions, however, challenge the user to go well beyond minimum requirements. Following the course of action delineated in the Manual will result in achieving and surpassing related statutory or regulatory requirements

A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

Science.gov (United States)

Lee, Joy L; Matthias, Marianne S; Menachemi, Nir; Frankel, Richard M; Weiner, Michael

2018-04-01

Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area. To understand how existing guidelines align with current practice, evidence, and technology. We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices. Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed. Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.

Technical Manual: 2002 Series GED Tests

Science.gov (United States)

Ezzelle, Carol; Setzer, J. Carl

2009-01-01

This manual was written to provide technical information regarding the 2002 Series GED (General Educational Development) Tests. Throughout this manual, documentation is provided regarding the development of the GED Tests, data collection activities, as well as reliability and validity evidence. The purpose of this manual is to provide evidence…

UK service level audit of insulin pump therapy in paediatrics.

Science.gov (United States)

Ghatak, A; Paul, P; Hawcutt, D B; White, H D; Furlong, N J; Saunders, S; Morrison, G; Langridge, P; Weston, P J

2015-12-01

To conduct an audit of insulin pump therapy in the UK after the issue of guidelines for the use of continuous subcutaneous insulin infusion by NICE in 2008 (Technology Appraisal 151). All centres in the UK, providing pump services to children and young people were invited to participate in an online audit. Audit metrics were aligned to NICE Technology Appraisal 151 and an electronic data collection tool was used. Of the 176 UK centres identified as providing pump services, 166 (94.3%) participated in the study. A total of 5094 children and young people were identified as using continuous subcutaneous insulin infusion (19% of all paediatric patients with Type 1 diabetes), with a median (range) of 16.9 (0.67-69.4)% per centre. Units had a median of 0.58 consultant sessions, 0.43 full-time equivalent diabetic specialist nurses, and 0.1 full-time equivalent dieticians delivering the pump service. The majority of this time was not formally funded. Families could access 24-h clinical and technical support (83% units), although the delivery varied between consultant, diabetic specialist nurse and company representatives. Only 53% of units ran, or accessed, structured education programmes for continuous subcutaneous insulin infusion use. Most units (86%) allowed continuous subcutaneous insulin infusion use for paediatric inpatients, but only 56% had written guidelines for this scenario. Nine percent of units had encountered funding refusal for a patient fulfilling NICE (Technology Appraisal 151) criteria. The number of children and young people on continuous subcutaneous insulin infusion therapy is consistent with numbers estimated by NICE. There is a worrying lack of funded healthcare professional time. The audit also identified gaps in the provision of structured education and absence of written inpatient guidelines. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

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

Technical Manual. The ACT®

Science.gov (United States)

ACT, Inc., 2014

2014-01-01

This manual contains technical information about the ACT® college readiness assessment. The principal purpose of this manual is to document the technical characteristics of the ACT in light of its intended purposes. ACT regularly conducts research as part of the ongoing formative evaluation of its programs. The research is intended to ensure that…

Environment, safety, and health manual, closeout report

International Nuclear Information System (INIS)

1975-12-01

A coordination draft of the Environment, Safety, and Health (ES and H) manual was submitted on 2 September 1975. Comments provided by Operational Safety personnel were being incorporated by a task team when the effort was terminated on 31 October 1975. This report documents the development history of the manual and provides a status of the manual up to the time the efforts were discontinued. Also discussed are issues which effect completion of the manual. Additionally a plan for completion of the manual is suggested

An Increase in the Incidence of Infective Endocarditis in England since 2008: A secular trend interrupted time series analysis

Science.gov (United States)

Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M.; Lockhart, Peter B; Thornhill, Martin H

2017-01-01

Background Antibiotic prophylaxis (AP) administered prior to invasive procedures in patients at risk of developing infective endocarditis (IE) has historically been the focus of IE prevention. Recent changes in AP guidelines in the US and Europe have substantially reduced the numbers for whom AP is recommended. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommended complete cessation of AP in March 2008. We report the impact of these guidelines on AP prescribing; in addition, IE incidence was examined following the introduction of the guidelines. Methods We analyzed English AP prescribing data from January 2004 to March 2013 and hospital discharge episode statistics for patients with a primary diagnosis of IE from January 2000 to March 2013. Findings AP prescribing rates fell dramatically after introduction of the NICE guidance (10,935 prescriptions/month vs. 2,236 prescriptions/month, p<0·0001). Commencing in March 2008, there was also a significant increase in the number of IE cases/month (0·11 cases/10million/month, CI 0·05–0·16, p<0·0001) above the projected historical trend. By March 2013, there were an additional 35 cases/month than would have been expected if the previous trend had continued. This increase in IE incidence was significant for both ‘high-risk’ and ‘lower-risk’ individuals. Interpretation Although our data do not establish a causal relationship, there has been a substantial reduction in AP prescribing and a significant increase in IE incidence in England since introduction of the NICE guidelines in 2008. Funding Different aspects of this study were supported by Heart Research UK and Simplyhealth [Grant Ref: RG2632/13/14] and NIDCR R03 grant [Ref: 1R03DE023092-01] from the National Institutes for Health. PMID:25467569

Marketing Research. Instructor's Manual.

Science.gov (United States)

Small Business Administration, Washington, DC.

Prepared for the Administrative Management Course Program, this instructor's manual was developed to serve small-business management needs. The sections of the manual are as follows: (1) Lesson Plan--an outline of material covered, which may be used as a teaching guide, presented in two columns: the presentation, and a step-by-step indication of…

Indoor Air Quality Manual.

Science.gov (United States)

Baldwin Union Free School District, NY.

This manual identifies ways to improve a school's indoor air quality (IAQ) and discusses practical actions that can be carried out by school staff in managing air quality. The manual includes discussions of the many sources contributing to school indoor air pollution and the preventive planning for each including renovation and repair work,…

25 CFR 175.5 - Operations manual.

Science.gov (United States)

2010-04-01

... Provisions § 175.5 Operations manual. (a) The Area Director shall establish an operations manual for the... Director shall amend the operations manual as needed. (b) The public shall be notified by the Area Director... shall be published in local newspaper(s) of general circulation, posted at the utility office(s), and...

Regulations and Procedures Manual

Energy Technology Data Exchange (ETDEWEB)

Young, Lydia J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2011-07-25

The purpose of the Regulations and Procedures Manual (RPM) is to provide LBNL personnel with a reference to University and Lawrence Berkeley National Laboratory (LBNL or Laboratory) policies and regulations by outlining normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory organizations. Much of the information in this manual has been condensed from detail provided in LBNL procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. RPM sections on personnel apply only to employees who are not represented by unions. Personnel policies pertaining to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the LBNL organization responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which organization is responsible for a policy, please contact Requirements Manager Lydia Young or the RPM Editor.

Regulations and Procedures Manual

Energy Technology Data Exchange (ETDEWEB)

Young, Lydia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2010-09-30

The purpose of the Regulations and Procedures Manual (RPM) is to provide Laboratory personnel with a reference to University and Lawrence Berkeley National Laboratory policies and regulations by outlining the normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory departments. Much of the information in this manual has been condensed from detail provided in Laboratory procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. The sections on personnel apply only to employees who are not represented by unions. Personnel policies pertaining to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the department responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which department should be called, please contact the Associate Laboratory Director of Operations.

Wastes power generation introduction manual. Main edition; Haikibutsu hatsuden donyu manual. Honpen

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

A practical and specific working manual was prepared that satisfies the standards and criteria defined in the relevant law such as the Sanitation and Environment Ordinance No. 249, the guideline for generation of dioxins caused by refuse disposal, and that enables the reports evaluating the wastes quantitatively to be submitted to heads of the local governments when persons in charge of planning the introduction of wastes power generation at local governments discuss the wastes power generation systems. Taking general combustible wastes and sewage sludge treatments as the object, this paper details from the economic performance to size of wastes treatment at the priority limit for the power generation facility introduction. The subject power generation systems include the following: the stoker furnace/separation type ash melting furnace power generation system, the fluidized bed/separation type ash melting furnace power generation system, and the direct type gasification melting furnace power generation system, whose establishment of safety, reliability and stability have been verified by full-size system operation record available at the local governments, the gas turbine re-powering composite type power generation system (gas turbine power plants are installed beside the incineration furnaces) that makes high-efficiency power generation possible, and the RDF power generation system (power generation by mixed combustion with general refuses, and power generation using RDF (refuse derived fuel) exclusive combustion). Other important discussion and assessment items include environment and resource utilization performances. (NEDO)

For information: A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. Seminars planned this week are: Editer des sites Web avec Frontpage 2003 (FR), Tuesday 1st of June, 14:30. Créer des documents bureautiques avec Windows Word 2003 et Excel 2003 (FR), Thursday 3rd of June, 14:30. The seminars will take place in the IT Auditorium (bldg. 31, 3-005) and last for about one hour plus questions. No registration is necessary. More information is available at http://cern.ch/Win/Seminars/Tutorials. Interested users can also have a look to courses offered by CERN Technical Training, at http://cern.ch/humanr...

FOR INFORMATION - A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

IT Department

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. The topics and the dates are as follows: - Windows XP, une nouvelle experience (FR), Tuesday, 11th May 2004, 14.30 hrs. - Windows XP: a new experience (EN), Tuesday 8th of June, 14:30. - Lire votre email et plus avec Outlook 2003 (FR), Thursday 27th of May, 14:30. - Read your mail and more with Outlook 2003 (EN), Thursday 10th of June, 14:30. - Creer des documents Office avec Windows Word 2003 et Excel 2003 (FR), Thursday 3rd of June, 14:30. - Make Office documents with Windows Word 2003 and Excel 2003 (EN), Thursday 17th of June, 1...

For information: A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. Seminars planned for these weeks are : Windows XP: a new experience (EN), Tuesday 8th of June, 14:30. Read your mail and more with Outlook 2003 (EN), Thursday 10th of June, 14:30. The seminars will take place in the IT Amphitheatre (bldg. 31, 3-005) and last for about one hour plus questions. No registration is necessary. More information is available at http://cern.ch/Win/Seminars/Tutorials. Interested users can also have a look to courses offered by CERN Technical Training, at http://cern.ch/humanresources/external/training/tec...

For Information: A Series of Seminars about NICE Environment during May / June 2004

CERN Multimedia

IT Department

2004-01-01

Recently deployed at CERN, Windows XP and Office 2003 offer new functionalities. IT/IS Group has prepared a series of seminars to both introduce the CERN NICE environment to beginners and also to show how to benefit from the advanced features offered by the new versions of Windows and Office. Particular attention will be paid to Collaborative Tasks, like reviewing a document, planning a meeting and to Mobile Computing like working offline, remotely accessing CERN resources, etc.. Seminars for planned these week are : Editing Web Sites with Frontpage 2003 (EN), Tuesday 25th of May, 14:30. Lire votre email et plus avec Outlook 2003 (FR), Thursday 27th of May, 14:30. The seminars will take place in the IT Amphitheatre (bldg. 31, 3-005) and last for about one hour plus questions. No registration is necessary. More information is available at http://cern.ch/Win/Seminars/Tutorials Interested users can also have a look to courses offered by CERN Technical Training, at http://cern.ch/humanresources/external/train...

Contributions from the Department of Wind Energy and Atmospheric Physics to EWEC `99 in Nice, France

Energy Technology Data Exchange (ETDEWEB)

Larsen, Gunner C; Westermann, Kirsten; Noergaard, Per [eds.

1999-03-01

The first conference following the merger of the series of European Union Wind Energy Conference and the European Wind Energy Conferences - EWEC`99 - was held in Nice, France during the period 1-5 March 1999. About 600 delegates, mainly from Europe but also from other parts of the world, attended the conference. The conference contributions included 96 oral presentations and 305 posters. The Department of Wind Energy and Atmospheric Physics contributed with 29 oral presentations and 36 posters with members of the department as authors or co-authors. The present report contains the set of these papers available at the deadline 19 March 1999. The contributions cover a wide spectrum of subjects including wind resources, aerodynamics, reliability and load assessment, grid connection, measurement methods, innovative wind turbines and market aspects. (au)

Major Depressive Disorder

Directory of Open Access Journals (Sweden)

G Grobler

2013-08-01

Full Text Available The treatment guideline draws on several international guidelines: (iPractice Guidelines of the American Psychiatric Association (APAfor the Treatment of Patients with Major Depressive Disorder, SecondEdition;[1](ii Clinical Guidelines for the Treatment of DepressiveDisorders by the Canadian Psychiatric Association and the CanadianNetwork for Mood and Anxiety Treatments (CANMAT;[2](iiiNational Institute for Clinical Excellence (NICE guidelines;[3](iv RoyalAustralian and New Zealand College of Psychiatrists Clinical PracticeGuidelines Team for Depression (RANZCAP;[4](v Texas MedicationAlgorithm Project (TMAP Guidelines;[5](vi World Federation ofSocieties of Biological Psychiatry (WFSBP Treatment Guideline forUnipolar Depressive Disorder;[6]and (vii British Association forPsychopharmacology Guidelines.[7

Reconceptualising manual therapy skills in contemporary practice.

Science.gov (United States)

Rabey, Martin; Hall, Toby; Hebron, Clair; Palsson, Thorvaldur Skuli; Christensen, Steffan Wittrup; Moloney, Niamh

2017-06-01

With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put forward, based upon a contemporary understanding of pain science, rather than considering these skills only in terms of how they should "guide" manual therapy interventions. The place for manual examination findings within complex, multidimensional presentations is considered using vignettes describing the presentations of five people with low back pain. As part of multidimensional, individualised management, the balance of evidence relating to the effectiveness, mechanisms of action and rationale for manual skills is discussed. It is concluded that if manual examination and therapeutic skills are used in a manner consistent with a contemporary understanding of pain science, multidimensional patient profiles and a person-centred approach, their selective and judicious use still has an important role. Copyright © 2017 Elsevier Ltd. All rights reserved.

The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study.

Science.gov (United States)

van der Krieke, Lian; Bird, Victoria; Leamy, Mary; Bacon, Faye; Dunn, Rebecca; Pesola, Francesca; Janosik, Monika; Le Boutillier, Clair; Williams, Julie; Slade, Mike

2015-05-23

Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ (2)(3) = 133.77, p Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.

TRUBA User Manual

International Nuclear Information System (INIS)

Tereshchenko, M. A.; Castejon, F.; Cappa, A.

2008-01-01

The TRUBA (pipeline in Russian) code is a computational tool for studying the propagation of Gaussian-shaped microwave beams in a prescribed equilibrium plasma. This manual covers the basic material handed to use the implementation of TRUBA (version 3,4) interfaced with the numerical library of the TJ-II stellarator. The manual provides a concise theoretical background of the problem, specifications for setting up the input files and interpreting the output of the code, and some information useful in modifying TRUBA. (Author) 13 refs

TRUBA User Manual

Energy Technology Data Exchange (ETDEWEB)

Tereshchenko, M. A.; Castejon, F.; Cappa, A.

2008-04-25

The TRUBA (pipeline in Russian) code is a computational tool for studying the propagation of Gaussian-shaped microwave beams in a prescribed equilibrium plasma. This manual covers the basic material handed to use the implementation of TRUBA (version 3,4) interfaced with the numerical library of the TJ-II stellarator. The manual provides a concise theoretical background of the problem, specifications for setting up the input files and interpreting the output of the code, and some information useful in modifying TRUBA. (Author) 13 refs.

Developing a Pupil Transportation Manual.

Science.gov (United States)

Douglas, Dave

1987-01-01

District-level pupil transportation manuals that contain clear, concise information about objectives, policies, and regulations are a must. These manuals should also specify procedures concerning evaluation processes, personnel recruitment and selection, and the driver training program. (MLH)

Derivation of residual radioactive material guidelines for uranium in soil at the Former Associate Aircraft Tool and Manufacturing Company Site, Fairfield, Ohio

International Nuclear Information System (INIS)

Faillace, E.R.; Nimmagadda, M.; Yu, C.

1995-01-01

Residual radioactive material guidelines for uranium in soil were derived for the former Associate Aircraft Tool and Manufacturing Company site in Fairfield, Ohio. This site has been identified for remedial action under the U.S. Department of Energy's (DOE's) Formerly Utilized Sites Remedial Action Program (FUSRAP). Single-nuclide and total-uranium guidelines were derived on the basis of the requirement that, after remedial action, the 50-year committed effective dose equivalent to a hypothetical individual living or working in the immediate vicinity of the site should not exceed (1) 30 mrem/yr for the current-use and likely future-use scenarios or (2) 100 mrem/yr for less likely future-use scenarios. The DOE residual radioactive material (RESRAD) computer code, which implements the methodology described in the DOE manual for establishing residual radioactive material guidelines, was used in this evaluation

The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

Science.gov (United States)

Southerst, Danielle; Yu, Hainan; Randhawa, Kristi; Côté, Pierre; D'Angelo, Kevin; Shearer, Heather M; Wong, Jessica J; Sutton, Deborah; Varatharajan, Sharanya; Goldgrub, Rachel; Dion, Sarah; Cox, Jocelyn; Menta, Roger; Brown, Courtney K; Stern, Paula J; Stupar, Maja; Carroll, Linda J; Taylor-Vaisey, Anne

2015-01-01

Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity. Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI. We screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults. The current evidence on the effectiveness of manual therapy

Missouri Highway Safety Manual Recalibration

Science.gov (United States)

2018-05-01

The Highway Safety Manual (HSM) is a national manual for analyzing the highway safety of various facilities, including rural roads, urban arterials, freeways, and intersections. The HSM was first published in 2010, and a 2014 supplement addressed fre...

Ultrasonic testing of materials at level 2. Manual for the syllabi contained in IAEA-TECDOC-628, training guidelines in non-destructive testing techniques

International Nuclear Information System (INIS)

1999-01-01

The International Atomic Energy Agency (IAEA) has been active in the promotion of non-destructive testing (NDT) technology for many years. The prime reason for this interest has been the need for stringent quality control standards for the safe operation of nuclear installations. The IAEA has successfully executed a number of regional projects of which NDT was an important part. These were the Regional Co-operative Arrangements for the Promotion of Nuclear Science and Technology in Latin America (ARCAL), the Regional Co-operative Agreement for Asia and the Pacific (RCA), the African Regional Co-operative Agreement (AFRA) and lately the NDT Regional Project in West Asia. Through these projects a large number of persons have been trained in Member States and a state of self-sufficiency in this area of technology has been achieved in many of them. There has long been a realization of the need to have well established training guidelines and related books in order, firstly, to guide IAEA experts who were involved in this training programme and, secondly, to achieve some level of international uniformity and harmonization of training materials and consequent competence of personnel. The syllabi for training courses have been published in the form of two publications, IAEA-TECDOC-407 and IAEA-TECDOC-628. IAEA-TECDOC-628, as well as most of the international standards on the subject of training and certification of NDT personnel includes ISO 9712. The next logical step is to compile the textbooks and training manuals. Work in this regard has been undertaken and a manual on radiographic testing was issued in 1992 in the Training Course Series. This publication is a continuation of that effort. Earlier training notes on this subject existed in the form of IAEA-TECDOC-462, which was compiled in accordance with the syllabus of IAEA-TECDOC-407. These fulfilled the training needs of the member countries of RCA for quite some time. The present book is in fact an expanded and

US Department of Energy Radiological Control Manual

International Nuclear Information System (INIS)

1992-06-01

This manual establishes practices for the conduct of radiological control activities. The Manual states DOE's positions and views on the best courses of action currently available in the area of radiological controls. Accordingly, the provisions in the Manual should be viewed by contractors as an acceptable technique, method or solution for fulfilling their duties and responsibilities. This Manual shall be used by DOE in evaluating the performance of its contractors. (VC)

User's manual for the HYPGEN hyperbolic grid generator and the HGUI graphical user interface

Science.gov (United States)

Chan, William M.; Chiu, Ing-Tsau; Buning, Pieter G.

1993-01-01

The HYPGEN program is used to generate a 3-D volume grid over a user-supplied single-block surface grid. This is accomplished by solving the 3-D hyperbolic grid generation equations consisting of two orthogonality relations and one cell volume constraint. In this user manual, the required input files and parameters and output files are described. Guidelines on how to select the input parameters are given. Illustrated examples are provided showing a variety of topologies and geometries that can be treated. HYPGEN can be used in stand-alone mode as a batch program or it can be called from within a graphical user interface HGUI that runs on Silicon Graphics workstations. This user manual provides a description of the menus, buttons, sliders, and typein fields in HGUI for users to enter the parameters needed to run HYPGEN. Instructions are given on how to configure the interface to allow HYPGEN to run either locally or on a faster remote machine through the use of shell scripts on UNIX operating systems. The volume grid generated is copied back to the local machine for visualization using a built-in hook to PLOT3D.

Issues Related to the Frequency of Exploratory Analyses by Evidence Review Groups in the NICE Single Technology Appraisal Process.

Science.gov (United States)

Kaltenthaler, Eva; Carroll, Christopher; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

2017-06-01

Evidence Review Groups (ERGs) critically appraise company submissions as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal (STA) process. As part of their critique of the evidence submitted by companies, the ERGs undertake exploratory analyses to explore uncertainties in the company's model. The aim of this study was to explore pre-defined factors that might influence or predict the extent of ERG exploratory analyses. The aim of this study was to explore predefined factors that might influence or predict the extent of ERG exploratory analyses. We undertook content analysis of over 400 documents, including ERG reports and related documentation for the 100 most recent STAs (2009-2014) for which guidance has been published. Relevant data were extracted from the documents and narrative synthesis was used to summarise the extracted data. All data were extracted and checked by two researchers. Forty different companies submitted documents as part of the NICE STA process. The most common disease area covered by the STAs was cancer (44%), and most ERG reports (n = 93) contained at least one exploratory analysis. The incidence and frequency of ERG exploratory analyses does not appear to be related to any developments in the appraisal process, the disease area covered by the STA, or the company's base-case incremental cost-effectiveness ratio (ICER). However, there does appear to be a pattern in the mean number of analyses conducted by particular ERGs, but the reasons for this are unclear and potentially complex. No clear patterns were identified regarding the presence or frequency of exploratory analyses, apart from the mean number conducted by individual ERGs. More research is needed to understand this relationship.

Professional courtesy: can you legally provide it?

Science.gov (United States)

Burke, Michael; Baum, Neil

2010-01-01

Professional courtesy: Something most physicians did and enjoyed doing, and that was a nice perk that physicians offered their colleagues. But is it legal? Can it still be done without breaking the law? What are the guidelines? This article will answer these questions. After reading this article, you will understand the guidelines for professional courtesy and what the risks and penalties are if they are violated.

Reconceptualising manual therapy skills in contemporary practice

DEFF Research Database (Denmark)

Rabey, Martin; Hall, Toby; Hebron, Clair

2017-01-01

With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put...

New highway accident location manual for Missouri.

Science.gov (United States)

2013-12-01

The Missouri HAL manual is used to identify, analyze, and correct high crash locations, and has not been updated since : 1999. This new edition brings the manual up to date, while incorporating the methodology of the national Highway Safety : Manual ...

An architecture for a continuous, user-driven, and data-driven application of clinical guidelines and its evaluation.

Science.gov (United States)

Shalom, Erez; Shahar, Yuval; Lunenfeld, Eitan

2016-02-01

Design, implement, and evaluate a new architecture for realistic continuous guideline (GL)-based decision support, based on a series of requirements that we have identified, such as support for continuous care, for multiple task types, and for data-driven and user-driven modes. We designed and implemented a new continuous GL-based support architecture, PICARD, which accesses a temporal reasoning engine, and provides several different types of application interfaces. We present the new architecture in detail in the current paper. To evaluate the architecture, we first performed a technical evaluation of the PICARD architecture, using 19 simulated scenarios in the preeclampsia/toxemia domain. We then performed a functional evaluation with the help of two domain experts, by generating patient records that simulate 60 decision points from six clinical guideline-based scenarios, lasting from two days to four weeks. Finally, 36 clinicians made manual decisions in half of the scenarios, and had access to the automated GL-based support in the other half. The measures used in all three experiments were correctness and completeness of the decisions relative to the GL. Mean correctness and completeness in the technical evaluation were 1±0.0 and 0.96±0.03 respectively. The functional evaluation produced only several minor comments from the two experts, mostly regarding the output's style; otherwise the system's recommendations were validated. In the clinically oriented evaluation, the 36 clinicians applied manually approximately 41% of the GL's recommended actions. Completeness increased to approximately 93% when using PICARD. Manual correctness was approximately 94.5%, and remained similar when using PICARD; but while 68% of the manual decisions included correct but redundant actions, only 3% of the actions included in decisions made when using PICARD were redundant. The PICARD architecture is technically feasible and is functionally valid, and addresses the realistic

Evidence-based clinical guidelines in Kyrgyz Republic.

Science.gov (United States)

Zurdinova, A A

2015-01-01

Improving quality of care in many countries is one of the priorities of health systems. At the same time one of the most important methods of improving quality of care is the widespread use of methods and principles of evidence-based medicine (EBM) [1]. The implementation of EBM in public health practice provides for the optimization of quality of care in terms of safety, efficacy and cost, one way of which is the use of clinical guidelines. Clinical guidelines developed with the use of EBM, provide an opportunity to use the latest and accurate information to optimize or neutralize impact on physician decision-making of subjective factors such as intuition, expertise, opinion of respected colleagues, recommendations of popular manuals and handbooks, etc. To assess and analyze the developed clinical guidelines (CG) and protocols (CP) in the Kyrgyz Republic in the period from 2008 to 2014 and evaluate their implementation in practical healthcare. Retrospective analysis of the developed clinical guidelines and protocols according to the approved methodology, interviewing leaders, questioning doctors and patients for their implementation. All participants gave informed consent for voluntary participation in the study. Within the framework of the National Program "Manas Taalimi" "Strategy for development of evidence-based medicine in the Kyrgyz Republic for 2006-2010" (MOH Order №490 from 09.04.06) was developed and approved for use. Its main purpose was to create a sustainable system of development, deployment and monitoring of the CG and CP and further promotion of EBM into practical health care, education and science. As a result, a number of documents ("Expert Council for assessing the quality of clinical guidelines/protocols", "AGREE instrument to assess the methodological content of clinical guidelines" [2], "The methodology of development and adaptation of clinical guidelines based on evidence-based medicine") were approved by the Order of the Ministry of

ETAP user's manual

International Nuclear Information System (INIS)

Watanabe, Norio; Higuchi, Suminori.

1990-11-01

The event tree analysis technique has been used in Probabilistic Safety Assessment for LWRs to delineate various accident scenarios leading to core melt or containment failure and to evaluate their frequencies. This technique often requires manual preparation of event trees with iterative process and time-consuming work in data handling. For the purpose of reducing manual efforts in event tree analysis, we developed a new software package named ETAP (Event Tree Analysis Supporting Program) for event tree analysis. ETAP is an interactive PC-based program which has the ability to construct, update, document, and quantify event trees. Because of its fast running capability to quantify event trees, use of the EATP program can make it easy to perform the sensitivity studies on a variety of system/containment performance issues. This report provides a user's manual for ETAP, which describes the structure, installation, and use of EATP. This software runs on NEC/PC-9800 or compatible PCs that have a 640 KB memory and MS-DOS 2.11 or higher. (author)

OASIS User Manual

CERN Document Server

Bojtar, L

2009-01-01

The OASIS system has been operational for years now. After a long development the project has reached a state where the number of features it provides exceeds largely what most of its users knows about. The author felt it was time to write a user manual explaining all the functionality of the viewer application. This document is a user manual, concentrating on the functionality of the viewer from the user’s point of view. There are already documents available on the project’s web site about the technical aspects at http://project-oasis.web.cern.ch/project-oasis/presentations.htm . There was an attempt to produce a tutorial on the viewer, but it didn’t get much further than the table of contents, that however is well thought. The structure of this user manual follows the same principle, the basic and most often used features are grouped together. Advanced or less often used features are described in a separate chapter. There is a second organizational principle, features belong to different levels: chann...

Manually controlled neutron-activation system

International Nuclear Information System (INIS)

Johns, R.A.; Carothers, G.A.

1982-01-01

A manually controlled neutron activation system, the Manual Reactor Activation System, was designed and built and has been operating at one of the Savannah River Plant's production reactors. With this system, samples can be irradiated for up to 24 hours and pneumatically transferred to a shielded repository for decay until their activity is low enough for them to be handled at a radiobench. The Manual Reactor Activation System was built to provide neutron activation of solid waste forms for the Alternative Waste Forms Leach Testing Program. Neutron activation of the bulk sample prior to leaching permits sensitive multielement radiometric analyses of the leachates

Methane measurements manual; Handbok metanmaetningar

Energy Technology Data Exchange (ETDEWEB)

Holmgren, Magnus Andreas (SP Technical research institute of Sweden, Boraas (Sweden))

2011-02-15

Emissions to air in different parts of the system may arise in biogas plants, where there is biological treatment of organic matter by anaerobic degradation, and during upgrading of biogas to vehicle fuel. There are mainly four reasons why these emissions must be minimized. These are safety, greenhouse gas emissions, economy and smell. This manual gathers experience of several years of work with measurement of methane emissions from biogas and upgrading facilities. This work has been done mainly in the context of Swedish Waste Management's system of voluntary commitment. The purpose of this manual is to standardize methods and procedures when methane measurements are carried out so that the results are comparable between different providers. The main target group of the manual is measurement consultants performing such measurements. Calculation template in Excel is part of the manual, which further contributes to the measurements evaluated in a standardized way. The manual contains several examples which have been calculated in the accompanying Excel template. The handbook also contains a chapter mainly intended for facility staff, in which implementation of accurate leak detection is described, and where there are hints of a system of so-called intermediate inspections to detect leaks in time

The minimal manual: is less really more?

NARCIS (Netherlands)

Lazonder, Adrianus W.; van der Meij, Hans

1993-01-01

Carroll, Smith-Kerker, Ford and Mazur-Rimetz (The minimal manual, Human-Computer Interaction , 3, 123-153, 1987) have introduced the minimal manual as an alternative to standard self-instruction manuals. While their research indicates strong gains, only a few attempts have been made to validate

How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

Directory of Open Access Journals (Sweden)

Hyun-Woo Cho

Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

Manual on indoor air quality

International Nuclear Information System (INIS)

Diamond, R.C.; Grimsrud, D.T.

1983-12-01

This reference manual was prepared to assist electric utilities in helping homeowners, builders, and new home buyers to understand a broad range of issues related to indoor air quality. The manual is directed to technically knowledgeable persons employed by utility companies - the customer service or marketing representative, applications engineer, or technician - who may not have specific expertise in indoor air quality issues. In addition to providing monitoring and control techniques, the manual summarizes the link between pollutant concentrations, air exchange, and energy conservation and describes the characteristics and health effects of selected pollutants. Where technical information is too lengthy or complex for inclusion in this volume, reference sources are given. Information for this manual was gathered from technical studies, manufacturers' information, and other materials from professional societies, institutes, and associations. The aim has been to provide objective technical and descriptive information that can be used by utility personnel to make informed decisions about indoor air quality issues

Manual on indoor air quality

Energy Technology Data Exchange (ETDEWEB)

Diamond, R.C.; Grimsrud, D.T.

1983-12-01

This reference manual was prepared to assist electric utilities in helping homeowners, builders, and new home buyers to understand a broad range of issues related to indoor air quality. The manual is directed to technically knowledgeable persons employed by utility companies - the customer service or marketing representative, applications engineer, or technician - who may not have specific expertise in indoor air quality issues. In addition to providing monitoring and control techniques, the manual summarizes the link between pollutant concentrations, air exchange, and energy conservation and describes the characteristics and health effects of selected pollutants. Where technical information is too lengthy or complex for inclusion in this volume, reference sources are given. Information for this manual was gathered from technical studies, manufacturers' information, and other materials from professional societies, institutes, and associations. The aim has been to provide objective technical and descriptive information that can be used by utility personnel to make informed decisions about indoor air quality issues.

21 CFR 868.1030 - Manual algesimeter.

Science.gov (United States)

2010-04-01

... DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1030 Manual algesimeter. (a) Identification. A manual algesimeter is a mechanical device intended to determine a patient's sensitivity to pain after...

The Relationship of Labor Pain, Medication Usage, and Length of Labor with Childbirth Preparation in Primigravidas.

Science.gov (United States)

1992-01-01

that the placenta was not a barrier between the mother and the infant. Dr. Virginia Apgar , a world renown authority on birth defects, described the...out. My placenta did not extract so she had to manually get it. Everyone was really nice and supportive but until you have a baby you really don’t

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

21 CFR 868.5915 - Manual emergency ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual emergency ventilator. 868.5915 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5915 Manual emergency ventilator. (a) Identification. A manual emergency ventilator is a device, usually incorporating a bag and valve, intended to...

Dental Chairside Technique. Student's Manual.

Science.gov (United States)

Apfel, Maura; Weaver, Trudy Karlene

This manual is part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. This student manual contains four units covering the following topics: local anesthesia; dental office emergencies; oral hygiene;…

Nuclear material operations manual

International Nuclear Information System (INIS)

Tyler, R.P.

1981-02-01

This manual provides a concise and comprehensive documentation of the operating procedures currently practiced at Sandia National Laboratories with regard to the management, control, and accountability of nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion

Nuclear material operations manuals

International Nuclear Information System (INIS)

Tyler, R.P.

1979-06-01

This manual is intended to provide a concise and comprehensive documentation of the operating procedures currently practiced at Sandia Laboratories with regard to the management, control, and accountability of radioactive and nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion

Manual vs. computer-assisted sperm analysis: can CASA replace manual assessment of human semen in clinical practice?

Science.gov (United States)

Talarczyk-Desole, Joanna; Berger, Anna; Taszarek-Hauke, Grażyna; Hauke, Jan; Pawelczyk, Leszek; Jedrzejczak, Piotr

2017-01-01

The aim of the study was to check the quality of computer-assisted sperm analysis (CASA) system in comparison to the reference manual method as well as standardization of the computer-assisted semen assessment. The study was conducted between January and June 2015 at the Andrology Laboratory of the Division of Infertility and Reproductive Endocrinology, Poznań University of Medical Sciences, Poland. The study group consisted of 230 men who gave sperm samples for the first time in our center as part of an infertility investigation. The samples underwent manual and computer-assisted assessment of concentration, motility and morphology. A total of 184 samples were examined twice: manually, according to the 2010 WHO recommendations, and with CASA, using the program set-tings provided by the manufacturer. Additionally, 46 samples underwent two manual analyses and two computer-assisted analyses. The p-value of p CASA and manually. In the group of patients where all analyses with each method were performed twice on the same sample we found no significant differences between both assessments of the same probe, neither in the samples analyzed manually nor with CASA, although standard deviation was higher in the CASA group. Our results suggest that computer-assisted sperm analysis requires further improvement for a wider application in clinical practice.

WE-AB-BRA-05: Fully Automatic Segmentation of Male Pelvic Organs On CT Without Manual Intervention

International Nuclear Information System (INIS)

Gao, Y; Lian, J; Chen, R; Wang, A; Shen, D

2015-01-01

Purpose: We aim to develop a fully automatic tool for accurate contouring of major male pelvic organs in CT images for radiotherapy without any manual initialization, yet still achieving superior performance than the existing tools. Methods: A learning-based 3D deformable shape model was developed for automatic contouring. Specifically, we utilized a recent machine learning method, random forest, to jointly learn both image regressor and classifier for each organ. In particular, the image regressor is trained to predict the 3D displacement from each vertex of the 3D shape model towards the organ boundary based on the local image appearance around the location of this vertex. The predicted 3D displacements are then used to drive the 3D shape model towards the target organ. Once the shape model is deformed close to the target organ, it is further refined by an organ likelihood map estimated by the learned classifier. As the organ likelihood map provides good guideline for the organ boundary, the precise contouring Result could be achieved, by deforming the 3D shape model locally to fit boundaries in the organ likelihood map. Results: We applied our method to 29 previously-treated prostate cancer patients, each with one planning CT scan. Compared with manually delineated pelvic organs, our method obtains overlap ratios of 85.2%±3.74% for the prostate, 94.9%±1.62% for the bladder, and 84.7%±1.97% for the rectum, respectively. Conclusion: This work demonstrated feasibility of a novel machine-learning based approach for accurate and automatic contouring of major male pelvic organs. It shows the potential to replace the time-consuming and inconsistent manual contouring in the clinic. Also, compared with the existing works, our method is more accurate and also efficient since it does not require any manual intervention, such as manual landmark placement. Moreover, our method obtained very similar contouring results as the clinical experts. Project is partially support

WE-AB-BRA-05: Fully Automatic Segmentation of Male Pelvic Organs On CT Without Manual Intervention

Energy Technology Data Exchange (ETDEWEB)

Gao, Y; Lian, J; Chen, R; Wang, A; Shen, D [Univ North Carolina, Chapel Hill, NC (United States)

2015-06-15

Purpose: We aim to develop a fully automatic tool for accurate contouring of major male pelvic organs in CT images for radiotherapy without any manual initialization, yet still achieving superior performance than the existing tools. Methods: A learning-based 3D deformable shape model was developed for automatic contouring. Specifically, we utilized a recent machine learning method, random forest, to jointly learn both image regressor and classifier for each organ. In particular, the image regressor is trained to predict the 3D displacement from each vertex of the 3D shape model towards the organ boundary based on the local image appearance around the location of this vertex. The predicted 3D displacements are then used to drive the 3D shape model towards the target organ. Once the shape model is deformed close to the target organ, it is further refined by an organ likelihood map estimated by the learned classifier. As the organ likelihood map provides good guideline for the organ boundary, the precise contouring Result could be achieved, by deforming the 3D shape model locally to fit boundaries in the organ likelihood map. Results: We applied our method to 29 previously-treated prostate cancer patients, each with one planning CT scan. Compared with manually delineated pelvic organs, our method obtains overlap ratios of 85.2%±3.74% for the prostate, 94.9%±1.62% for the bladder, and 84.7%±1.97% for the rectum, respectively. Conclusion: This work demonstrated feasibility of a novel machine-learning based approach for accurate and automatic contouring of major male pelvic organs. It shows the potential to replace the time-consuming and inconsistent manual contouring in the clinic. Also, compared with the existing works, our method is more accurate and also efficient since it does not require any manual intervention, such as manual landmark placement. Moreover, our method obtained very similar contouring results as the clinical experts. Project is partially support

Micturating cystourethrogram as a tool for investigating UTI in children - An institutional audit.

Science.gov (United States)

Hua, L; Linke, R J; Boucaut, H A P; Khurana, S

2016-10-01

Micturating cystourethrograms (MCUG) are the gold standard for evaluating vesicoureteric reflux (VUR). There is a growing consensus for increasing the threshold for performing MCUGs following urinary tract infections (UTI) in children. There are several varying guidelines. It is important to detect high-grade reflux in the setting of an UTI because of potential long-term complications. This audit aimed to retrospectively: (1) identify the conformance rate of local guidelines at the Women's and Children's Hospital (WCH); (2) assess predictors for an abnormal MCUG; and (3) compare local guidelines against the Royal Children's Hospital, Melbourne (RCH), National Institute for Healthcare and Excellence (NICE), and American Academy of Pediatrics (AAP) guidelines for selectively detecting high-grade reflux. The number of MCUGs performed from 2008 to 2012 at the WCH radiology department was collected. Patients undergoing MCUG during the 2012 calendar year were identified. Only children having an initial MCUG as part of an UTI investigation with prerequisite imaging as per guidelines were included. Each child's age, sex, referral source, reason, renal ultrasound (RUS) prior to the MCUG, MCUG result and VUR grade were recorded. The WCH guidelines were applied to determine conformance, to evaluate predictors for an abnormal MCUG, and compared against other retrospectively applied guidelines (RCH, NICE, AAP). There was complete data for 168 children who underwent MCUG as part of an UTI investigation (median age 0.79 years, range 0.12-8.74, male:female 67:101). There were 67/168 abnormal MCUGs (62 children with VUR, five bladder diverticulum), and 97 refluxing renal units (43 high-grade VUR units). No posterior urethral valves (PUV) were identified as part of the UTI investigation. A total of 143/168 patients had prior RUS (normal:abnormal 67:76). The WCH guidelines had 82% conformance. There was no statistically significant association between an abnormal MCUG and age, sex

Ponatinib for Treating Chronic Myeloid Leukaemia: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

Science.gov (United States)

Pandor, Abdullah; Stevenson, Matt; Stevens, John; James, Marrissa Martyn-St; Hamilton, Jean; Byrne, Jenny; Rudin, Claudius; Rawdin, Andrew; Wong, Ruth

2018-02-26

As part of its single technology appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures ponatinib (Inclusig ® ; Incyte Corporation) to submit evidence for the clinical and cost effectiveness for previously treated chronic myeloid leukaemia (CML) and Philadelphia-chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL). This paper focusses on the three phases of CML: the chronic phase (CP), the accelerated phase (AP) and the blast crisis phase (BP). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). This article presents the critical review of the company's submission by the ERG and the outcome of the NICE guidance. Clinical evidence for ponatinib was derived from a phase II, industry-sponsored, single-arm, open-label, multicentre, non-comparative study. Despite the limited evidence and potential for biases, this study demonstrated that ponatinib was likely to be an effective treatment (in terms of major cytogenetic response and major haematological response) with an acceptable safety profile for patients with CML. Given the absence of any head-to-head studies comparing ponatinib with other relevant comparators, the company undertook a matching-adjusted indirect comparison (MAIC) of ponatinib with bosutinib. The approach was only used for patients with CP-CML because comprehensive data were not available for the AP- or BP-CML groups to allow the matching technique to be used. Despite the uncertainty about the MAIC approach, ponatinib was considered likely to offer advantages over bosutinib in the third-line setting, particularly for complete cytogenetic response. The company developed two health economic models to assess the cost effectiveness of ponatinib for the treatment of patients in CP-CML or in advanced CML (AP- or BP-CML, which were modelled separately). The company did

Geothermal reservoir assessment manual; 1984-1992 nendo chinetsu choryusou hyoka shuhou manual

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-02-01

A geothermal reservoir assessment manual was prepared for the promotion of the development of geothermal power generation, based on the results of the 'geothermal reservoir assessment technique development project' implemented during the fiscal 1984-1992 period and on the results of surveys conducted in Japan and abroad. Of the geothermal systems generally classified into the steam dominant type and the hot water dominant type, encounters with the steam dominant type are but seldom reported. This manual therefore covers the hot water dominant type only. In addition to the explanation of the basic concept and the outline of geothermal reservoirs, the manual carries data necessary for reservoir assessment; geological and geophysical data analyses; geochemistry in reservoir assessment; data of underground logging and of fuming; conceptual models; simulators and models for reservoir simulation; natural-state simulation, history-matching simulation, and reservoir behavior predicting simulation; case history (modeling of a geothermal reservoir prior to exploitation), references, and so forth. (NEDO)

Geothermal reservoir assessment manual; 1984-1992 nendo chinetsu choryusou hyoka shuhou manual

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-02-01

A geothermal reservoir assessment manual was prepared for the promotion of the development of geothermal power generation, based on the results of the 'geothermal reservoir assessment technique development project' implemented during the fiscal 1984-1992 period and on the results of surveys conducted in Japan and abroad. Of the geothermal systems generally classified into the steam dominant type and the hot water dominant type, encounters with the steam dominant type are but seldom reported. This manual therefore covers the hot water dominant type only. In addition to the explanation of the basic concept and the outline of geothermal reservoirs, the manual carries data necessary for reservoir assessment; geological and geophysical data analyses; geochemistry in reservoir assessment; data of underground logging and of fuming; conceptual models; simulators and models for reservoir simulation; natural-state simulation, history-matching simulation, and reservoir behavior predicting simulation; case history (modeling of a geothermal reservoir prior to exploitation), references, and so forth. (NEDO)

Light-water-reactor hydrogen manual

International Nuclear Information System (INIS)

Camp, A.L.; Cummings, J.C.; Sherman, M.P.; Kupiec, C.F.; Healy, R.J.; Caplan, J.S.; Sandhop, J.R.; Saunders, J.H.

1983-06-01

A manual concerning the behavior of hydrogen in light water reactors has been prepared. Both normal operations and accident situations are addressed. Topics considered include hydrogen generation, transport and mixing, detection, and combustion, and mitigation. Basic physical and chemical phenomena are described, and plant-specific examples are provided where appropriate. A wide variety of readers, including operators, designers, and NRC staff, will find parts of this manual useful. Different sections are written at different levels, according to the most likely audience. The manual is not intended to provide specific plant procedures, but rather, to provide general guidance that may assist in the development of such procedures

[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.

21 CFR 872.6855 - Manual toothbrush.

Science.gov (United States)

2010-04-01

... remove adherent plaque and food debris from the teeth to reduce tooth decay. (b) Classification. Class I... DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6855 Manual toothbrush. (a) Identification. A manual...

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

14 CFR 125.75 - Airplane flight manual.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane flight manual. 125.75 Section 125... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Airplane flight manual. (a) Each certificate holder shall keep a current approved Airplane Flight Manual or...

Societal views on NICE, cancer drugs fund and value-based pricing criteria for prioritising medicines: a cross-sectional survey of 4118 adults in Great Britain.

Science.gov (United States)

Linley, Warren G; Hughes, Dyfrig A

2013-08-01

The criteria used by the National Institute for Health and Clinical Excellence (NICE) for accepting higher incremental cost-effectiveness ratios for some medicines over others, and the recent introduction of the Cancer Drugs Fund (CDF) in England, are assumed to reflect societal preferences for National Health Service resource allocation. Robust empirical evidence to this effect is lacking. To explore societal preferences for these and other criteria, including those proposed for rewarding new medicines under the future value-based pricing (VBP) system, we conducted a choice-based experiment in 4118 UK adults via web-based surveys. Preferences were determined by asking respondents to allocate fixed funds between different patient and disease types reflecting nine specific prioritisation criteria. Respondents supported the criteria proposed under the VBP system (for severe diseases, address unmet needs, are innovative--provided they offered substantial health benefits, and have wider societal benefits) but did not support the end-of-life premium or the prioritisation of children or disadvantaged populations as specified by NICE, nor the special funding status for treatments of rare diseases, nor the CDF. Policies introduced on the basis of perceived--and not actual--societal values may lead to inappropriate resource allocation decisions with the potential for significant population health and economic consequences. Copyright © 2012 John Wiley & Sons, Ltd.

Kinesiology Workbook and Laboratory Manual.

Science.gov (United States)

Harris, Ruth W.

This manual is written for students in anatomy, kinesiology, or introductory biomechanics courses. The book is divided into two sections, a kinesiology workbook and a laboratory manual. The two sections parallel each other in content and format. Each is divided into three corresponding sections: (1) Anatomical bases for movement description; (2)…

Tank waste remediation system process engineering instruction manual

International Nuclear Information System (INIS)

ADAMS, M.R.

1998-01-01

The purpose of the Tank Waste Remediation System (TWRS) Process Engineering Instruction Manual is to provide guidance and direction to TWRS Process Engineering staff regarding conduct of business. The objective is to establish a disciplined and consistent approach to business such that the work processes within TWRS Process Engineering are safe, high quality, disciplined, efficient, and consistent with Lockheed Martin Hanford Corporation Policies and Procedures. The sections within this manual are of two types: for compliance and for guidance. For compliance sections are intended to be followed per-the-letter until such time as they are formally changed per Section 2.0 of this manual. For guidance sections are intended to be used by the staff for guidance in the conduct of work where technical judgment and discernment are required. The guidance sections shall also be changed per Section 2.0 of this manual. The required header for each manual section is illustrated in Section 2.0, Manual Change Control procedure. It is intended that this manual be used as a training and indoctrination resource for employees of the TWRS Process Engineering organization. The manual shall be required reading for all TWRS Process Engineering staff, matrixed, and subcontracted employees

The efficacy of manual joint mobilisation/manipulation in treatment of lateral ankle sprains: a systematic review.

Science.gov (United States)

Loudon, Janice K; Reiman, Michael P; Sylvain, Jonathan

2014-03-01

Lateral ankle sprains are common and can have detrimental consequences to the athlete. Joint mobilisation/manipulation may limit these outcomes. Systematically summarise the effectiveness of manual joint techniques in treatment of lateral ankle sprains. This review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A computer-assisted literature search of MEDLINE, CINHAL, EMBASE, OVID and Physiotherapy Evidence Database (PEDro) (January 1966 to March 2013) was used with the following keywords alone and in combination 'ankle', 'sprain', 'injuries', 'lateral', 'manual therapy', and 'joint mobilisation'. The methodological quality of individual studies was assessed using the PEDro scale. After screening of titles, abstracts and full articles, eight articles were kept for examination. Three articles achieved a score of 10 of 11 total points; one achieved a score of 9; two articles scored 8; one article scored a 7 and the remaining article scored a 5. Three articles examined joint techniques for acute sprains and the remainder examined subacute/chronic ankle sprains. Outcome measures included were pain level, ankle range of motion, swelling, functional score, stabilometry and gait parameters. The majority of the articles only assessed these outcome measures immediately after treatment. No detrimental effects from the joint techniques were revealed in any of the studies reviewed. For acute ankle sprains, manual joint mobilisation diminished pain and increased dorsiflexion range of motion. For treatment of subacute/chronic lateral ankle sprains, these techniques improved ankle range-of-motion, decreased pain and improved function.

Radiology Aide. Instructor Key [and] Student Manual.

Science.gov (United States)

Hartwein, Jon; Dunham, John

This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

Nuclear material operations manual

International Nuclear Information System (INIS)

Tyler, R.P.; Gassman, L.D.

1978-04-01

This manual is intended to provide a concise and comprehensive documentation of the operating procedures currently practiced at Sandia Laboratories with regard to the management, control, and accountability of radioactive and nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations--management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of ''play-scripts'' in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion

WAM-E user's manual

International Nuclear Information System (INIS)

Rayes, L.G.; Riley, J.E.

1986-07-01

The WAM-E series of mainframe computer codes have been developed to efficiently analyze the large binary models (e.g., fault trees) used to represent the logic relationships within and between the systems of a nuclear power plant or other large, multisystem entity. These codes have found wide application in reliability and safety studies of nuclear power plant systems. There are now nine codes in the WAM-E series, with six (WAMBAM/WAMTAP, WAMCUT, WAMCUT-II, WAMFM, WAMMRG, and SPASM) classified as Type A Production codes and the other three (WAMFTP, WAMTOP, and WAMCONV) classified as Research codes. This document serves as a combined User's Guide, Programmer's Manual, and Theory Reference for the codes, with emphasis on the Production codes. To that end, the manual is divided into four parts: Part I, Introduction; Part II, Theory and Numerics; Part III, WAM-E User's Guide; and Part IV, WAMMRG Programmer's Manual

Managerial Accounting. Course Administrative Manual.

Science.gov (United States)

Central Michigan Univ., Mount Pleasant. Inst. for Personal and Career Development.

This manual is part of the materials for a college-level programmed course in managerial accounting and intended to aid instructors in helping students to work their way through the self-instructional study guide around which the course is organized. The manual describes the various materials and components used in the self-instructional sequence…

NV/YMP RADIOLOGICAL CONTROL MANUAL

Energy Technology Data Exchange (ETDEWEB)

U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION NEVADA SITE OFFICE; BECHTEL NEVADA

2004-11-01

This manual contains the radiological control requirements to be used for all radiological activities conducted by programs under the purview of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) and the Yucca Mountain Office of Repository Development (YMORD). Compliance with these requirements will ensure compliance with Title 10 Code of Federal Regulations Part 835 (10 CFR 835), Occupational Radiation Protection. Programs covered by this manual are located at the Nevada Test Site (NTS); Nellis Air Force Base and North Las Vegas, Nevada; Santa Barbara and Pleasanton, California; and at Andrews Air Force Base, Maryland. In addition, field work by NNSA/NSO at other locations is also covered by this manual.

NV/YMP RADIOLOGICAL CONTROL MANUAL

International Nuclear Information System (INIS)

2004-01-01

This manual contains the radiological control requirements to be used for all radiological activities conducted by programs under the purview of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) and the Yucca Mountain Office of Repository Development (YMORD). Compliance with these requirements will ensure compliance with Title 10 Code of Federal Regulations Part 835 (10 CFR 835), Occupational Radiation Protection. Programs covered by this manual are located at the Nevada Test Site (NTS); Nellis Air Force Base and North Las Vegas, Nevada; Santa Barbara and Pleasanton, California; and at Andrews Air Force Base, Maryland. In addition, field work by NNSA/NSO at other locations is also covered by this manual

Radiological Control Manual. Revision 0, January 1993

Energy Technology Data Exchange (ETDEWEB)

1993-04-01

This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

Users Manual for the FEHMN application

International Nuclear Information System (INIS)

Zyvoloski, G.A.; Robinson, B.A.; Dash, Z.V.; Trease, L.L.

1996-01-01

The user's manual documents the use of the Yucca Mountain Site Characterization Projects Finite element heat and mass transfer code (FEHMN) application. The manual covers: Program considerations, data files, input data, output, system interface, and examples

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Science.gov (United States)

2014-01-01

Background Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. Methods These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. Results These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions. Conclusions Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. PMID:25081580

Risk factors and control of hospital acquired infections: a comparison between Wikipedia and scientific literature

Directory of Open Access Journals (Sweden)

Elisa Maggi

2013-03-01

Full Text Available Background: nowadays Wikipedia is one of the main on-line sources of general information. It contains several items about nosocomial infections and their prevention, together of items on virtually every scientific topic.This study aims to assess whether Wikipedia can be considered a reliable source for professional updating, concerning Healthcare-associated Infections (HAI.Methods: Wikipedia has been searched in order to gather items on HAI. 387 items were found with a search string. The field of research was reduced at those articles (27 items containing exhaustive information in relation to prevention of HAI. The messages contained in those articles were than compared with the recommendations of a selected guideline (NICE 2003, completed by a literature search, with the aim of testing their reliability and exhaustivity.Results: 15 Wiki items were found and 51 messages selected. NICE guidelines contained 119 recommendations and 52 more recommendations has been found in a further literature search. 45.1% of Wikipedia’s messages were even found in the guidelines. On this percentage, 21.6% completely agreed with the messages of the guidelines, 15.7% partially agreed, 3.9% disagreed and 3.9% showed different level of evidence in different articles. Moreover, 54.9% of Wikipedia’s messages were not included in the guidelines and 84.2% of the recommendations contained in the guidelines were not present in Wikipedia.Conclusions: Wikipedia should not be considered as a reliable source for professional updating on HAI.

MANUAL. Fly ash in civil engineering, Gravel roads; HANDBOK. Flygaska i mark- och vaegbyggnad, Grusvaegar

Energy Technology Data Exchange (ETDEWEB)

Munde, Hanna; Svedberg, Bo; Macsik, Josef; Maijala, Aino; Lahtinen, Pentti; Ekdahl, Peter; Neren, Jens [Vattenfall AB, Stockholm (Sweden). Vaerme Norden

2006-01-15

Fly ash based on biofuels or coal has been used as construction material for a long time in roads and other civil engineering applications. Some example, where it has been used in roadbase and subbase of gravel roads, are in the counties of Uppsala, Soedermanland, Vaestmanland and in Finland. The use of fly ash has contributed to good function for example as bearing capacity, thaw and frost capacity and good durability. This has also reduced costs for maintenance. The objective of this project was to develop a manual to provide a base for contemporary use of fly ash in road constructions. In the manual experience from studies, field tests and regulations has been compiled. The manual handles fly ash as base for products to be used in base and subbase in gravel roads. Future user of the guidelines are mainly consultant engineers and contractors. However the aim of the manual is to also support road administrators, environmental authorities and industry. The project has been carried out parallel to another ongoing national project titled 'Guidelines, Use of alternative materials in civil engineering'. The objective of that project is to establish a base for handling of alternative materials in Sweden. Fly ash in gravel roads are mainly used in two typical applications, one without any additive in a single layer and one with fly ash mixed with gravel. The use of flyash provides functional properties such as increased stiffness, stability and enhanced frost and thaw capacity for the road construction in total. Furthermore the products based on fly ash will have low permeability and good frost and thaw durability. These properties are for example related to fly ash quality, design and construction and are in general expected to be better than for traditional constructions using, for example, sand or gravel. The properties can be enhanced further by using binders such as cement and Merit. Fly ash should always be used above the ground water table with

Barriers to implementing the NICE guidelines for early-onset neonatal infection: cross-sectional survey of neonatal blood culture reporting by laboratories in the UK.

Science.gov (United States)

Paul, S P; Caplan, E M; Morgan, H A; Turner, P C

2018-04-01

The National Institute for Health and Care Excellence published guidelines for managing early-onset neonatal infections in 2012. It recommended provision for reporting blood cultures (BCs) with growth detected or not detected at 36 h. To determine if this was followed, a telephone survey was conducted amongst lead biomedical scientists based at microbiology laboratories (N = 209) in the UK. Overall, 202/209 responded and 139/202 had on-site facilities for BCs. BC results with growth detected or not detected at 36 h were available out-of-hours in 36/139 (26.6%) and 66/139 (47.5%) neonatal units, respectively. Early discontinuation of antibiotics should lead to improved antibiotic stewardship. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Development of an environmental safety case guidance manual

International Nuclear Information System (INIS)

Wellstead, Matthew John

2014-01-01

NDA RWMD is currently considering the scope, purpose and structure of a safety case manual that covers the development of nuclear operational, transport and environmental safety cases for a geological disposal facility in the United Kingdom. This paper considers the Environmental Safety Case (ESC) input into such a manual (herein referred to as the 'ESC Manual'), looking at the drivers and benefits that a guidance manual in this area may provide. (authors)

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

Site security personnel training manual

International Nuclear Information System (INIS)

1978-10-01

As required by 10 CFR Part 73, this training manual provides guidance to assist licensees in the development of security personnel training and qualifications programs. The information contained in the manual typifies the level and scope of training for personnel assigned to perform security related tasks and job duties associated with the protection of nuclear fuel cycle facilities and nuclear power reactors

Radiation protection manual

International Nuclear Information System (INIS)

Spang, A.

1983-01-01

According to the Radiation Protection Ordinance, radiation protection experts directing or supervising the handling of radioactive materials must have expert knowledge. The concept of expert knowledge has been clearly defined by the Fachverband e.V. in a catalogue of instruction goals. The manual follows the principles of this catalogue; it presents the expert knowledge required in a total of 15 subject groups. There is an index which helps the reader to find his specific subject group and the knowledge required of him in this subject group. However, the manual gives only an outline of the subject matter in many instances and should therefore not be regarded as a textbook in the proper sense. (orig./HP) [de