WorldWideScience

Sample records for plan includes guidelines

  1. Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

    Science.gov (United States)

    Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

    2005-01-01

    Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

  2. EM Health and Safety Plan Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

  3. No. 354-Canadian HIV Pregnancy Planning Guidelines.

    Science.gov (United States)

    Loutfy, Mona; Kennedy, V Logan; Poliquin, Vanessa; Dzineku, Frederick; Dean, Nicola L; Margolese, Shari; Symington, Alison; Money, Deborah M; Hamilton, Scot; Conway, Tracey; Khan, Sarah; Yudin, Mark H

    2018-01-01

    The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist Canadians affected by HIV with their fertility, preconception, and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible and take into account diverse and intersecting local/population needs based on the social determinants of health. EVIDENCE: Literature searches were conducted by a librarian using the Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase databases for published articles in English and French related to HIV and pregnancy and HIV and pregnancy planning for each section of the guidelines. The full search strategy is available upon request. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the SOGC under the leadership of the principal authors, and recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. Guideline implementation should assist the practitioner in developing an evidence-based approach for the prevention of unplanned pregnancy, preconception, fertility, and pregnancy planning counselling in the context of HIV infection. These guidelines have been reviewed and approved by the Infectious Disease Committee and the Executive and Council of the SOGC. Canadian Institutes of Health Research Grant Planning and Dissemination grant (Funding Reference # 137186), which funded a Development Team meeting in 2016. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  4. 7 CFR 611.10 - Standards, guidelines, and plans.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Standards, guidelines, and plans. 611.10 Section 611... § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines for naming, classifying, and interpreting soils and for disseminating soil survey information. (b...

  5. Societal Planning: Identifying a New Role for the Transport Planner-Part II: Planning Guidelines

    DEFF Research Database (Denmark)

    Khisty, C. Jotin; Leleur, Steen

    1997-01-01

    The paper seeks to formulate planning guidelines based on Habermas's theory of communicative action. Specifically, this has led to the formulation of a set of four planning validity claims concerned to four types of planning guidelines concerning adequacy, dependency, suitability and adaptability......-a-vis the planning validity claims. Among other things the contingency of this process is outlined. It is concluded (part I & II) that transport planners can conveniently utilize the guidelines in their professional practice, tailored to their particular settings....

  6. 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.

  7. Sandia software guidelines: Software quality planning

    Energy Technology Data Exchange (ETDEWEB)

    1987-08-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standard for Software Quality Assurance Plans, this volume identifies procedures to follow in producing a Software Quality Assurance Plan for an organization or a project, and provides an example project SQA plan. 2 figs., 4 tabs.

  8. Assessing the impact of the U.S. Endangered Species Act recovery planning guidelines on managing threats for listed species.

    Science.gov (United States)

    Troyer, Caitlin M; Gerber, Leah R

    2015-10-01

    The Endangered Species Act (ESA) of the United States was enacted in 1973 to prevent the extinction of species. Recovery plans, required by 1988 amendments to the ESA, play an important role in organizing these efforts to protect and recover species. To improve the use of science in the recovery planning process, the Society for Conservation Biology (SCB) commissioned an independent review of endangered species recovery planning in 1999. From these findings, the SCB made key recommendations for how management agencies could improve the recovery planning process, after which the U.S. Fish and Wildlife Service and the National Marine Fisheries Service redrafted their recovery planning guidelines. One important recommendation called for recovery plans to make threats a primary focus, including organizing and prioritizing recovery tasks for threat abatement. We sought to determine the extent to which results from the SCB study were incorporated into these new guidelines and whether the SCB recommendations regarding threats manifested in recovery plans written under the new guidelines. Recovery planning guidelines generally incorporated the SCB recommendations, including those for managing threats. However, although recent recovery plans have improved in their treatment of threats, many fail to adequately incorporate threat monitoring. This failure suggests that developing clear guidelines for monitoring should be an important priority in improving ESA recovery planning. © 2015 Society for Conservation Biology.

  9. Praxis and guidelines for planned homebirths in the Nordic countries - an overview

    DEFF Research Database (Denmark)

    Lindgren, Helena; Kjaergaard, Hanne; Olafsdottir, Olof Asta

    2014-01-01

    to a midwife attending the birth varies geographically. In the Stockholm County Council guidelines have been developed for publicly funding of planned home births; for the rest of Sweden no national guidelines have been formulated and the service is privately funded. KEY CONCLUSION: Inconsistencies in the home...... birth services of the Nordic countries imply different opportunities for midwifery care to women with regard to their preferred place of birth. Uniform sociodemography, health care systems and cultural context in the Nordic countries are factors in favour of further research to compare and aggregate...... woman has the right to be attended by a midwife during a homebirth and each county council must present a plan for the organization of birth services, including homebirth services. In Norway and Iceland the service is fully or partly funded by taxes and national guidelines are available but access...

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

    Science.gov (United States)

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

    2008-01-01

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

  11. Guidelines for evaluating software configuration management plans for digital instrumentation and control systems

    International Nuclear Information System (INIS)

    Cheon, Se Woo; Park, Jong Kyun; Lee, Ki Young; Lee, Jang Soo; Kim, Jang Yeon

    2001-08-01

    Software configuration management (SCM) is the process for identifying software configuration items (CIs), controlling the implementation and changes to software, recording and reporting the status of changes, and verifying the completeness and correctness of the released software. SCM consists of two major aspects: planning and implementation. Effective SCM involves planning for how activities are to be performed, and performing these activities in accordance with the Plan. This report first reviews the background of SCM that include key standards, SCM disciplines, SCM basic functions, baselines, software entity, SCM process, the implementation of SCM, and the tools of SCM. In turn, the report provides the guidelines for evaluating the SCM Plan for digital I and C systems of nuclear power plants. Most of the guidelines in the report are based on IEEE Std 828 and ANSI/IEEE Std 1042. According to BTP-14, NUREG-0800, the evaluation topics on the SCM Plan is classified into three categories: management, implementation, and resource characteristics

  12. PREPARE: guidelines for planning animal research and testing.

    Science.gov (United States)

    Smith, Adrian J; Clutton, R Eddie; Lilley, Elliot; Hansen, Kristine E Aa; Brattelid, Trond

    2018-04-01

    There is widespread concern about the quality, reproducibility and translatability of studies involving research animals. Although there are a number of reporting guidelines available, there is very little overarching guidance on how to plan animal experiments, despite the fact that this is the logical place to start ensuring quality. In this paper we present the PREPARE guidelines: Planning Research and Experimental Procedures on Animals: Recommendations for Excellence. PREPARE covers the three broad areas which determine the quality of the preparation for animal studies: formulation, dialogue between scientists and the animal facility, and quality control of the various components in the study. Some topics overlap and the PREPARE checklist should be adapted to suit specific needs, for example in field research. Advice on use of the checklist is available on the Norecopa website, with links to guidelines for animal research and testing, at https://norecopa.no/PREPARE .

  13. Serving our communities better. Guidelines for planning and developing integrated delivery networks.

    Science.gov (United States)

    Prybil, L; Golden, P; Ballance, X

    1995-04-01

    In 1994 the Daughters of Charity National Health System-East Central (DCNHS-East Central) adopted 11 guidelines to help corporate staff and local leaders plan and develop integrated networks. Guideline 1 emphasizes needs-based strategic planning. Guideline 2 focuses on the community-based network planning process, recommending a team approach and ongoing communication with the local ordinary. In guidelines 3 through 5, the DCNHS-East Central Board of Directors spells out key issues that must be covered in proposals ultimately presented for governance action. Guideline 6 presents three core elements that should characterize all CBNs in which DCNHS-East Central institutions participate. Guideline 7 emphasizes that all CBN proposals and agreements must be clear with respect to the Catholic identity of DCNHS-East Central institutions. Guidelines 8 and 9 require that proposed changes to traditional policies and management practices be explicit in CBN proposals. The tenth guideline requires that all CBN proposals indicate an explicit evaluation function. The final guideline underscores that regardless of the strategic fit or how well a CBN is designed, it is unlikely to succeed unless both internal and external relationships are based on a solid foundation of honesty, mutual respect, and trust.

  14. nestor Guideline for Preservation Planning – a Process Model

    Directory of Open Access Journals (Sweden)

    Sabine Schrimpf

    2014-02-01

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

  15. Canadian HIV Pregnancy Planning Guidelines: No. 278, June 2012.

    Science.gov (United States)

    Loutfy, Mona R; Margolese, Shari; Money, Deborah M; Gysler, Mathias; Hamilton, Scot; Yudin, Mark H

    2012-10-01

    Four main clinical issues need to be considered for HIV-positive individuals and couples with respect to pregnancy planning and counselling: (1) pre-conceptional health; (2) transmission from mother to infant, which has been significantly reduced by combined antiretroviral therapy; (3) transmission between partners during conception, which requires different prevention and treatment strategies depending on the status and needs of those involved; and (4) management of infertility issues. The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist HIV-positive individuals and couples with their fertility and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible, and they take into account diverse and intersecting local/population needs and the social determinants of health. Intended outcomes are (1) reduction of risk of vertical transmission and horizontal transmission of HIV, (2) improvement of maternal and infant health outcomes in the presence of HIV, (3) reduction of the stigma associated with pregnancy and HIV, and (4) increased access to pregnancy planning and fertility services. PubMed and Medline were searched for articles published in English or French to December 20, 2010, using the following terms: "HIV" and "pregnancy" or "pregnancy planning" or "fertility" or "reproduction" or "infertility" or "parenthood" or "insemination" or "artificial insemination" or "sperm washing" or "IVF" or "ICSI" or "IUI." Other search terms included "HIV" and 'horizontal transmission" or "sexual transmission" or "serodiscordant." The following conference databases were also searched: Conference on Retroviruses and Opportunistic Infections, International AIDS Conference, International AIDS Society, Interscience Conference on Antimicrobial Agents and Chemotherapy, the Canadian Association of HIV/AIDS Research, and the Ontario HIV Treatment

  16. A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy

    International Nuclear Information System (INIS)

    Fokas, Emmanouil; Eccles, Cynthia; Patel, Neel; Chu, Kwun-Ye; Warren, Samantha; McKenna, W. Gillies; Brunner, Thomas B.

    2013-01-01

    Background and purpose: Contouring of target volumes varies significantly in radiotherapy of pancreatic ductal adenocarcinoma (PDAC). There is a lack of consensus as to whether elective lymph nodes (eLN’s) should be included or not in the planning target volume (PTV). In the present study we analyzed the dosimetric coverage of the eLN’s and organs at risk (OAR) by comparing four different contouring guidelines. Methods and materials: PTVs were delineated with (Oxford and RTOG guidelines) or without (Michigan and SCALOP guidelines) including the eLNs in eleven patients with PDAC. eLNs included the peripancreatic, paraaortic, paracaval, celiac trunk, superior mesenteric and portal vein clinical target volumes (CTVs). A 3D-CRT plan (50.40 Gy in 28 fractions) was performed to analyze and compare the dosimetric coverage of all eLNs and OAR between the 4 contouring guidelines. Results: The size of Oxford and RTOG PTVs was comparable and significantly larger than the SCALOP and Michigan PTVs. Interestingly the eLNs received a significant amount of incidental dose irradiation by PTV-based plans that only aimed to treat the tumor without the eLNs. The dosimetric coverage of eLN presented a large variability according to the respective contouring methods. The difference in the size of the 4 PTVs was reflected to the dose distribution at the OAR. Conclusions: Our study provides important information regarding the impact of different contouring guidelines on the dose distribution to the eLNs and the OAR in patients with locally advanced PDAC treated with radiotherapy

  17. Failed fuel action plan guidelines: Special report

    International Nuclear Information System (INIS)

    1987-11-01

    The objective of this document is to provide a generic guideline that can be used to formulate a failed fuel action plan (FFAP) for specific application by a utility. This document is intended to be part of a comprehensive fuel reliability monitoring, management, and improvement program. The utilities may utilize this document as one resource in developing a failed fuel action plan. This document is not intended to be used as a failed fuel action plan standard. This document is intended to provide guidance on: management responsibilities; fuel performance parameters; cost/benefit analysis; action levels; long-term improvement methods; and data collection, analysis, and trending. 3 refs., 4 figs., 6 tabs

  18. National planning guidelines for environment ally sustainable development in Scotland and lessons learnt for Pakistan

    International Nuclear Information System (INIS)

    Qamar-ul-Islam; Anjum, G.A.; Shahzad, M.

    2005-01-01

    This piece of research work reflects the researcher's academic as well as the practical experiences of Scottish planning about the concept, issues and policy formulations. It is in the context of National Planning Policy Guidelines, originated in Scotland with particular reference to it's Fife Region. The first part reflects the general overview of Scotland followed by brief description of the region. Another part deals with the existing strategic issues in the region which are related to land and the environment notably rural planning priorities, agricultural scarce land, conservation of recreational and tourist areas, forest land potentials, landscape resources, national scenic areas, petro-chemical, industrial zones, river pollution and future land use for housing. This study has suggested National Planning Policy Guidelines to these issues. Last section deals with the lessons learnt from Scotland and appropriate application of these guidelines in case of Pakistan. The establishment of the relevant National Planning Guidelines according to our local environmental and socio-economic conditions can also play a significant role to safe guard our rural and urban landscapes and their respective environments. These broad guidelines must therefore be recommended in the broader spectrum in spatial linkage. Moreover these guidelines must therefore synthesize and articulated specifically at structure plans, master plans at district, sub district or local plans and planning processes which can lead Pakistan towards environmentally sustainable development. (author)

  19. Administrative Guidelines: Education of Gifted Students [and] Plan for Education of the Gifted in South Dakota.

    Science.gov (United States)

    South Dakota State Dept. of Education and Cultural Affairs, Pierre.

    This document is intended to assist South Dakota schools in the development and implementation of Gifted Education Plans, and includes state laws and rules pertaining to gifted education, guidelines for reporting, and explanations of the necessary components of a district's written plan. A brief statement of philosophy addresses characteristics of…

  20. APA guidelines: their importance and a plan to keep them current: 2013 annual report of the Policy and Planning Board.

    Science.gov (United States)

    2014-01-01

    When guidelines are approved by APA, they become association policy, and it is imperative that they remain current. The revision of guidelines poses several challenges to the association. These challenges range from the availability and allocation of resources to support the complicated processes involved in developing and updating these policies to the lack of a clearly defined process that includes identification of tasks, assignments of responsibilities, and so forth. For this reason, the APA Board of Directors asked the Policy and Planning Board (P&P) to work with the boards of the four directorates (i.e., the Education Directorate, the Practice Directorate, the Public Interest Directorate, and the Science Directorate) to create a proposal that would (a) make recommendations with regard to how the review and revision of guidelines documents might best be accomplished in accordance with the APA Strategic Plan and existing policies and procedures and (b) make suggestions regarding the association resources that might be required. The Board of Directors approved the proposed review process in December 2013. 2014 APA, all rights reserved

  1. Guidelines for the review of state ITS/CVO business plans

    Science.gov (United States)

    1997-08-01

    This document provides guidelines for the review of state ITS/CVO business plans by the FHWA. The purpose of the review is to ensure that the state business plans have been developed in a manner consistent with the FHWAs intent in awarding ITS/CVO...

  2. Considering wind energy in regional planning guidelines and communal land-use planning; Die Beruecksichtigung der Windenergie in der Richt- und Nutzungsplanung

    Energy Technology Data Exchange (ETDEWEB)

    Soguel, R. [Atelier North and Robyr, Neuchatel (Switzerland); Henz, H.R. [Metron Raumplanung AG, Brugg (Switzerland)

    2001-07-01

    This report made for the Swiss Federal Office of Energy (SFOE) discusses the situation in Switzerland regarding the planning guidelines required at regional and communal level that are required for the granting of permission to build wind energy installations. Various types of wind turbines and wind farms are described and topics such as planning tools, landscape protection and promotional concepts are discussed. The role of the Swiss Cantons in the promotion of wind energy is examined and the question of how to integrate wind energy plant into cantonal and communal planning guidelines is looked at. This working guide introduces two schemes that demonstrate how the planning process for the construction of wind farms can be co-ordinated with the development of land-use plans. Examples of current cantonal guidelines are presented in the appendix to the report.

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

    Energy Technology Data Exchange (ETDEWEB)

    TRUCANO,TIMOTHY G.; MOYA,JAIME L.

    1999-12-01

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

  4. Post-mastectomy radiotherapy in Denmark: From 2D to 3D treatment planning guidelines of The Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Thomsen, Mette Skovhus; Berg, Martin; Nielsen, Hanne M.

    2008-01-01

    centres participated. This work also included a definition of the tissue structures needed to be outlined on the planning CT-scan. The work was initiated in 2003 and the guidelines were approved by the DBCG Radiotherapy Committee in 2006. The first of January 2007 the 3D guidelines had been fully...

  5. Plans to adapt Point Lepreau ageing management to new industry guidelines

    International Nuclear Information System (INIS)

    Greenlaw, G.; Gendron, T.; Slade, J.; Rankin, B.

    2008-01-01

    In preparation for PLGS life extension, NBPN spent considerable effort to evaluate the impact of ageing and to develop ageing management processes to maintain the required safety functions for extended operation. These were based on INPO AP-913. Recently, the CNSC has been developing Canadian ageing management guidelines in line with the IAEA approach. In response, NBPN plans to document how current PLGS processes meet the new CNSC guidelines and to identify any areas for improvement. Best practices from utilities that have retrofitted IAEA guidelines and PLGS experience in applying risk-based methods for ageing management will be used to implement improvements. (author)

  6. Operating Plan and Guidelines (2011 - 2016)

    International Nuclear Information System (INIS)

    2011-01-01

    The Committee on Nuclear Regulatory Activities (CNRA) of the OECD Nuclear Energy Agency (NEA) is an international committee made up primarily of senior nuclear regulators. It was established in 1989 as a forum for the exchange of information and experience among regulatory organisations and for the review of developments which could affect regulatory requirements. The Committee is responsible for the programme of the NEA, concerning the regulation, licensing and inspection of nuclear installations. In particular, the Committee reviews current practices and operating experience. The Joint CSNI/CNRA Strategic Plan states that: The Operating Plan for each committee aligns with the Joint CNRA/ CSNI Strategic Plan. The Committee's Operating Plans describes each Committee's organisation, priorities, and operating procedures to be used in fulfilling their mandates in accordance with this strategic plan. Specific attention will be given to ensure that cross-cutting issues are satisfactorily dealt with. This report represents such an operating plan. The intention is that it should fit onto a new third rung on the ladder representing the hierarchy of documents that govern the work of CNRA. At the top of this hierarchy is the Strategic Plan of the NEA; immediately below that is the Joint CSNI/CNRA Strategic Plan; followed by the new operating plan and the guidelines for methods of work. This plan sets the basis for establishing the current CNRA Programme of Work. Since the issuance of the last plan in 2007 there has been a significant shift and many member countries are now constructing new facilities or in the process of legislative or technical processing for new licenses. This comes along in an atmosphere in which current operating plants requesting power up-rates, extended licenses, and substantial activity in new licensing and new construction. It is clear that all these activities require similar attention from the regulators and operators, and the responsibilities

  7. Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

    Science.gov (United States)

    Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

    2018-04-01

    LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

  8. Photovoltaic system criteria documents. Volume 1: Guidelines for evaluating the management and operations planning of photovoltaic applications

    Science.gov (United States)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    Guidelines are provided to the Field Centers for organization, scheduling, project and cost control, and performance in the areas of project management and operations planning for Photovoltaics Test and Applications. These guidelines may be used in organizing a T and A Project Team for system design/test, site construction and operation, and as the basis for evaluating T and A proposals. The attributes are described for project management and operations planning to be used by the Field Centers. Specifically, all project management and operational issues affecting costs, schedules and performance of photovoltaic systems are addressed. Photovoltaic tests and applications include residential, intermediate load center, central station, and stand-alone systems. The sub-categories of system maturity considered are: Initial System Evaluation Experiments (ISEE); System Readiness Experiments (SRE); and Commercial Readiness Demonstration Projects (CRDP).

  9. Planning new basic guideline to the radiological risk. Content, radiological criteria and implementation

    International Nuclear Information System (INIS)

    Calvin Cuartero, M.; Vega Riber, R. de la; Martin Calvarro, J. M.

    2011-01-01

    The most important aspects of the Basic Guideline focus on their area of planning, groups of potential radiological emergencies in the type of activity associated with the levels of response planning and responsible organizations, structure and functions for each level, radiological criteria, implementation and maintenance of the effectiveness of the level of response plans abroad.

  10. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    Science.gov (United States)

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  11. Patient attributes warranting consideration in clinical practice guidelines, health workforce planning and policy

    Directory of Open Access Journals (Sweden)

    Segal Leonie

    2011-09-01

    Full Text Available Abstract Background In order for clinical practice guidelines (CPGs to meet their broad objective of enhancing the quality of care and supporting improved patient outcomes, they must address the needs of diverse patient populations. We set out to explore the patient attributes that are likely to demand a unique approach to the management of chronic disease, and which are crucial if evidence or services planning is to reflect clinic populations. These were incorporated into a new conceptual framework; using diabetes mellitus as an exemplar. Methods The patient attributes that informed the framework were identified from CPGs, the diabetes literature, an expert academic panel, and two cross-disciplinary panels; and agreed upon using a modified nominal group technique. Results Full consensus was reached on twenty-four attributes. These factors fell into one of three themes: (1 type/stage of disease, (2 morbid events, and (3 factors impacting on capacity to self-care. These three themes were incorporated in a convenient way in the workforce evidence-based (WEB model. Conclusions While biomedical factors are frequently recognised in published clinical practice guidelines, little attention is given to attributes influencing a person's capacity to self-care. Paying explicit attention to predictable threats to effective self-care in clinical practice guidelines, by drawing on the WEB model, may assist in refinements that would address observed disparities in health outcomes across socio-economic groups. The WEB model also provides a framework to inform clinical training, and health services and workforce planning and research; including the assessment of healthcare needs, and the allocation of healthcare resources.

  12. Are there national strategies, plans and guidelines for the treatment of hepatitis C in people who inject drugs?

    DEFF Research Database (Denmark)

    Maticic, Mojca; Videcnik Zorman, Jerneja; Gregorcic, Sergeja

    2014-01-01

    . RESULTS: All of the 33 invited European countries participated in the survey. Twenty-two responses came from non-governmental organizations, six from public health institutions, four from university institutions and one was an independent consultant. Fourteen (42.4%) of the countries reported having...... have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular...

  13. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    International Nuclear Information System (INIS)

    Ng, Michael; Leong, Trevor; Chander, Sarat; Chu, Julie; Kneebone, Andrew; Carroll, Susan; Wiltshire, Kirsty; Ngan, Samuel; Kachnic, Lisa

    2012-01-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

  14. Guidelines for Learning Stations.

    Science.gov (United States)

    Fehrle, Carl C.; Schulz, Jolene

    Guidelines for designing and planning learning stations for pupils at the elementary grade level include suggestions on how to develop a station that will be successful in meeting the learners' needs. Instructions for the use of tapes at a station and matching pupils with stations are given, as are guidelines on classroom arrangement and record…

  15. Continuity of operations planning in college athletic programs: The case for incorporating Federal Emergency Management Guidelines.

    Science.gov (United States)

    Hall, Stacey A; Allen, Brandon L; Phillips, Dennis

    2016-01-01

    College athletic departments have a responsibility to provide a safe environment for student-athletes; however, most colleges do not have a crisis management plan that includes procedures for displaced student-athletes or alternate facilities to perform athletic events. Continuity of operations planning ensures athletic programs are equipped to maintain essential functions during, or shortly after, a disruption of operations due to possible hazards. Previous studies have identified a lack of emergency preparedness and continuity planning in college athletic departments. The purpose of this article is to illustrate in detail one approach to disaster planning for college athletic departments, namely the Federal Emergency Management Agency (FEMA) continuity of operations framework. By adhering to FEMA guidelines and promoting a best practices model, athletic programs can effectively plan to address potential hazards, as well as protect the organization's brand, image, and financial sustainability after a crisis event.

  16. Guidelines for inclusion: Ensuring Indigenous peoples' involvement in water planning processes across South Eastern Australia

    Science.gov (United States)

    Saenz Quitian, Alejandra; Rodríguez, Gloria Amparo

    2016-11-01

    Indigenous peoples within the Murray-Darling Basin have traditionally struggled for the recognition of their cultural, social, environmental, spiritual, commercial and economic connection to the waters that they have traditionally used, as well as their right to engage in all stages of water planning processes. Despite Australian national and federal frameworks providing for the inclusion of Indigenous Australians' objectives in planning frameworks, water plans have rarely addressed these objectives in water, or the strategies to achieve them. Indeed, insufficient resources, a lack of institutional capacity in both Indigenous communities and agencies and an inadequate understanding of Indigenous people's objectives in water management have limited the extent to which Indigenous objectives are addressed in water plans within the Murray-Darling Basin. In this context, the adoption of specific guidelines to meet Indigenous requirements in relation to basin water resources is crucial to support Indigenous engagement in water planning processes. Using insights from participatory planning methods and human rights frameworks, this article outlines a set of alternative and collaborative guidelines to improve Indigenous involvement in water planning and to promote sustainable and just water allocations.

  17. 20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

    Science.gov (United States)

    2010-04-01

    ... benefits, how such benefits will be computed, and the conditions under which an employee will be... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Guidelines for content of a nongovernmental plan. 323.4 Section 323.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD...

  18. Play for All Guidelines: Planning, Design and Management of Outdoor Play Settings for All Children. Second Edition.

    Science.gov (United States)

    Moore, Robin C., Ed.; Goltsman, Susan M., Ed.; Iacofano, Daniel S., Ed.

    These guidelines assist professional designers, park and recreation managers, and community groups when making decisions about the planning, design, and ongoing management of children's public play environments. The guidelines are updated to meet or exceed the requirements of the Americans with Disabilities Act Guidelines (July 26, 1991) and the…

  19. Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Beal, D.; McIlvaine , J.; Fonorow, K.; Martin, E.

    2011-11-01

    This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. This document illustrates guidelines for the efficient installation of interior duct systems in new housing. Interior ducts result from bringing the duct work inside a home's thermal and air barrier. Architects, designers, builders, and new home buyers should thoroughly investigate any opportunity for energy savings that is as easy to implement during construction, such as the opportunity to construct interior duct work. In addition to enhanced energy efficiency, interior ductwork results in other important advantages, such as improved indoor air quality, increased system durability and increased homeowner comfort. While the advantages of well-designed and constructed interior duct systems are recognized, the implementation of this approach has not gained a significant market acceptance. This guideline describes a variety of methods to create interior ducts including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. As communication of the intent of an interior duct system, and collaboration on its construction are paramount to success, this guideline details the critical design, planning, construction, inspection, and verification steps that must be taken. Involved in this process are individuals from the design team; sales/marketing team; and mechanical, insulation, plumbing, electrical, framing, drywall and solar contractors.

  20. Including Children Dependent on Ventilators in School.

    Science.gov (United States)

    Levine, Jack M.

    1996-01-01

    Guidelines for including ventilator-dependent children in school are offered, based on experience with six such students at a New York State school. Guidelines stress adherence to the medical management plan, the school-family partnership, roles of the social worker and psychologist, orientation, transportation, classroom issues, and steps toward…

  1. 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

  2. Utah obstetricians' opinions of planned home birth and conflicting NICE/ACOG guidelines: A qualitative study.

    Science.gov (United States)

    Rainey, Emily; Simonsen, Sara; Stanford, Joseph; Shoaf, Kimberley; Baayd, Jami

    2017-06-01

    The United Kingdom's National Institute for Health and Care Excellence (NICE) recently published recommendations that support planned home birth for low-risk women. The American College of Obstetricians and Gynecologists (ACOG) remains wary of planned home birth, asserting that hospitals and birthing centers are the safest birth settings. Our objective was to examine opinions of obstetricians in Salt Lake City, Utah about home birth in the context of rising home birth rates and conflicting guidelines. Participants were recruited through online searches of Salt Lake City obstetricians and through snowball sampling. We conducted individual interviews exploring experiences with and attitudes toward planned home birth and the ACOG/NICE guidelines. Fifteen obstetricians who varied according to years of experience, location of medical training, sex, and subspecialty (resident, OB/GYN, maternal-fetal medicine specialist) were interviewed. Participants did not recommend home birth but supported a woman's right to choose her birth setting. Obstetrician opinions about planned home birth were shaped by misconceptions of home birth benefits, confusion surrounding the scope of care at home and among home birth providers, and negative transfer experiences. Participants were unfamiliar with the literature on planned home birth and/or viewed the evidence as unreliable. Support for ACOG guidelines was high, particularly in the context of the United States health care setting. Physician objectivity may be limited by biases against home birth, which stem from limited familiarity with published evidence, negative experiences with home-to-hospital transfers, and distrust of home birth providers in a health care system not designed to support home birth. © 2017 Wiley Periodicals, Inc.

  3. Commentary on guidelines for radiation measurement and treatment of substances including naturally occurring radioactive materials

    International Nuclear Information System (INIS)

    Sakurai, Naoyuki; Ishiguro, Hideharu

    2007-01-01

    Study group on safety regulation on research reactors in Ministry of Education, Culture, Sports, Science and Technology (MEXT) reported the guidelines of 'Guidelines on radiation measurement and treatment of naturally occurring radioactive materials (NORM)' on 6 February 2006. RANDEC made the website contents 'Study on use and safety of the substances including uranium or thorium', based on the contract with MEXT to make theirs contents. This paper describes the outline of the website in MEXT homepage, background and contents of NORM guidelines in order to understand easily and visually the NORM guidelines, adding in some flowcharts and figures. (author)

  4. Personalised Care Plan Management Utilizing Guideline-Driven Clinical Decision Support Systems.

    Science.gov (United States)

    Laleci Erturkmen, Gokce Banu; Yuksel, Mustafa; Sarigul, Bunyamin; Lilja, Mikael; Chen, Rong; Arvanitis, Theodoros N

    2018-01-01

    Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans.

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

    International Nuclear Information System (INIS)

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

    1986-09-01

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

  6. BWR emergency procedure guidelines

    International Nuclear Information System (INIS)

    Post, J.S.; Karner, E.F.; Stratman, R.A.

    1984-01-01

    This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

  7. Revising the South African guidelines for human settlement planning and design (the red book)

    CSIR Research Space (South Africa)

    Van Niekerk, Willemien

    2015-11-01

    Full Text Available The Guidelines for Human Settlement Planning and Design, commonly known as the Red Book, is a South African publication aimed at providing practical guidance to built environment professionals in support of the creation of sustainable and vibrant...

  8. Diabetes Nutrition: Including Sweets in Your Meal Plan

    Science.gov (United States)

    Diabetes nutrition: Including sweets in your meal plan Diabetes nutrition focuses on healthy foods, but sweets aren't necessarily ... your meal plan. By Mayo Clinic Staff Diabetes nutrition focuses on healthy foods. But you can eat ...

  9. Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice

    Directory of Open Access Journals (Sweden)

    Gagliardi Anna R

    2012-07-01

    Full Text Available Abstract Background Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. Methods We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Results Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Discussion Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research.

  10. Guidelines for Planning the School Breakfast Program. Revised.

    Science.gov (United States)

    Georgia State Dept. of Education, Atlanta. Office of School Administrative Services.

    Some of the factors considered in these guidelines include basic nutritional requirements, food component minimums, food variety, and amounts of food served in elementary and secondary school breakfast programs. Suggestions are made for serving foods that will appeal to young people. Samples of hot and cold menus are provided. Forms for evaluating…

  11. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

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

  12. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

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

  13. Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy.

    Science.gov (United States)

    Gifford, Wendy; Davies, Barbara; Tourangeau, Ann; Lefebre, Nancy

    2011-01-01

    Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood. To describe the planning and evaluation of a leadership intervention to facilitate nurses' use of guideline recommendations for diabetic foot ulcers in home health care. Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n=15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews. Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals. Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  14. Policy guidelines for collective bargaining and family planning.

    Science.gov (United States)

    Finnigan, O D; Parulan, D

    1973-01-01

    The benfits of establishing family planning through collective bargaining to both labor and management are discussed. Until workers can be convinced that their children will receive health care, education and employment, and that they will be economically secure in old age, it is difficult to convince them of the many benefits of child spacing and small family size. In 1953, it was calculated by management in a Japanese steel factory that about 70% of all acidents could be attributable to difficulties in the private lives of employees. In order to ease problems in the home, collective agreements were initiated by management in the Nippon Express Company to provide family planning services. Labor agreed as long as the workers were to share in the economic awards which came from participation. Costs of implementing the family planning programs were fully offset by the decrease in expenditure on family allowances, confinement, nursing, and so on. In India some ten estates began a program in which a certain amount of money is paid into an account for every month that a woman does not become pregnant. If the woman becomes pregnant, she forfeits a substantial amount of the fund. This money comes directly from the funds which would normally have to be set aside to provide for maternity and child support programs. Certain guidelines are presented in the paper to outline the areas of responsibility of labor and management in the provision of family planning services. Among the many possibilities mentioned is the idea that both labor and management could look into the conceivability of plowing back a portion of whatever savings are accrued by management into a pension scheme to compensate workers for the loss of labor caused by having fewer children than were previously anticipated.

  15. EMPLOY: Step-by-step guidelines for calculating employment effects of renewable energy investments [including annex 2

    Energy Technology Data Exchange (ETDEWEB)

    Breitschopf, Barbara [Fraunhofer Inst. for Systems and Innovation Research (Germany); Nathani, Carsten [Ruetter and Partner Socioeconomic Research and Consulting (Switzerland); Resch, Gustav [Vienna Univ. of Technology, Energy Economics Group (EEG) (Austria

    2012-07-15

    The EMPLOY project aimed to help achieve the IEA-RETD’s objective to 'empower policy makers and energy market actors through the provision of information, tools and resources' by underlining the economic and industrial impacts of renewable energy technology deployment and providing reliable methodological approaches for employment – similar to those available for the incumbent energy technologies. The EMPLOY project resulted in a comprehensive set of methodological guidelines for estimating the employment impacts of renewable energy deployment in a coherent, uniform and systematic way. Guidelines were prepared for four different methodological approaches. In the introduction section of the guidelines policy makers are guided in their choice for the most suited approach, depending on the policy questions to be answered, the data availability and budget. The guidelines were tested for the IEA-RETD member state countries and Tunisia. The results of these calculations are included in the annex to the guidelines.

  16. Integrating the environment in local strategic planning : Guidelines (Case of Morocco)

    Science.gov (United States)

    Benbrahim, Hafsa

    2018-05-01

    Since 2010, an advanced regionalization project has been initiated by Morocco, which plans to consolidate the processes of decentralization and deconcentration by extending the powers of the regions and other local authorities. This project, institutionalized in the 2011 Constitution, defines the territorial organization of the Kingdom and reinforces decentralization according to a model of advanced regionalization. Through advanced regionalization, Morocco aims at integrated and sustainable development in economic, social, cultural and environmental terms, through the development of the potential and resources of each region. However, in order to honor this commitment of advanced regionalization, local authorities must be assisted in adopting a local strategic planning approach, allowing them to develop territorial plans for sustainable development in accordance with the national legal framework, specifically the Framework law 99-12, and international commitments in terms of environmental protection. This research deals with the issue of environmental governance in relation to the role and duties of local authorities. Thus, the main goal of our study is to present the guidelines to be followed by the local authorities to improve the quality of the environment integration process in the local strategic planning with the aim of putting it in a perspective of sustainable development.

  17. Guidelines for District Heating Substations

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-15

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

  18. Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

    Science.gov (United States)

    Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

    2015-04-01

    Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

  19. RANET technical guidelines: Interim technical guidelines for national assistance capabilities. Emergency preparedness and response. Date effective: 1 January 2007

    International Nuclear Information System (INIS)

    2006-12-01

    The publication is issued as an attachment to EPR-RANET (2006) and has the same status. It provides administrative and technical guidelines for National Assistance Capabilities and enters into effect on 1 January 2007. Additional technical guidelines are under development by assistance work group under international Action Plan for Strengthening the International Preparedness and Response System for Nuclear and Radiological Emergencies. As these are finalised they will be included in this document

  20. Guidelines on the defense-in-depth and diversity planning and analysis in digital instrumentation and control systems

    International Nuclear Information System (INIS)

    Cheon, Se Woo; Park, Jong Kyun; Lee, Ki Young; Kwon, Ki Choon; Lee, Jang Soo; Kim, Jang Yeol

    2000-08-01

    Digital instrumentation and control (I and C) systems are becoming an ever-increasing part in I and C systems of nuclear power plants due to such features such as versatility, flexibility, and reduced sizes. The digital technology introduces a possibility that common-cause or common-mode failures (CCF or CMF) may cause redundant safety systems to fail in such a way that there is loss of safety function. A special form of CMF analysis called 'defense-in-depth and diversity' (D-in-D and D) analysis has been developed to identify possible common-mode failure vulnerabilities and to support a specific licensing action in digital systems. There are two main stages in D-in-D and D activities: both plan and analysis. The purposes of this technical report are i) to review background of D-in-D and D and some of important issues in digital D-in-D and D, ii) to provide guidelines for a vendor to prepare planning and/or analysis documents on D-in-D and D, and iii) to provide guidelines for an evaluator to review applicant's D-in-D and D planning and/or analysis documents, to ensure that the requirements of the D-in-D and D for digital I and C systems are followed. Most of guidelines suggested in this report were based on NUREG/CR-6303 which was published in 1994. The report will be helpful for a vendor to prepare and for an evaluator to review both D-in-D and D planning or analysis documents for digital I and C systems such as the KNGR project

  1. Guidelines on the defense-in-depth and diversity planning and analysis in digital instrumentation and control systems

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Se Woo; Park, Jong Kyun; Lee, Ki Young; Kwon, Ki Choon; Lee, Jang Soo; Kim, Jang Yeol

    2000-08-01

    Digital instrumentation and control (I and C) systems are becoming an ever-increasing part in I and C systems of nuclear power plants due to such features such as versatility, flexibility, and reduced sizes. The digital technology introduces a possibility that common-cause or common-mode failures (CCF or CMF) may cause redundant safety systems to fail in such a way that there is loss of safety function. A special form of CMF analysis called 'defense-in-depth and diversity' (D-in-D and D) analysis has been developed to identify possible common-mode failure vulnerabilities and to support a specific licensing action in digital systems. There are two main stages in D-in-D and D activities: both plan and analysis. The purposes of this technical report are (i) to review background of D-in-D and D and some of important issues in digital D-in-D and D, (ii) to provide guidelines for a vendor to prepare planning and/or analysis documents on D-in-D and D, and (iii) to provide guidelines for an evaluator to review applicant's D-in-D and D planning and/or analysis documents, to ensure that the requirements of the D-in-D and D for digital I and C systems are followed. Most of guidelines suggested in this report were based on NUREG/CR-6303 which was published in 1994. The report will be helpful for a vendor to prepare and for an evaluator to review both D-in-D and D planning or analysis documents for digital I and C systems such as the KNGR project.

  2. Public informations guidelines

    International Nuclear Information System (INIS)

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities

  3. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  4. 30 CFR 250.110 - What must I include in my welding plan?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must I include in my welding plan? 250.110... must I include in my welding plan? You must include all of the following in the Welding Plan that you... qualified personnel weld; (c) Practices and procedures for safe welding that address: (1) Welding in...

  5. Child- and youth-friendly land-use and transport planning guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, R.; O' Brien, C. [Centre for Sustainable Transportation, Toronto, ON (Canada)

    2005-04-27

    Increased automobile use has been associated with rising obesity, reduced academic performance and compromised emotional development in children and youths. This paper proposed a range of guidelines focused on the needs of children and young people. It is intended for use by municipalities or other agencies in transport and land-use planning. Recommendations included the appointment of a staff or council member responsible for bringing a children's perspective to transport and land use planning issues; an identification of the travel needs of young people; an exploration of pedestrian routes used by children to ensure their safety and useability; and the arrangement of walking buses and other means of supervision for very young children. The construction of separate sidewalks for children and youth on heavy traffic roads was recommended, as well as separate bicycle paths and provisions at intersections. It was suggested that planners should ensure that destinations needed by children are within walking or cycling distance. It was also suggested that the transit system should be made safer and introduce or maintain low fares. It was observed that school funding formulas encourage the construction and use of large schools that are more likely to have traffic congestion, and that parents often pressure school boards for more buses so that children will not have to walk or cycle to school. Reductions in road traffic and the enforcement of speed limits in urban areas were recommended, as well as the use of low emission or electric vehicles. It was suggested that there is a lack of parental awareness regarding the short- and long-term health impacts of driving their children rather than supporting active transport. 90 refs., 2 tabs., 9 figs.

  6. Toward Personalized Pressure Ulcer Care Planning: Development of a Bioinformatics System for Individualized Prioritization of Clinical Pratice Guideline

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-15-1-0342 TITLE: Toward Personalized Pressure Ulcer Care Planning: Development of a Bioinformatics System for Individualized...Planning: Development of a Bioinformatics System for Individualized Prioritization of Clinical Pratice Guideline 5a. CONTRACT NUMBER 5b. GRANT...recommendations of CPG has been identified by experts in the field. We will use bioinformatics to enable data extraction, storage, and analysis to support

  7. Development application guidelines : Newfoundland offshore area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-12-01

    The Canada-Newfoundland Offshore Petroleum Board has created a set of guidelines which describe the information needed by the Board to process a development application by a proponent of an offshore hydrocarbon development project. The guidelines also describe the review process that will be followed in considering a proponent`s application. Proponents must also refer to the Canada-Newfoundland Atlantic Accord Implementation Act and the Canada-Newfoundland Atlantic Accord Implementation (Newfoundland) Act. These guidelines also describe the requirements for the Canada-Newfoundland benefits plan, the environmental impact statement, the socio-economic impact statement, the safety plan, and the environmental protection plan.

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

    International Nuclear Information System (INIS)

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

    1985-08-01

    The Guidelines are intended to provide guidance to the user in preparing a written plan for a proposed nuclear organization and administration. The Guidelines allow for individual approaches to organizational structures to account for differences in plant size, number of operating units, number of plant sites, and the individual utility approach to providing technical support. These unique approaches, however, should meet the criteria of a reasoned, fully developed, and logically consistent focus on the user's organization in terms of organization of work, policies and procedures, staffing, and external relationships

  9. Advanced methodology for generation expansion planning including interconnected systems

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, M; Yokoyama, R; Yasuda, K [Tokyo Metropolitan Univ. (Japan); Sasaki, H [Hiroshima Univ. (Japan); Ogimoto, K [Electric Power Development Co. Ltd., Tokyo (Japan)

    1994-12-31

    This paper reviews advanced methodology for generation expansion planning including interconnected systems developed in Japan, putting focus on flexibility and efficiency in a practical application. First, criteria for evaluating flexibility of generation planning considering uncertainties are introduced. Secondly, the flexible generation mix problem is formulated as a multi-objective optimization with more than two objective functions. The multi-objective optimization problem is then transformed into a single objective problem by using the weighting method, to obtain the Pareto optimal solution, and solved by a dynamics programming technique. Thirdly, a new approach for electric generation expansion planning of interconnected systems is presented, based on the Benders Decomposition technique. That is, large scale generation problem constituted by the general economic load dispatch problem, and several sub problems which are composed of smaller scale isolated system generation expansion plans. Finally, the generation expansion plan solved by an artificial neural network is presented. In conclusion, the advantages and disadvantages of this method from the viewpoint of flexibility and applicability to practical generation expansion planning are presented. (author) 29 refs., 10 figs., 4 tabs.

  10. Guidelines for developing certification programs for newly generated TRU waste

    International Nuclear Information System (INIS)

    Whitty, W.J.; Ostenak, C.A.; Pillay, K.K.S.; Geoffrion, R.R.

    1983-05-01

    These guidelines were prepared with direction from the US Department of Energy (DOE) Transuranic (TRU) Waste Management Program in support of the DOE effort to certify that newly generated TRU wastes meet the Waste Isolation Pilot Plant (WIPP) Waste Acceptance Criteria. The guidelines provide instructions for generic Certification Program preparation for TRU-waste generators preparing site-specific Certification Programs in response to WIPP requirements. The guidelines address all major aspects of a Certification Program that are necessary to satisfy the WIPP Waste Acceptance Criteria and their associated Compliance Requirements and Certification Quality Assurance Requirements. The details of the major element of a Certification Program, namely, the Certification Plan, are described. The Certification Plan relies on supporting data and control documentation to provide a traceable, auditable account of certification activities. Examples of specific parts of the Certification Plan illustrate the recommended degree of detail. Also, a brief description of generic waste processes related to certification activities is included

  11. 40 CFR 60.3012 - What should I include in my waste management plan?

    Science.gov (United States)

    2010-07-01

    ..., 2004 Model Rule-Waste Management Plan § 60.3012 What should I include in my waste management plan? A waste management plan must include consideration of the reduction or separation of waste-stream elements.... The plan must identify any additional waste management measures and implement those measures the...

  12. 40 CFR 62.14590 - What should I include in my waste management plan?

    Science.gov (United States)

    2010-07-01

    ... Commenced Construction On or Before November 30, 1999 Waste Management Plan § 62.14590 What should I include in my waste management plan? A waste management plan must include consideration of the reduction or... use of recyclable materials. The plan must identify any additional waste management measures, and the...

  13. 40 CFR 60.2630 - What should I include in my waste management plan?

    Science.gov (United States)

    2010-07-01

    ... or Before November 30, 1999 Model Rule-Waste Management Plan § 60.2630 What should I include in my waste management plan? A waste management plan must include consideration of the reduction or separation... of recyclable materials. The plan must identify any additional waste management measures, and the...

  14. 36 CFR 910.67 - Square guidelines.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Square guidelines. 910.67... GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE PENNSYLVANIA AVENUE DEVELOPMENT AREA Glossary of Terms § 910.67 Square guidelines. Square Guidelines establish the Corporation's...

  15. 40 CFR 60.33c - Emission guidelines for municipal solid waste landfill emissions.

    Science.gov (United States)

    2010-07-01

    ... waste landfill emissions. 60.33c Section 60.33c Protection of Environment ENVIRONMENTAL PROTECTION... Guidelines and Compliance Times for Municipal Solid Waste Landfills § 60.33c Emission guidelines for municipal solid waste landfill emissions. (a) For approval, a State plan shall include control of MSW...

  16. Regional adaptation strategies to climate change: Guidelines for urban planning in Serbia

    Directory of Open Access Journals (Sweden)

    Maruna Marija

    2012-01-01

    regulations especially in areas exposed to climate impacts. In the absence of a national strategy of adaptation to climate change, urban planning guidelines could be determined by comparative analysis of regional recommendations in the field of urban planning and the existing legislative framework in Serbia.

  17. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  18. Bridge removal plan requirements.

    Science.gov (United States)

    2011-04-15

    This report provides resources that detail specifications and guidelines related to bridge removal plans across the : United States. We have organized the information into three sections: : ! National Guidance : Includes language from AASHTO specific...

  19. Optimization-based guidelines to retirement planning and pension product design

    DEFF Research Database (Denmark)

    Konicz Bell, Agnieszka Karolina

    their retirement savings, this thesis presents some optimization techniques that could be applied by pension providers and financial advisers to provide individuals with such guidelines. For a given objective function and a number of constraints, we search for the optimal solution, which indicates, for example...... investigate the optimal annuity choice under inflation risk, which is often ignored both by practitioners advising on the retirement planning and by scholars investigating the consumption-investment problems. We search for an optimal level of retirement income in real terms, given investment opportunities...... in inflation-linked, nominal, and variable annuities, as well as in stocks and bonds. Our findings show that real annuities are a crucial asset in every portfolio, and that trying to hedge inflation without investing in inflation-linked products leads to a lower and more volatile retirement income. In the last...

  20. 40 CFR 60.2901 - What should I include in my waste management plan?

    Science.gov (United States)

    2010-07-01

    ... Analysis Waste Management Plan § 60.2901 What should I include in my waste management plan? A waste management plan must include consideration of the reduction or separation of waste-stream elements such as... must identify any additional waste management measures and implement those measures the source...

  1. 78 FR 48159 - Preliminary 2012 Effluent Guidelines Program Plan and 2011 Annual Effluent Guidelines Review Report

    Science.gov (United States)

    2013-08-07

    ... publish a preliminary plan in the odd numbered years and a final plan in the even numbered years. The... necessary before concluding the review of the three remaining point source categories: Pulp, Paper and... standards for the 2012 reviews. These methodologies included: Identifying pass-through pollutants in sewage...

  2. A pre-feasibility case study on integrated resource planning including renewables

    International Nuclear Information System (INIS)

    Yilmaz, Pelin; Hakan Hocaoglu, M.; Konukman, Alp Er S.

    2008-01-01

    In recent years, economical and environmental constraints force governments and energy policy decision-makers to change the prominent characteristics of the electricity markets. Accordingly, depending on local conditions on the demand side, usage of integrated resource planning approaches in conjunction with renewable technologies has gained more importance. In this respect, an integrated resource planning option, which includes the design and optimization of grid-connected renewable energy plants, should be evaluated to facilitate a cost-effective and green solution to a sustainable future. In this paper, an integrated resource planning case is studied for an educational campus, located in Gebze, Turkey. It is found that for the considered campus, the integrated resource planning scenario that includes renewables as a supply-side option with existing time-of-use tariff may provide a cost-effective energy production, particularly for the high penetration level of the renewables

  3. The conundrum of hodgkin lymphoma nodes: To be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines

    International Nuclear Information System (INIS)

    Girinsky, Theodore; Specht, Lena; Ghalibafian, Mithra; Edeline, Veronique; Bonniaud, Guillaume; Maazen, Richard van der; Aleman, Berthe; Paumier, Amaury; Meijnders, Paul; Lievens, Yolande; Noordijk, Evert; Poortmans, Philip

    2008-01-01

    Purpose: To develop easily applicable guidelines for the determination of initially involved lymph nodes to be included in the radiation fields. Patients and methods: Patients with supra-diaphragmatic Hodgkin lymphoma. All the imaging procedures were carried out with patients in the treatment position. The prechemotherapy PET/CT was coregistered with the postchemotherapy CT simulation for planning purposes. Initially involved lymph nodes were determined on fused prechemotherapy CT and FDG-PET imaging data. The initial assessment was verified with the postchemotherapy CT scan. Results: The classic guidelines for determining the involvement of lymph nodes were not easily applicable and did not seem to reflect the exact extent of Hodgkin lymphoma. Three simple steps were used to pinpoint involved lymph nodes. First, FDG-PET scans were meticulously analysed to detect lymph nodes that were overlooked on CT imaging. Second, any morphological and/or functional asymmetry was sought on CT and FDG-PET scans. Third, a decrease in size or the disappearance of initially visible lymph nodes on the prechemotherapy CT scan as compared to the postchemotherapy CT scan was considered as surrogate proof of initial involvement. Conclusions: All the radiological procedures should be performed on patients in the treatment position for proper coregistration. It is highly advisable that all CT and/or CT/PET scans be performed with IV contrast. Using the above-mentioned three simple guidelines, initially involved lymph nodes can be detected with very satisfactory accuracy. It is also emphasized that the classic guidelines (2, 3, 4) can always be used when deemed necessary

  4. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Directory of Open Access Journals (Sweden)

    Külpmann, Rüdiger

    2016-02-01

    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  5. 12 CFR 563b.105 - What information must I include in my business plan?

    Science.gov (United States)

    2010-01-01

    ... information must I include in my business plan? (a) Prior to filing an application for conversion, you must adopt a business plan reflecting your intended plans for deployment of the proposed conversion proceeds. Your business plan is required, under § 563b.150, to be included in your conversion application. At a...

  6. OSART guidelines

    International Nuclear Information System (INIS)

    1988-02-01

    The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the operational safety of nuclear power plants. These OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness

  7. Radiotherapy facilities: Master planning and concept design considerations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-08-15

    This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals.

  8. Radiotherapy facilities: Master planning and concept design considerations

    International Nuclear Information System (INIS)

    2014-01-01

    This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

  9. Development of urban planning guidelines for improving emergency response capacities in seismic areas of Iran.

    Science.gov (United States)

    Hosseini, Kambod Amini; Jafari, Mohammad Kazem; Hosseini, Maziar; Mansouri, Babak; Hosseinioon, Solmaz

    2009-10-01

    This paper presents the results of research carried out to improve emergency response activities in earthquake-prone areas of Iran. The research concentrated on emergency response operations, emergency medical care, emergency transportation, and evacuation-the most important issues after an earthquake with regard to saving the lives of victims. For each topic, some guidelines and criteria are presented for enhancing emergency response activities, based on evaluations of experience of strong earthquakes that have occurred over the past two decades in Iran, notably Manjil (1990), Bam (2003), Firouz Abad-Kojour (2004), Zarand (2005) and Broujerd (2006). These guidelines and criteria are applicable to other national contexts, especially countries with similar seismic and social conditions as Iran. The results of this study should be incorporated into comprehensive plans to ensure sustainable development or reconstruction of cities as well as to augment the efficiency of emergency response after an earthquake.

  10. Guidelines for Preservation, Conservation, and Restoration of Local History and Local Genealogical Materials.

    Science.gov (United States)

    RQ, 1993

    1993-01-01

    Presents guidelines adopted by the American Library Association (ALA) relating to the preservation, conservation, and restoration of local history and local genealogical materials. Topics addressed include assessing preservation needs; developing a plan; choosing appropriate techniques, including microduplication, photoduplication, electronic…

  11. Sandia software guidelines, Volume 4: Configuration management

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-01

    This volume is one in a series of Sandia Software Guidelines for use in producing quality software within Sandia National Laboratories. This volume is based on the IEEE standard and guide for software configuration management. The basic concepts and detailed guidance on implementation of these concepts are discussed for several software project types. Example planning documents for both projects and organizations are included.

  12. What to include in your birth plan

    Science.gov (United States)

    Pregnancy - birth plan ... Birth plans are guides that parents-to-be make to help their health care providers best support them during ... things to consider before you make a birth plan. This is a great time to learn about ...

  13. 40 CFR 799.11 - Availability of test guidelines.

    Science.gov (United States)

    2010-07-01

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

  14. 40 CFR 60.36e - Inspection guidelines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Inspection guidelines. 60.36e Section...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.36e Inspection guidelines. (a) For approval, a State plan shall...

  15. 10 CFR 719.10 - What information must be included in the legal management plan?

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false What information must be included in the legal management plan? 719.10 Section 719.10 Energy DEPARTMENT OF ENERGY CONTRACTOR LEGAL MANAGEMENT REQUIREMENTS Legal Management Plan § 719.10 What information must be included in the legal management plan? The legal management...

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  17. Guidelines for sustainable tourism planning in the township of San Francisco de Asis (Acandi Municipality, Choco, Colombia)

    International Nuclear Information System (INIS)

    Roldan Carvajal, Carlos Daniel

    2012-01-01

    This paper presents important management guidelines for conducting a tourism planning process in the township of San Francisco de Asis, which were developed from the conceptual notion of sustainable tourism and participation of local people. This case considered the participatory research method, used ethnography techniques and implemented shops with the community. As a main result proposed the consolidation of four components, socio- political, socio- cultural, social- ecological and socio- economic; that must be managed in an integrated fashion to achieve real sustainable tourism in this territory. In the first component outlines an participatory process that must take place between the various stake holders; in the second considered strengthen the social tissue and valuing cultural traditions to adequately integrate tourism activities; the third proposes an integrated environmental conservation in the whole territory and as an obligation of all stake holders, including to tourists; finally, in the fourth component, recommend the creation of more opportunities and general welfare for the entire local population in order to prevent the growth of tourism segregated. As a general conclusion will projected that the implementation of these guidelines permitted advance, from the practical, in the development of a truly sustainable tourism that help improve the living conditions of local people and conserve valuable natural and cultural resources that exist in this territory.

  18. 40 CFR 60.33e - Emissions guidelines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emissions guidelines. 60.33e Section 60...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.33e Emissions guidelines. (a) For approval, a State plan shall...

  19. Criteria for evaluation and guidelines for land use planning in terms of sustainable urban development

    Directory of Open Access Journals (Sweden)

    Irena Ostojić

    2014-10-01

    Full Text Available Sustainable spatial development is a generally accepted objective and principle in spatial planning. It is implemented mainly by regulations in the sectors for management of natural resources, but not comprehensively in implementing regulations for urban space management. One of the most important instruments of spatial planning at local level is land use, for which there is no comprehensive framework of implementing measures for achieving sustainable spatial objectives in urban areas. In accordance with the review and critical analysis of literature, there are four measures presented in the paper: protection of natural resources and reduction of environmental-climate risks, compact urban structure, mixed-use and accessibility of urban functions. The review and analysis have shown that the listed measures enable sustainable development of urban areas, but only if they are planned and implemented in accordance with supporting physical, social and economic elements of urban space. In the conclusion, indicators which can assess the level of sustainability in land use design are presented and guidelines for restructuring land use in existing settlement areas are described.

  20. 40 CFR 60.2065 - What should I include in my waste management plan?

    Science.gov (United States)

    2010-07-01

    ... Management Plan § 60.2065 What should I include in my waste management plan? A waste management plan must... additional waste management measures and implement those measures the source considers practical and feasible, considering the effectiveness of waste management measures already in place, the costs of additional measures...

  1. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design.

    Science.gov (United States)

    Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

    2016-07-01

    People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual. © 2015 John Wiley & Sons Ltd.

  2. Data Qualification guidelines

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  3. Radiotherapy Facilities: Master Planning and Concept Design Considerations (Russian Edition)

    International Nuclear Information System (INIS)

    2015-01-01

    This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology and a typical project work plan, and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

  4. Project Gasbuggy well plugging and site restoration plan

    International Nuclear Information System (INIS)

    1978-07-01

    The operational plan for conducting the final restoration work at the site of the first U.S. underground nuclear experiment for the stimulation of low-productivity natural gas reservoirs is given. The plan includes well plugging procedures, surface facilities decontamination and removal procedures, radiological guidelines, and environmental considerations

  5. 40 CFR 256.01 - Purpose and scope of the guidelines.

    Science.gov (United States)

    2010-07-01

    ... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose... guidelines is to assist in the development and implementation of State solid waste management plans, in... objectives of environmentally sound management and disposal of solid and hazardous waste, resource...

  6. Project gnome decontamination and decommissioning plan

    International Nuclear Information System (INIS)

    1979-04-01

    The document presents the operational plan for conducting the final decontamination and decommissioning work at the site of the first U.S. nuclear detonation designed specifically for peaceful purposes and the first underground event on the Plowshare Program to take place outside the Nevada Test Site. The plan includes decontamination and decommissioning procedures, radiological guidelines, and the NV concept of operations

  7. 25 CFR 170.411 - What may a long-range transportation plan include?

    Science.gov (United States)

    2010-04-01

    ...) Social and economic development planning to identify transportation improvements or needs to accommodate... 25 Indians 1 2010-04-01 2010-04-01 false What may a long-range transportation plan include? 170.411 Section 170.411 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN...

  8. KAERI software verification and validation guideline for developing safety-critical software in digital I and C system of NPP

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jang Yeol; Lee, Jang Soo; Eom, Heung Seop

    1997-07-01

    This technical report is to present V and V guideline development methodology for safety-critical software in NPP safety system. Therefore it is to present V and V guideline of planning phase for the NPP safety system in addition to critical safety items, for example, independence philosophy, software safety analysis concept, commercial off the shelf (COTS) software evaluation criteria, inter-relationships between other safety assurance organizations, including the concepts of existing industrial standard, IEEE Std-1012, IEEE Std-1059. This technical report includes scope of V and V guideline, guideline framework as part of acceptance criteria, V and V activities and task entrance as part of V and V activity and exit criteria, review and audit, testing and QA records of V and V material and configuration management, software verification and validation plan production etc., and safety-critical software V and V methodology. (author). 11 refs.

  9. KAERI software verification and validation guideline for developing safety-critical software in digital I and C system of NPP

    International Nuclear Information System (INIS)

    Kim, Jang Yeol; Lee, Jang Soo; Eom, Heung Seop.

    1997-07-01

    This technical report is to present V and V guideline development methodology for safety-critical software in NPP safety system. Therefore it is to present V and V guideline of planning phase for the NPP safety system in addition to critical safety items, for example, independence philosophy, software safety analysis concept, commercial off the shelf (COTS) software evaluation criteria, inter-relationships between other safety assurance organizations, including the concepts of existing industrial standard, IEEE Std-1012, IEEE Std-1059. This technical report includes scope of V and V guideline, guideline framework as part of acceptance criteria, V and V activities and task entrance as part of V and V activity and exit criteria, review and audit, testing and QA records of V and V material and configuration management, software verification and validation plan production etc., and safety-critical software V and V methodology. (author). 11 refs

  10. 12 CFR 516.20 - What information must I include in my draft business plan?

    Science.gov (United States)

    2010-01-01

    ... business plan? 516.20 Section 516.20 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE... What information must I include in my draft business plan? If you must submit a draft business plan... described in the savings association's draft business plan; and (d) Demonstrate how applicable requirements...

  11. Innovations in emergency response plans : making the useful application of the 2007 CDA guidelines for emergency response plans

    Energy Technology Data Exchange (ETDEWEB)

    Stevenson, A.J. [Columbia Power Corp., Castlegar, BC (Canada)

    2008-07-01

    Columbia Power Corporation (CPC) changed its perspective and approach to emergency response plans (ERP) between 2002 and 2007 from one of administrative necessity to one of important functional reference. The new 2007 Canadian Dam Association Guidelines helped facilitate that transition for both CPC and all dam owners. As part of the licensing requirements for its new facility, CPC had an ERP commissioned and developed in 2002. A potential dam safety event occurred in 2004, which necessitated the need for the ERP to be put to use. However, at the time, it was found to be lacking in functionality for field personnel. As a result, CPC recognized the significance of having a functional ERP for field staff and undertook a substantial redraft between 2005 and 2007. This paper discussed the development of the ERP with particular reference to assessing the top potential emergency scenarios for the facility; development of response plans for the identified scenarios; a flow chart to guide personnel through the required actions; response checklist; detailed inspection checklists and any required forms, photos or specific information. It was concluded that the new ERP has been well received and has improved facility awareness and emergency preparedness. 1 ref., 2 figs.

  12. Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

    Science.gov (United States)

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

    This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

  13. Water management planning guideline for waterpower

    International Nuclear Information System (INIS)

    2002-05-01

    Hydroelectric power has been used in Ontario for over 150 years, providing the impetus to economic development in the province. Currently, 83 hydroelectric utilities own the more than 200 hydro power facilities in Ontario, accounting for approximately 26 per cent of the total electrical generating capacity in the province. Flood control and the creation of recreational opportunities were added benefits derived from the construction of hydroelectric dams. The three ways of operating hydroelectric facilities are: run-of-the-river which involves minimal forebay storage, peaking which involves the operation of the dam for specific periods of high energy demand, and intermediate. The Ontario government plans to open the electricity market to competition, guided by four principles: (1) protecting consumers and offering more choice, (2) ensuring a strong business climate with a reliable supply of electricity, (3) protecting the environment, and (4) encouraging new ways of doing business and new sources of power. To address issues that arise from the operation of hydroelectric facilities, dam owners and hydroelectric facilities operators are required to develop Water Management Plans, outlining how the facility will be operated to balance environmental, social and economic objectives. The present document was developed to define goals and principles concerning planning, the scope of Water Management Plans, the criteria and the general planning process to be adopted for the preparation of the Plans. 1 tab., 4 figs

  14. The World Health Organization-United Nations Population Fund Strategic Partnership Programme's implementation of family planning guidelines and tools in Asia-Pacific countries.

    Science.gov (United States)

    Mody, Sheila K; Ba-Thike, Katherine; Gaffield, Mary E

    2013-04-01

    The aim of this study was to assess the impact of the Strategic Partnership Programme, a collaboration between the World Health Organization and the United Nations Population Fund to improve evidence-based guidance for country programs through the introduction of selected practice guidelines to improve sexual and reproductive health. Information for this report is from questionnaires sent to Ministries of Health in 2004 (baseline assessment) and in 2007 (assessment of outcome), annual country reports and personal communication with focal points from Ministries of Health and World Health Organization regional and country offices. Following the Strategic Partnership Programme, family planning guidance was used extensively to: formulate and update reproductive health policy; update standards and guidelines; improve training curricula; conduct training activities; develop advocacy and communication materials; and promote change in service. The Strategic Partnership Programme was successful in promoting the introduction of evidence-based guidelines for reproductive health in several Asian countries. The countries that adapted the family planning guidance observed an increase in demand for contraceptives commodities. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  15. UMTRA Project environmental, health, and safety plan

    International Nuclear Information System (INIS)

    1989-02-01

    The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH ampersand S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH ampersand S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs

  16. Planning new basic guideline to the radiological risk. Content, radiological criteria and implementation; Nueva direcctriz basica de planificacion ante el riesgo radiologico. Contenido, criterio radiologicos e implantacion

    Energy Technology Data Exchange (ETDEWEB)

    Calvin Cuartero, M.; Vega Riber, R. de la; Martin Calvarro, J. M.

    2011-07-01

    The most important aspects of the Basic Guideline focus on their area of planning, groups of potential radiological emergencies in the type of activity associated with the levels of response planning and responsible organizations, structure and functions for each level, radiological criteria, implementation and maintenance of the effectiveness of the level of response plans abroad.

  17. Siting guidelines and their role in repository site selection

    International Nuclear Information System (INIS)

    Hanlon, C.L.

    1985-01-01

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

  18. Commentary on recent therapeutic guidelines for osteoarthritis.

    Science.gov (United States)

    Cutolo, Maurizio; Berenbaum, Francis; Hochberg, Marc; Punzi, Leonardo; Reginster, Jean-Yves

    2015-06-01

    Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. A symposium of European and US OA experts was held within the framework of the Annual European Congress of Rheumatology to discuss and compare guidelines and recommendations for the treatment of knee OA and to reach a consensus for management, particularly for areas in which there is no clear consensus: non-pharmacological therapy; efficacy and safety of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); intra-articular (i.a.) hyaluronates (HA); and the role of chondroitin sulfate (CS) and/or glucosamine sulfate (GS). All guidelines reviewed agree that knee OA is a progressive disease of the joint whose management requires non-pharmacological and pharmacological approaches. Discrepancies between guidelines are few and mostly reflect heterogeneity of expert panels involved, geographical differences in the availability of pharmacotherapies, and heterogeneity of the studies included. Panels chosen for guideline development should include experts with real clinical experience in drug use and patient management. Implementation of agreed guidelines can be thwarted by drug availability and reimbursement plans, resulting in optimal OA treatment being jeopardized, HA and symptomatic slow-acting drugs for osteoarthritis (SySADOAs) being clear examples of drugs whose availability and prescription can greatly vary geographically. In addition, primary care providers, often responsible for OA management (at least in early disease), may not adhere to clinical care guidelines, particularly for non-pharmacological OA treatment. Harmonization of the recommendations for knee OA treatment is challenging but feasible, as shown by the step-by-step therapeutic algorithm developed by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). More easily disseminated and

  19. Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

    Science.gov (United States)

    Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

    2018-06-01

    Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post

  20. The Importance of Documenting and Including Traditional Wisdom in Community-Based Ecotourism Planning

    Directory of Open Access Journals (Sweden)

    Vesna Đukić

    2017-01-01

    Full Text Available This article accords to the theory of community-based tourism, which represents a concept that respects natural and cultural resources of a particular community and encourages participation of its members in the process of tourist product creation. The article operates in the planning phase and aims to give insights into the process of establishing the groundwork for community-based tourism. The key element is documenting and illustrating everything that could be a part of what is known as “traditional wisdom,” namely, the skills and knowledge of traditional life practices. The methods of case study, content analysis, and observation of the village of Omoljica, Serbia, were used. The positive aspect of this locality is reflected in the existing short-term initiatives of organizations and individuals engaging in preserving traditional practices, but without systematic, long-term planning and management of community-based tourism, these individual efforts to revalue traditional life practices would stay unrecognizable and invisible for visitors and stakeholders. Thus, the main goal of this article is to understand the relation between short-term bottom-up initiatives and long-term top-down strategic planning of specific ecotourism destinations, one that would embrace the traditional ways of rural community life. The contribution of this study, in addition to documenting and illustrating “traditional wisdom” of the specific rural community placed in the protected area which encompasses a particular local social system, will be reflected in the creation of a set of guidelines for sustainable, rural, community-based ecotourism as a soft-driver development of protected areas near big cities of the postsocialist countries.

  1. Value and limitations of clinical practice guidelines in neonatology.

    Science.gov (United States)

    Polin, Richard A; Lorenz, John M

    2015-12-01

    Given the overwhelming size of the neonatal literature, clinicians must rely upon expert panels such as the Committee on Fetus and Newborn in the USA and the National Institute for Healthcare and Excellence in the UK for guidance. Guidelines developed by expert panels are not equivalent to evidence-based medicine and are not rules, but do provide evidence-based recommendations (when possible) and at minimum expert consensus reports. The standards used to develop evidence-based guidelines differ among expert panels. Clinicians must be able judge the quality of evidence from an expert panel, and decide whether a recommendation applies to their neonatal intensive care unit or infant under their care. Furthermore, guidelines become outdated within a few years and must be revised or discarded. Clinical practice guidelines should not always be equated with standard of care. However, they do provide a framework for determining acceptable care. Clinicians do not need to follow guidelines if the recommendations are not applicable to their population or infant. However, if a plan of care is not consistent with apparently applicable clinical practice guidelines, the medical record should include an explanation for the deviation from the relevant practice guideline. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Discharge planning for a patient with a new ostomy: best practice for clinicians.

    Science.gov (United States)

    Prinz, Anita; Colwell, Janice C; Cross, Heidi H; Mantel, Janet; Perkins, Jacqueline; Walker, Cynthia A

    2015-01-01

    A comprehensive discharge plan for a patient with a new stoma is needed to ensure the individual receives the necessary ostomy education prior to discharge. The plan should include teaching basic skills and providing information about how to manage the ostomy (ie, emptying and changing the pouch, how to order supplies, available manufacturers, dietary/fluid guidelines, potential complications, medications, and managing gas and odor), assisting with transitions in care, and providing information about resources for support and assistance. The purpose of this best practice guideline is to provide clinicians with a brief overview of the essential elements that should be included in the discharge plan to facilitate patient education and the transition of care from hospital to home.

  3. OSART guidelines. 1992 edition

    International Nuclear Information System (INIS)

    1992-01-01

    The IAEA Operational Safety Review Team (OSART) Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as a guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness. Additional guidance and reference material has been prepared by the IAEA to complement the expertise of the OSART members

  4. Integrating evidence-based interventions into client care plans.

    Science.gov (United States)

    Doran, Diane; Carryer, Jennifer; Paterson, Jane; Goering, Paula; Nagle, Lynn; Kushniruk, Andre; Bajnok, Irmajean; Clark, Carrie; Srivastava, Rani

    2009-01-01

    Within the mental health care system, there is an opportunity to improve patient safety and the overall quality of care by integrating clinical practice guidelines with the care planning process through the use of information technology. Electronic assessment tools such as the Resident Assessment Inventory - Mental Health (RAI-MH) are widely used to identify the health care needs and outcomes of clients. In this knowledge translation initiative, an electronic care planning tool was enhanced to include evidence-based clinical interventions from schizophrenia guidelines. This paper describes the development of a mental health decision support prototype, a field test by clinicians, and user experiences with the application.

  5. Multicultural Communities: Guidelines for Library Services. Third Edition

    Science.gov (United States)

    International Federation of Library Associations and Institutions (NJ1), 2009

    2009-01-01

    These Guidelines constitute the third edition of the International Federation of Library Associations (IFLA) "Multicultural Communities: "Guidelines for Library Services." This revision follows the IFLA Section of Library Services to Multicultural Populations' "2006-2010 Strategic Plans": to review and revise the…

  6. Technical standards and guidelines: prenatal screening for Down syndrome that includes first-trimester biochemistry and/or ultrasound measurements.

    Science.gov (United States)

    Palomaki, Glenn E; Lee, Jo Ellen S; Canick, Jacob A; McDowell, Geraldine A; Donnenfeld, Alan E

    2009-09-01

    This statement is intended to augment the current general ACMG Standards and Guidelines for Clinical Genetics Laboratories and to address guidelines specific to first-trimester screening for Down syndrome. The aim is to provide the laboratory the necessary information to ensure accurate and reliable Down syndrome screening results given a screening protocol (e.g., combined first trimester and integrated testing). Information about various test combinations and their expected performance are provided, but other issues such as availability of reagents, patient interest in early test results, access to open neural tube defect screening, and availability of chorionic villus sampling are all contextual factors in deciding which screening protocol(s) will be selected by individual health care providers. Individual laboratories are responsible for meeting the quality assurance standards described by the Clinical Laboratory Improvement Act, the College of American Pathologists, and other regulatory agencies, with respect to appropriate sample documentation, assay validation, general proficiency, and quality control measures. These guidelines address first-trimester screening that includes ultrasound measurement and interpretation of nuchal translucency thickness and protocols that combine markers from both the first and second trimesters. Laboratories can use their professional judgment to make modification or additions.

  7. SU-F-BRA-14: Optimization of Dosimetric Guidelines for Accelerated Partial Breast Irradiation (APBI) Using the Strut-Adjusted Volume Implant (SAVI)

    International Nuclear Information System (INIS)

    Mooney, K; Altman, M; Garcia-Ramirez, J; Thomas, M; Zoberi, I; Mullen, D; DeWees, T; Esthappan, J

    2015-01-01

    Purpose: Treatment planning guidelines for accelerated partial breast irradiation (ABPI) using the strut-adjusted volume implant (SAVI) are inconsistent between the manufacturer and NSABP B-39/RTOG 0413 protocol. Furthermore neither set of guidelines accounts for different applicator sizes. The purpose of this work is to establish guidelines specific to the SAVI that are based on clinically achievable dose distributions. Methods: Sixty-two consecutive patients were implanted with a SAVI and prescribed to receive 34 Gy in 10 fractions twice daily using high dose-rate (HDR) Ir-192 brachytherapy. The target (PTV-EVAL) was defined per NSABP. The treatments were planned and evaluated using a combination of dosimetric planning goals provided by the NSABP, the manufacturer, and our prior clinical experience. Parameters evaluated included maximum doses to skin and ribs, and volumes of PTV-EVAL receiving 90%, 95%, 100%, 150%, and 200% of the prescription (V90, etc). All target parameters were evaluated for correlation with device size using the Pearson correlation coefficient. Revised dosimetric guidelines for target coverage and heterogeneity were determined from this population. Results: Revised guidelines for minimum target coverage (ideal in parentheses): V90≥95%(97%), V95≥90%(95%), V100≥88%(91%). The only dosimetric parameters that were significantly correlated (p<0.05) with device size were V150 and V200. Heterogeneity criteria were revised for the 6–1 Mini/6-1 applicators to V150≤30cc and V200≤15cc, and unchanged for the other sizes. Re-evaluation of patient plans showed 90% (56/62) met the revised minimum guidelines and 76% (47/62) met the ideal guidelines. All and 56/62 patients met our institutional guidelines for maximum skin and rib dose, respectively. Conclusions: We have optimized dosimetric guidelines for the SAVI applicators, and found that implementation of these revised guidelines for SAVI treatment planning yielded target coverage exceeding

  8. 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

  9. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... in existing guidelines. Health Resources and Services Administration Women's Preventive Services Guidelines Non-grandfathered plans (plans or policies created or sold after March 23, 2010, or older plans or policies that ...

  10. Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Beal, D. [BA-PIRC, Cocoa, FL (United States); McIlvaine, J. [BA-PIRC, Cocoa, FL (United States); Fonorow, K. [BA-PIRC, Cocoa, FL (United States); Martin, E. [BA-PIRC, Cocoa, FL (United States)

    2011-11-01

    This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces.

  11. 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

  12. Guideline on action plans and strategies to mobilize waste-to-energy production

    Energy Technology Data Exchange (ETDEWEB)

    Loonik, J.; Saarepera, R.; Kaeger, M. [and others

    2012-12-15

    This report presents some results of the REMOWE project and sets guidelines for regional policy makers, SME's and the general public as well for more deep realization of waste-to-energy policy principles in action. The overall objective of the project is, on regional levels, to contribute to a decreased negative effect on the environment by reduction of carbon dioxide emission by creating a balance between energy consumption and sustainable use of renewable energy sources (waste-to-energy cycle). Reduction of carbon dioxide emissions and use of renewable energy sources are broad areas and this project will focus on energy resources from waste and actions to facilitate implementation of energy efficient technology in the Baltic Sea region within the waste-to-energy area. The focus is to utilise waste from cities, farming and industry for energy purposes in an efficient way. The project seeks to facilitate the implementation of sustainable systems for waste-to-energy in the Baltic Sea region and specifically, in a first step, in the project partner regions. The project's duration is 12/2009-12/2012. This report is structured into 8 chapters, which are further divided into subchapters if needed. Relevant data about current situation about waste generation and management in partner regions of REMOWE project are described in Chapter 1. There are guidelines on action plan and strategies for regional policy makers, SME's and the general public to mobilize waste to energy production in Chapter 2. Beside guidelines, this report contains references to basic political acts of waste and energy management of EU and best practices of implementation them in regional level (Chapter 3). The focus of Chapters 4 and 5 is on energetic potential of waste and technologies for utilisation of waste for energy purposes. During the project period in each of partner region innovation processes were realised and innovation ides evaluated, basic results are collected into

  13. Electric heating guidelines: power smart home; 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    Guidelines, for use by B. C. Hydro, were established for proper planning and design of an electric heating system for residential buildings. The guidebook is divided into five sections: (1) comfort and electric heating systems, (2) contractors` guide to heat loss calculation, (3) imperial heat loss factors, (4) metric heat loss factors, and (5) installation guidelines for electric heating systems. Individual topics discussed include heat loss and the human body, heating systems and comfort, heat loss design, air leakage, and soil conductivity factors. Design considerations and equipment standards were described for the following electric heating systems: electric resistance baseboard systems, forced flow unitary heaters, electric radiant cable in-floor systems, radiant ceiling systems, forced warm air heating systems, furnaces, and heat pumps. 68 tabs., 29 figs.

  14. Introducing the Canadian Thoracic Society Framework for Guideline Dissemination and Implementation, with Concurrent Evaluation

    Directory of Open Access Journals (Sweden)

    Samir Gupta

    2013-01-01

    Full Text Available The Canadian Thoracic Society (CTS is leveraging its strengths in guideline production to enable respiratory guideline implementation in Canada. The authors describe the new CTS Framework for Guideline Dissemination and Implementation, with Concurrent Evaluation, which has three spheres of action: guideline production, implementation infrastructure and knowledge translation (KT methodological support. The Canadian Institutes of Health Research ‘Knowledge-to-Action’ process was adopted as the model of choice for conceptualizing KT interventions. Within the framework, new evidence for formatting guideline recommendations to enhance the intrinsic implementability of future guidelines were applied. Clinical assemblies will consider implementability early in the guideline production cycle when selecting clinical questions, and new practice guidelines will include a section dedicated to KT. The framework describes the development of a web-based repository and communication forum to inventory existing KT resources and to facilitate collaboration and communication among implementation stakeholders through an online discussion board. A national forum for presentation and peer-review of proposed KT projects is described. The framework outlines expert methodological support for KT planning, development and evaluation including a practical guide for implementers and a novel ‘Clinical Assembly – KT Action Team’, and in-kind logistical support and assistance in securing peer-reviewed funding.

  15. Antihyperlipidemic Medication Treatment Patterns and Statin Adherence Among Patients with ASCVD in a Managed Care Plan After Release of the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol.

    Science.gov (United States)

    Bellows, Brandon K; Olsen, Cody J; Voelker, Jennifer; Wander, Curtis

    2016-08-01

    The American College of Cardiology (ACC) and American Heart Association (AHA) released a new blood cholesterol treatment guideline in November 2013. It is unknown how the new recommendations have affected cholesterol medication use and adherence in a commercial health plan. To evaluate the effect of the 2013 guideline release on antihyperlipidemic treatment patterns and statin adherence in patients with atherosclerotic cardiovascular disease (ASCVD) compared with a historical control group. This study was a historical cohort analysis of adult patients (aged 21-75 years) with clinical ASCVD enrolled in a SelectHealth commercial health plan. Patients were included in the guideline implementation cohort if they had a medical claim with an ICD-9-CM diagnosis of ASCVD in the year before the November 2013 ACC/AHA guideline release. The index date was defined as the first outpatient medical claim with an ICD-9-CM for ASCVD in the first 6 months after the guideline was released. Patients were required to have continuous enrollment for ≥ 1 year before and after the index date. These same criteria were applied to patients exactly 4 years earlier to identify a historical control group. Patients meeting these criteria formed the antihyperlipidemic treatment patterns cohort. Of these, patients who also had ≥1 pharmacy claim for a statin in the 1-year pre- and post-index periods were included in the statin adherence cohort. Antihyperlipidemic treatment patterns were assessed using pharmacy claims for antihyperlipidemic medications in the 1-year pre- and post-index periods. Antihyperlipidemic medication claims were classified as a nonstatin cholesterol medication, low-intensity statin, moderate-intensity statin, or high-intensity statin. To address differences in pre-index antihyperlipidemic medications between the guideline implementation and historical control groups, patients were randomly matched 1:1 based on pre-index classification in a post hoc analysis. Post

  16. 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.

  17. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions

    DEFF Research Database (Denmark)

    Lord, E; Stockdale, A J; Malek, R

    2017-01-01

    OBJECTIVES: European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK...... are piloting methods to engage with guideline development groups to ensure that patients diagnosed with ICs/ADCs are tested for HIV. We then plan to apply our methodology in other European settings as part of the Optimising Testing and Linkage to Care for HIV across Europe (OptTEST) project....... to review specialty guidelines and ascertain if HIV was discussed and testing recommended. METHODS: UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies...

  18. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, J. W. [DOE ARM Climate Research Facility, Washington, DC (United States); Chapman, L. A. [DOE ARM Climate Research Facility, Washington, DC (United States)

    2015-12-01

    This document establishes a common set of guidelines for the Atmospheric Radiation Measurement (ARM) Climate Research Facility for planning, executing, and closing out field campaigns. The steps that guide individual field campaigns are described in the Field Campaign Tracking System and are specifically tailored to meet the scope of each field campaign.

  19. 29 CFR 1608.11 - Limitations on the application of these guidelines.

    Science.gov (United States)

    2010-07-01

    ... Guidelines are applicable only with respect to the circumstances described in § 1608.1(d), of this part. They... complained of, these Guidelines are inapplicable. (c) Currency of plan or program. Under section 713(b)(1), persons may rely on the plan or program only during the time when it is current. Currency is related to...

  20. 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

  1. Some guidance on preparing validation plans for the DART Full System Models.

    Energy Technology Data Exchange (ETDEWEB)

    Gray, Genetha Anne; Hough, Patricia Diane; Hills, Richard Guy (Sandia National Laboratories, Albuquerque, NM)

    2009-03-01

    Planning is an important part of computational model verification and validation (V&V) and the requisite planning document is vital for effectively executing the plan. The document provides a means of communicating intent to the typically large group of people, from program management to analysts to test engineers, who must work together to complete the validation activities. This report provides guidelines for writing a validation plan. It describes the components of such a plan and includes important references and resources. While the initial target audience is the DART Full System Model teams in the nuclear weapons program, the guidelines are generally applicable to other modeling efforts. Our goal in writing this document is to provide a framework for consistency in validation plans across weapon systems, different types of models, and different scenarios. Specific details contained in any given validation plan will vary according to application requirements and available resources.

  2. Postoperative Radiotherapy for Prostate Cancer: A Comparison of Four Consensus Guidelines and Dosimetric Evaluation of 3D-CRT Versus Tomotherapy IMRT

    International Nuclear Information System (INIS)

    Malone, Shawn; Croke, Jennifer; Roustan-Delatour, Nicolas; Belanger, Eric; Avruch, Leonard; Malone, Colin; Morash, Christopher; Kayser, Cathleen; Underhill, Kathryn; Li Yan; Malone, Kyle; Nyiri, Balazs; Spaans, Johanna

    2012-01-01

    Purpose: Despite the benefits of adjuvant radiotherapy after radical prostatectomy, approximately one-half of patients relapse. Four consensus guidelines have been published (European Organization for Research and Treatment of Cancer, Faculty of Radiation Oncology Genito-Urinary Group, Princess Margaret Hospital, Radiation Therapy Oncology Group) with the aim of standardizing the clinical target volume (CTV) delineation and improve outcomes. To date, no attempt has been made to compare these guidelines in terms of treatment volumes or organ at risk (OAR) irradiation. The extent to which the guideline-derived plans meet the dosimetric constraints of present trials or of the Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) trial is also unknown. Our study also explored the dosimetric benefits of intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 20 patients treated with postoperative RT were included. The three-dimensional conformal radiotherapy (3D-CRT) plans were applied to cover the guideline-generated planning target volumes (66 Gy in 33 fractions). Dose–volume histograms (DVHs) were analyzed for CTV/planning target volume coverage and to evaluate OAR irradiation. The OAR DVHs were compared with the constraints proposed in the QUANTEC and Radiotherapy and Androgen Deprivation In Combination After Local Surgery (RADICALS) trials. 3D-CRT plans were compared with the tomotherapy plans for the Radiation Therapy Oncology Group planning target volume to evaluate the advantages of IMRT. Results: The CTV differed significantly between guidelines (p < 0.001). The European Organization for Research and Treatment of Cancer-CTVs were significantly smaller than the other CTVs (p < 0.001). Differences in prostate bed coverage superiorly accounted for the major volumetric differences between the guidelines. Using 3D-CRT, the DVHs rarely met the QUANTEC or RADICALS rectal constraints, independent of the guideline used. The RADICALS

  3. What of guidelines for osteoarthritis?

    Science.gov (United States)

    Lim, Anita Y N; Doherty, Michael

    2011-05-01

    Osteoarthritis (OA) is by far the most common joint disease and a major cause of pain and disability. The prevalence and impact of OA will increase in the next decades in the Asia-Pacific region due to increased longevity, increasing urbanization and a parallel increase in obesity. The three main types of evidence to inform evidence-based practice are research evidence, expert experience and patient opinion--all three of these are equally weighted. Guideline development groups vary in terms of process and structure of guideline production and in how much integration there is between research, expert and patient evidence. Nevertheless, guidelines on OA concur in recommending: holistic assessment of the patient and individualizing the management plan; patient information access; weight loss if overweight or obese, and prescription of exercise. Additional adjunctive non-pharmacological and pharmacological interventions, including surgery, may be added to this core set as required. However, when audited, it appears that management of OA is often suboptimal, with a major focus on oral analgesics, especially non-steroidal anti-inflammatory drugs. A number of barriers to implementation are evident and appropriate audit of care is necessary to improve delivery of service and to plan healthcare resources. For OA, the effect size of placebo in clinical trials is usually far greater than the additional specific effect of individual treatments, emphasizing the importance of contextual ('meaning') response in this chronic painful condition. This has important implications for clinical care in that optimization of the contextual response can lead to improvements in patient outcomes even in the absence of very effective treatments. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

  4. Spatial planning of wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-01-01

    This paper proposes guidelines for spatial planning for wind power, based on experience with spatial planning in Belgium, Denmark, France and the Netherlands. In addition experiences from Germany and Ireland have been used. This guidelines quotes all decisive criteria for successful implementation of wind energy: landscape integration, stakeholders involvement, noise and distance from buildings. (author)

  5. Formalization of Medical Guidelines

    Czech Academy of Sciences Publication Activity Database

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

    2005-01-01

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

  6. The updating of clinical practice guidelines: insights from an international survey

    Directory of Open Access Journals (Sweden)

    Solà Ivan

    2011-09-01

    Full Text Available Abstract Background Clinical practice guidelines (CPGs have become increasingly popular, and the methodology to develop guidelines has evolved enormously. However, little attention has been given to the updating process, in contrast to the appraisal of the available literature. We conducted an international survey to identify current practices in CPG updating and explored the need to standardize and improve the methods. Methods We developed a questionnaire (28 items based on a review of the existing literature about guideline updating and expert comments. We carried out the survey between March and July 2009, and it was sent by email to 106 institutions: 69 members of the Guidelines International Network who declared that they developed CPGs; 30 institutions included in the U.S. National Guideline Clearinghouse database that published more than 20 CPGs; and 7 institutions selected by an expert committee. Results Forty-four institutions answered the questionnaire (42% response rate. In the final analysis, 39 completed questionnaires were included. Thirty-six institutions (92% reported that they update their guidelines. Thirty-one institutions (86% have a formal procedure for updating their guidelines, and 19 (53% have a formal procedure for deciding when a guideline becomes out of date. Institutions describe the process as moderately rigorous (36% or acknowledge that it could certainly be more rigorous (36%. Twenty-two institutions (61% alert guideline users on their website when a guideline is older than three to five years or when there is a risk of being outdated. Twenty-five institutions (64% support the concept of "living guidelines," which are continuously monitored and updated. Eighteen institutions (46% have plans to design a protocol to improve their guideline-updating process, and 21 (54% are willing to share resources with other organizations. Conclusions Our study is the first to describe the process of updating CPGs among prominent

  7. Guidelines for state ITS/CVO business plans

    Science.gov (United States)

    1997-02-01

    This technical memorandum was developed as part of the study, Systems Planning for Automated Commercial Vehicle Licensing and Permitting Systems. The objective of this study was to define the requirements and develop a plan for a national progr...

  8. Pediatric Sepsis Guidelines: Summary for resource-limited countries

    Science.gov (United States)

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

    2010-01-01

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

  9. From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis

    Directory of Open Access Journals (Sweden)

    Liliana Leone

    2017-10-01

    Full Text Available Background: Evidence-based guidelines published by health authorities for the promotion of health-enhancing physical activity (PA, continue to be implemented unsuccessfully and demonstrate a gap between evidence and policies. This review synthesizes evidence on factors influencing delivery, adoption and implementation of PA promotion guidelines within different policy sectors (e.g., health, transport, urban planning, sport, education. Methods: Published literature was initially searched using PubMed, EBSCO, Google Scholar and continued through an iterative snowball technique. The literature review spanned the period 2002–2017. The realist synthesis approach was adopted to review the content of 39 included studies. An initial programme theory with a four-step chain from evidence emersion to implementation of guidelines was tested. Results: The synthesis furthers our understanding of the link between PA guidelines delivery and the actions of professionals responsible for implementation within health services, school departments and municipalities. The main mechanisms identified for guidance implementation were scientific legitimation, enforcement, feasibility, familiarity with concepts and PA habits. Threats emerged to the successful implementation of PA guidelines at national/local jurisdictional levels. Conclusions: The way PA guidelines are developed may influence their adoption by policy-makers and professionals. Useful lessons emerged that may inform synergies between policymaking and professional practices, promoting win-win multisectoral strategies.

  10. SU-E-P-38: Comparison of Capri Applicator HDR Planning Methods to Meet the NCCN Uterine Neoplasm 2.2015 Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Klash, S; Steinman, J [Radphys Oncology Services, LLC, Knoxville, TN (United States); Stanley, T [CCS Oncology Center, Kenmore, NY (United States); Kim, D; Yi, S [CCS Oncology, Williamsville, NY (United States); Yap, J [CCS Oncology, Williamsville, New York (United States)

    2015-06-15

    Purpose: To establish a systematic planning approach for Capri intravaginal multichannel balloon applicators that meet updated Version 2.2015 NCCN guidelines for uterine neoplasms, which dictate delivery of 400 to 600 cGy in 2 to 3 fractions prescribed to the vaginal mucosa for HDR combined with EBRT as well as a regimen of 600 cGy x 5 (to the vaginal mucosa) for HDR brachytherapy alone. Methods: Studies have shown three different channel configurations of the Capri applicator are optimal for dosimetric conformity: central channel combined with the six inner ring channels (R12), all inner and outer ring channels (R23), or all thirteen channels (R123). To minimize the dose to the vaginal mucosa, a traditional 0.5cm expansion contour from the Capri surface was created. Optimization limits were set to push 600 cGy to 100% of the Capri volume, while simultaneously restricting dose to the expansion contour. Results: Plans were created using all three configurations (R12, R23, R123) and evaluated to determine which was best for delivering 600 cGy to the vaginal mucosa. Our criteria was: Capri V100 > 98%, Vaginal Mucosa Dmax < 125%, Bladder Dmax < 100%, Rectum Dmax < 100%. All configurations show Capri V100 values greater than 98.5%, with differences between plans varying by less than 1%. Vaginal mucosal Dmax values showed differences of roughly 5% of prescription. The R12 configuration proved the lowest vaginal mucosa Dmax, on average. The OAR Dmax values showed an average dose difference of roughly 2% of prescription, with the R23 configuration having the best results. Conclusion: The R12 channel configuration optimally fits our planning criteria and NCCN guidelines for 600 cGy prescribed to the vaginal mucosa. On average, it produced the highest Capri V100, the lowest vaginal mucosal Dmax, and a marginally higher OAR Dmax doses compared to the R23 and R123 plans.

  11. SU-E-P-38: Comparison of Capri Applicator HDR Planning Methods to Meet the NCCN Uterine Neoplasm 2.2015 Guidelines

    International Nuclear Information System (INIS)

    Klash, S; Steinman, J; Stanley, T; Kim, D; Yi, S; Yap, J

    2015-01-01

    Purpose: To establish a systematic planning approach for Capri intravaginal multichannel balloon applicators that meet updated Version 2.2015 NCCN guidelines for uterine neoplasms, which dictate delivery of 400 to 600 cGy in 2 to 3 fractions prescribed to the vaginal mucosa for HDR combined with EBRT as well as a regimen of 600 cGy x 5 (to the vaginal mucosa) for HDR brachytherapy alone. Methods: Studies have shown three different channel configurations of the Capri applicator are optimal for dosimetric conformity: central channel combined with the six inner ring channels (R12), all inner and outer ring channels (R23), or all thirteen channels (R123). To minimize the dose to the vaginal mucosa, a traditional 0.5cm expansion contour from the Capri surface was created. Optimization limits were set to push 600 cGy to 100% of the Capri volume, while simultaneously restricting dose to the expansion contour. Results: Plans were created using all three configurations (R12, R23, R123) and evaluated to determine which was best for delivering 600 cGy to the vaginal mucosa. Our criteria was: Capri V100 > 98%, Vaginal Mucosa Dmax < 125%, Bladder Dmax < 100%, Rectum Dmax < 100%. All configurations show Capri V100 values greater than 98.5%, with differences between plans varying by less than 1%. Vaginal mucosal Dmax values showed differences of roughly 5% of prescription. The R12 configuration proved the lowest vaginal mucosa Dmax, on average. The OAR Dmax values showed an average dose difference of roughly 2% of prescription, with the R23 configuration having the best results. Conclusion: The R12 channel configuration optimally fits our planning criteria and NCCN guidelines for 600 cGy prescribed to the vaginal mucosa. On average, it produced the highest Capri V100, the lowest vaginal mucosal Dmax, and a marginally higher OAR Dmax doses compared to the R23 and R123 plans

  12. Best Practice No 177: Best practice guideline: writing a business case for service development in pathology.

    Science.gov (United States)

    Galloway, M J

    2004-04-01

    This guideline reviews the introduction and development of business planning in the National Health Service. A guideline for writing a business case for service development that would form part of a pathology business plan has been developed. This guideline outlines six steps that are required in the preparation of a business case. The format of the guideline has been developed largely from other national guidelines that have been published for the development of capital projects. In view of the publication of these guidelines, the scope of this guideline excludes business cases for information, management, and technology projects and large capital projects.

  13. Guidelines for computer security in general practice.

    Science.gov (United States)

    Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

    2007-01-01

    As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making

  14. City of North Vancouver greenhouse gas local action plan : final report

    International Nuclear Information System (INIS)

    Hood, I.

    2005-02-01

    This paper presented details of a greenhouse gas (GHG) local action plan developed as a result of the City of North Vancouver's participation in the Partners for Climate Protection Program (PCPP). The plan is intended to better manage the impacts of urban development related to GHG and air quality, while also achieving community objectives related to affordable housing, transportation management, job creation and economic development. The report reviewed the local emissions inventory in addition to various programs, plans, policies and by-laws relating to energy management. Potential policies and programs were identified to achieve GHG emissions reductions in accordance with the PCPP. A plan for emissions reductions was also presented. A situation analysis was presented with details of population, transportation, residential and commercial building and industry. Solid waste management and transportation plans were outlined. A GHG emissions profile and forecast was presented. An outline of a GHG management framework included information on initiatives in the city as well as details of public consultation feedback. A program implementation plan includes forecasts of the program's impact, as well as details of program delivery and a performance measurement framework. Proposed initiatives in the plan included new building guidelines; fuel switching for light and heavy duty vehicles; driver training and enhanced vehicle maintenance programs; and, an environmental procurement policy. Community programs include residential and commercial building retrofits; land use planning; support for community energy systems; green building design guidelines; transportation demand management; and, public engagement and outreach programs. 21 tabs., 9 figs

  15. Medical Malpractice Implications of Clinical Practice Guidelines.

    Science.gov (United States)

    Ruhl, Douglas S; Siegal, Gil

    2017-08-01

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

  16. Guidelines on hospital emergency plans for the management of minor radiation accidents

    International Nuclear Information System (INIS)

    1992-12-01

    This document provides guidance on the organizational structure, personnel, facilities, equipment, supplies and treatment principles required for the initial care of injured persons who have been accidentally exposed to ionizing radiation and who may be contaminated with radioisotopes. The first part of the document, directed at hospital administrators, provides guidance on the principles of planning and preparedness for handling a radiation incident. The second part is directed at hospital emergency personnel responsible for treating patients who may be contaminated with radioactive materials. Three types of victims are considered. The first has been accidentally irradiated with X-rays or gamma rays over the entire body or in localized areas. There is no radioactive residue on or about the body. The second type of victim has known or suspected radioactive contamination within a wound, within the body or on the skin. A third type of victim believes he or she has been exposed and contaminated, but has not been. These guidelines apply in particular to smaller community hospitals. (L.L.) 27 refs., 3 figs

  17. Guidelines for determining flood flow frequency—Bulletin 17C

    Science.gov (United States)

    England, John F.; Cohn, Timothy A.; Faber, Beth A.; Stedinger, Jery R.; Thomas, Wilbert O.; Veilleux, Andrea G.; Kiang, Julie E.; Mason, Robert R.

    2018-03-29

    Accurate estimates of flood frequency and magnitude are a key component of any effective nationwide flood risk management and flood damage abatement program. In addition to accuracy, methods for estimating flood risk must be uniformly and consistently applied because management of the Nation’s water and related land resources is a collaborative effort involving multiple actors including most levels of government and the private sector.Flood frequency guidelines have been published in the United States since 1967, and have undergone periodic revisions. In 1967, the U.S. Water Resources Council presented a coherent approach to flood frequency with Bulletin 15, “A Uniform Technique for Determining Flood Flow Frequencies.” The method it recommended involved fitting the log-Pearson Type III distribution to annual peak flow data by the method of moments.The first extension and update of Bulletin 15 was published in 1976 as Bulletin 17, “Guidelines for Determining Flood Flow Frequency” (Guidelines). It extended the Bulletin 15 procedures by introducing methods for dealing with outliers, historical flood information, and regional skew. Bulletin 17A was published the following year to clarify the computation of weighted skew. The next revision of the Bulletin, the Bulletin 17B, provided a host of improvements and new techniques designed to address situations that often arise in practice, including better methods for estimating and using regional skew, weighting station and regional skew, detection of outliers, and use of the conditional probability adjustment.The current version of these Guidelines are presented in this document, denoted Bulletin 17C. It incorporates changes motivated by four of the items listed as “Future Work” in Bulletin 17B and 30 years of post-17B research on flood processes and statistical methods. The updates include: adoption of a generalized representation of flood data that allows for interval and censored data types; a new method

  18. An investigation of face and fingerprint feature-fusion guidelines

    CSIR Research Space (South Africa)

    Brown, Dane

    2016-05-01

    Full Text Available There are a lack of multi-modal biometric fusion guidelines at the feature-level. This paper investigates face and fingerprint features in the form of their strengths and weaknesses. This serves as a set of guidelines to authors that are planning...

  19. Sanitary landfill groundwater quality assessment plan Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Wells, D.G.; Cook, J.W.

    1990-06-01

    This assessment monitoring plan has been prepared in accordance with the guidance provided by the SCDHEC in a letter dated December 7, 1989 from Pearson to Wright and a letter dated October 9, 1989 from Keisler to Lindler. The letters are included a Appendix A, for informational purposes. Included in the plan are all of the monitoring data from the landfill monitoring wells for 1989, and a description of the present monitoring well network. The plan proposes thirty-two new wells and an extensive coring project that includes eleven soil borings. Locations of the proposed wells attempt to follow the SCDHEC guidelines and are downgradient, sidegradient and in the heart of suspected contaminant plumes. Also included in the plan is the current Savannah River Site Sampling and Analysis Plan and the well construction records for all of the existing monitoring wells around the sanitary landfill.

  20. 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

  1. Assessing Cultural Competency in School Crisis Plans

    Science.gov (United States)

    Annandale, Neil O.; Heath, Melissa Allen; Dean, Brenda; Kemple, Ana; Takino, Yozo

    2011-01-01

    This study reviewed school-based crisis planning resources and guidelines provided by 40 state departments of education and offices of safe and drug-free schools. Content was examined for indications of cultural competency. The most frequently reported topics included: (a) assisting students with mental and physical disabilities, (b) tapping into…

  2. Statistical guidelines for planning a limited drilling program

    International Nuclear Information System (INIS)

    Campbell, K.

    1988-06-01

    Site characterization for potential nuclear waste repository at Yucca Mountain in south-central Nevada will include the construction of a limited number of new drill holes to depths below the repository horizon from which information about the properties of the surrounding and underlying tuffs can be obtained. Quantitative techniques to estimate the amount of information to be gained from a proposed drilling plan are developed. These estimates are to be compared with economic costs and with risk analysis requirements for the potential repository. In some cases the existing data, although extremely limited, are sufficient for preliminary application of these methods. 33 refs., 19 figs., 3 tabs

  3. 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.

  4. BIM Guidelines Inform Facilities Management Databases: A Case Study over Time

    Directory of Open Access Journals (Sweden)

    Karen Kensek

    2015-08-01

    Full Text Available A building information model (BIM contains data that can be accessed and exported for other uses during the lifetime of the building especially for facilities management (FM and operations. Working under the guidance of well-designed BIM guidelines to insure completeness and compatibility with FM software, architects and contractors can deliver an information rich data model that is valuable to the client. Large owners such as universities often provide these detailed guidelines and deliverable requirements to their building teams. Investigation of the University of Southern California (USC Facilities Management Service’s (FMS website showed a detailed plan including standards, file names, parameter lists, and other requirements of BIM data, which were specifically designated for facilities management use, as deliverables on new construction projects. Three critical details were also unearthed in the reading of these documents: Revit was the default BIM software; COBie was adapted to help meet facilities management goals; and EcoDomus provided a display of the collected data viewed through Navisworks. Published accounts about the Cinema Arts Complex developed with and under these guidelines reported positive results. Further examination with new projects underway reveal the rapidly changing relational database landscape evident in the new USC “Project Record Revit Requirement Execution Plan (PRxP”.

  5. Formalization of 2007 ESH/ESC Hypertension Guidelines (HGL)

    Czech Academy of Sciences Publication Activity Database

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

    2008-01-01

    Roč. 26, Suppl. 1 (2008), s. 302-302 ISSN 0952-1178. [ Hypertension 2008. 14.06.2008-19.06.2008, Berlin] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : formalization of medical guidelines * 2007 ESH/ESC hypertension guidelines Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  6. Global Imaging referral guidelines

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  7. Cost analysis guidelines

    International Nuclear Information System (INIS)

    Strait, R.S.

    1996-01-01

    The first phase of the Depleted Uranium Hexafluoride Management Program (Program)--management strategy selection--consists of several program elements: Technology Assessment, Engineering Analysis, Cost Analysis, and preparation of an Environmental Impact Statement (EIS). Cost Analysis will estimate the life-cycle costs associated with each of the long-term management strategy alternatives for depleted uranium hexafluoride (UF6). The scope of Cost Analysis will include all major expenditures, from the planning and design stages through decontamination and decommissioning. The costs will be estimated at a scoping or preconceptual design level and are intended to assist decision makers in comparing alternatives for further consideration. They will not be absolute costs or bid-document costs. The purpose of the Cost Analysis Guidelines is to establish a consistent approach to analyzing of cost alternatives for managing Department of Energy's (DOE's) stocks of depleted uranium hexafluoride (DUF6). The component modules that make up the DUF6 management program differ substantially in operational maintenance, process-options, requirements for R and D, equipment, facilities, regulatory compliance, (O and M), and operations risk. To facilitate a consistent and equitable comparison of costs, the guidelines offer common definitions, assumptions or basis, and limitations integrated with a standard approach to the analysis. Further, the goal is to evaluate total net life-cycle costs and display them in a way that gives DOE the capability to evaluate a variety of overall DUF6 management strategies, including commercial potential. The cost estimates reflect the preconceptual level of the designs. They will be appropriate for distinguishing among management strategies

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

    Directory of Open Access Journals (Sweden)

    Nair Rosana Sommaruga Montiel

    2018-03-01

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

  9. Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

    2013-01-01

    Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

  10. 10 CFR 436.102 - General operations plan format and content.

    Science.gov (United States)

    2010-01-01

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

  11. 34 CFR 611.2 - What management plan must be included in a Teacher Quality Enhancement Grants Program application?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What management plan must be included in a Teacher... TEACHER QUALITY ENHANCEMENT GRANTS PROGRAM General Provisions § 611.2 What management plan must be... appropriate, a management plan that includes a proposed multiyear workplan. (b) At a minimum, this workplan...

  12. Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

    Science.gov (United States)

    Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

    2014-01-15

    Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

  13. Planning for Accessibility.

    Science.gov (United States)

    Spoor, Dana L.

    1997-01-01

    Argues that barrier-free designs should be incorporated in the first steps of school facility planning to avoid the difficulties in meeting Americans with Disabilities Act (ADA) guidelines during renovations. Explains why not all barriers need be removed to make a facility accessible to everyone. Discusses issues involving ADA guidelines and child…

  14. Improving planning, design, reporting and scientific quality of animal experiments by using the Gold Standard Publication Checklist, in addition to the ARRIVE guidelines.

    Science.gov (United States)

    Hooijmans, Carlijn R; de Vries, Rob; Leenaars, Marlies; Curfs, Jo; Ritskes-Hoitinga, Merel

    2011-03-01

    Several studies have demonstrated serious omissions in the way research that use animals is reported. In order to improve the quality of reporting of animal experiments, the Animals in research: reporting in vivo experiments (ARRIVE) Guidelines were published in the British Journal of Pharmacology in August 2010. However, not only the quality of reporting of completed animal studies needs to be improved, but also the design and execution of new experiments. With both these goals in mind, we published the Gold Standard Publication Checklist (GSPC) in May 2010, a few months before the ARRIVE guidelines appeared. In this letter, we compare the GSPC checklist with the ARRIVE Guidelines. The GSPC describes certain items in more detail, which makes it both easier to use when designing and conducting an experiment and particularly suitable for making systematic reviews of animal studies more feasible. In order to improve not only the reporting but also the planning, design, execution and thereby, the scientific quality of animal experiments, we strongly recommend to all scientists involved in animal experimentation and to editors of journals publishing animal studies to take a closer look at the contents of both the ARRIVE guidelines and GSPC, and select the set of guidelines which is most appropriate for their particular situation. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  15. Development of suicide postvention guidelines for secondary schools: a Delphi study

    Directory of Open Access Journals (Sweden)

    Georgina R. Cox

    2016-02-01

    Full Text Available Abstract Background Suicide of school-aged adolescents is a significant problem, with serious implications for students and staff alike. To date, there is a lack of evidence regarding the most effective way for a secondary school to respond to the suicide of a student, termed postvention [(Crisis 33:208-214, 2012, (Crisis 34:164-182, 2013]. The aim of this study was to employ the expert consensus (Delphi methodology to the development of a set of guidelines, to assist English-speaking secondary schools to develop a plan to respond to a student suicide, or to respond to a suicide in the absence of a predetermined plan. Methods The Delphi methodology was employed, which involved a two-stage process. Firstly, medical and research databases, existing postvention guidelines developed for schools, and lay literature were searched in order to identify potential actions that school staff could carry out following the suicide of a student. Based on this search, an online questionnaire was produced. Secondly, 40 experts in the area of suicide postvention from English-speaking countries were recruited and asked to rate each action contained within this questionnaire, in terms of how important they felt it was to be included in the postvention guidelines. A set of guidelines was developed based on these responses. In total, panel members considered 965 actions across three consensus rounds. Results Five hundred fourty-eight actions were endorsed for inclusion into the postvention guidelines based on an 80 % consensus agreement threshold. These actions were groups according to common themes, which are presented in the following sections: 1. Developing an Emergency Response Plan; 2. Forming an Emergency Response Team; 3. Activating the Emergency Response Team; 4. Managing a suspected suicide that occurs on school grounds; 5. Liaising with the deceased student’s family; 6. Informing staff of the suicide; 7. Informing students of the suicide; 8. Informing

  16. Comprehensive School Alienation Program, Guidelines.

    Science.gov (United States)

    Hawaii State Dept. of Education, Honolulu. Office of Instructional Services.

    This document presents guidelines developed by the Hawaii State Department of Education's Comprehensive School Alienation Program to consolidate and strengthen the delivery of services to alienated students. It is intended to assist district staff, school administrators, and project personnel in planning and implementing program activities and…

  17. Guidelines for writing an argumentative essay

    OpenAIRE

    Aleksandra Egurnova

    2014-01-01

    The guidelines below are intended for teachers, professors, students, and the public at large who are interested in the issues of English writing culture. They provide a detailed plan for completing the writing task–writing an argumentative essay.

  18. Impact of target volume coverage with Radiation Therapy Oncology Group (RTOG) 98-05 guidelines for transrectal ultrasound guided permanent Iodine-125 prostate implants

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Mitra, Raj K.; Uzzo, Robert G.; Das, Indra J.; Pinover, Wayne H.; Hanlon, Alexandra L.; McNeeley, Shawn W.; Hanks, Gerald E.

    2003-01-01

    Purpose: Despite the wide use of permanent prostate implants for the treatment of early stage prostate cancer, there is no consensus for optimal pre-implant planning guidelines that results in maximal post-implant target coverage. The purpose of this study was to compare post-implant target volume coverage and dosimetry between patients treated before and after Radiation Therapy Oncology Group (RTOG) 98-05 guidelines were adopted using several dosimetric endpoints. Materials and methods: Ten consecutively treated patients before the adoption of the RTOG 98-05 planning guidelines were compared with ten consecutively treated patients after implementation of the guidelines. Pre-implant planning for patients treated pre-RTOG was based on the clinical target volume (CTV) defined by the pre-implant TRUS definition of the prostate. The CTV was expanded in each dimension according to RTOG 98-05 and defined as the planning target volume. The evaluation target volume was defined as the post-implant computed tomography definition of the prostate based on RTOG 98-05 protocol recommendations. Implant quality indicators included V 100 , V 90 , V 100 , and Coverage Index (CI). Results: The pre-RTOG median V 100 , V 90 , D 90 , and CI values were 82.8, 88.9%, 126.5 Gy, and 17.1, respectively. The median post-RTOG V 100 , V 90 , D 90 , and CI values were 96.0, 97.8%, 169.2 Gy, and 4.0, respectively. These differences were all statistically significant. Conclusions: Implementation of the RTOG 98-05 implant planning guidelines has increased coverage of the prostate by the prescription isodose lines compared with our previous technique, as indicated by post-implant dosimetry indices such as V 100 , V 90 , D 90 . The CI was also improved significantly with the protocol guidelines. Our data confirms the validity of the RTOG 98-05 implant guidelines for pre-implant planning as it relates to enlargement of the CTV to ensure adequate margin between the CTV and the prescription isodose

  19. The siting guidelines, 10 CFR Part 960

    International Nuclear Information System (INIS)

    Hanlon, C.L.

    1991-01-01

    The Siting Guidelines, 10 CFR Part 960, have played a major role in the U.S. Department of Energy's (the Department) Office of Civilian Radioactive Waste Management siting program since their development and implementation in response to the Nuclear Waste Policy Act of 1982. According to the Act, the Siting Guidelines were applicable to the selection of sites for characterization. The Nuclear Waste Policy Amendments Act of 1987 (the Amendments Act) has selected the Yucca Mountain, Nevada, site for characterization from among those nominated according to the Siting Guidelines. Thus, the Amendments Act has taken the repository program beyond the phase of Siting Guidelines applicability, making the U.S. Nuclear Regulatory Commission's 10 CFR Part 60 the applicable regulation. However, the Department has chosen to make use of aspects of the Siting Guidelines in the Site Characterization Plan for the Yucca Mountain Site. (author) 4 figs., 11 refs

  20. Carotid and coronary disease management prior to open and endovascular aortic surgery. What are the current guidelines?

    Science.gov (United States)

    Thompson, J P

    2014-04-01

    Several bodies produce broadly concurring and updated guidelines for the evaluation and treatment of cardiovascular disease in both surgical and non-surgical patients. Recent developments include revised recommendations on preoperative stress testing, referral for possible coronary revascularization and medical management. It is recognized that non-invasive cardiac tests are relatively poor at predicting perioperative risk, and "prophylactic" coronary revascularization has a limited role. The planned aortic intervention (open or endovascular repair) also influences preoperative management. Patients presenting for elective abdominal aortic aneurysm (AAA) repair should only be referred for cardiological testing if they have active symptoms of coronary artery disease (CAD), known CAD and poor functional exercise capacity, or multiple risk factors for CAD. Coronary revascularization before AAA surgery should be limited to patients with established indications, so cardiac stress testing should only be performed if it would change management i.e. the patient is a candidate for and would benefit from coronary revascularization. When endovascular aortic repair is planned, it is reasonable to proceed to surgery without further cardiac stress testing or evaluation unless otherwise indicated. All non-emergency patients require medical optimization, but perioperative beta blockade benefits only certain patients. Some of the data informing recent guidelines have been questioned and some guidelines are being revised. Current guidelines do not specifically address the management of patients with known or suspected carotid artery disease who may require aortic surgery. For these patients, an individualized approach is required. This review considers recent guidelines. Algorithms for investigation and management based on their recommendations are included.

  1. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study

    International Nuclear Information System (INIS)

    Kline, Robert W.; Smith, Alfred R.; Coia, Lawrence R.; Owen, Jean B.; Hanlon, Alexandra; Wallace, Marsha; Hanks, Gerald

    1997-01-01

    Purpose: To conduct a study of the process of treatment planning and treatment of adenocarcinoma of the rectum and sigmoid in the United States, and to compare survey results to consensus guidelines. Methods and Materials: A consensus committee developed guidelines for the radiotherapeutic management of adenocarcinoma of the rectum and sigmoid, and also developed a survey form that was used to gather data to evaluate the practice patterns for patients treated in 1989 and 1990 against the consensus guidelines. Seventy-three facilities were randomly selected for site visits from the 1321 radiation therapy facilities in the US: 21 academic, 26 hospital based, and 26 free standing. During the site visits, the radiotherapy records were examined by the surveyor physicist and radiation oncologist to extract and record the required data. Data collected included items related to treatment specific parameters, including treatment planning considerations. Analyses included stratification as to the types of institutions, academic, hospital based, or free standing. Results: For many treatment parameters there are discrepancies between the patterns of practice determined by the surveys and the consensus guidelines for radiotherapy treatment of adenocarcinoma of the rectum and sigmoid. Significant differences in practice among the stratified institution types were found in only a few parameters

  2. Environmental audit guidelines for pipelines

    International Nuclear Information System (INIS)

    1991-01-01

    Environmental auditing is a form of management control which provides an objective basis by which a company can measure the degree of compliance with environmental regulations. Other benefits of this type of auditing include improved environmental management, furthering communication on environmental issues of concern within the company, and provision of documentation on environmental diligence. A series of environmental audit guidelines for pipelines is presented in the form of lists of questions to be asked during an environmental audit followed by recommended actions in response to those questions. The questions are organized into seven main categories: environmental management and planning; operating procedures; spill prevention; management of wastes and hazardous materials; environmental monitoring; construction of pipelines; and pipeline abandonment, decommissioning and site reclamation

  3. Guideline Knowledge Representation Model (GLIKREM)

    Czech Academy of Sciences Publication Activity Database

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

    2008-01-01

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

  4. 222-S Laboratory Quality Assurance Plan. Revision 1

    International Nuclear Information System (INIS)

    Meznarich, H.K.

    1995-01-01

    This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A quality assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document

  5. Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools.

    Science.gov (United States)

    Evans-Agnew, Robin A; Klein, Nicole; Lecce, Sally

    2015-11-01

    Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students. © 2015 The Author(s).

  6. The Plan's the Thing.

    Science.gov (United States)

    Raley, Nancy

    1986-01-01

    Planning is the process of setting direction, priorities, and guidelines. A CASE survey of public relations professionals is described that notes the use of staff retreats and brainstorming sessions, among other techniques and strategies, that help professionals plan. (MLW)

  7. 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

  8. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-01

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

  9. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

  10. ECOWindS Joint Action Plan - Guidelines for Implementation

    DEFF Research Database (Denmark)

    2015-01-01

    The Joint Action Plan (JAP) is a deliverable of the European Clusters for Offshore Wind Servicing (ECOWindS) project Work Package 4 (WP4) “Joint Action Plan”. It presents a plan of action or a roadmap for research, development, and innovation (RDI) for the Offshore Wind Service (OWS) industry. Th...

  11. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines

    Directory of Open Access Journals (Sweden)

    Bruno Crestani

    2014-06-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is the most frequent chronic idiopathic interstitial pneumonia in adults. The management of rare diseases in France has been organised by a national plan for rare diseases, which endorsed a network of expert centres for rare diseases throughout France. This article is an overview of the executive summary of the French guidelines for the management of IPF, an initiative that emanated from the French National Reference Centre and the Network of Regional Competence Centres for Rare Lung Diseases. This review aims at providing pulmonologists with a document that: 1 combines the current available evidence; 2 reviews practical modalities of diagnosis and management of IPF; and 3 is adapted to everyday medical practice. The French practical guidelines result from the combined efforts of a coordination committee, a writing committee and a multidisciplinary review panel, following recommendations from the Haute Autorité de Santé. All recommendations included in this article received at least 90% agreement by the reviewing panel. Herein, we summarise the main conclusions and practical recommendations of the French guidelines.

  12. 222-S laboratory quality assurance plan

    International Nuclear Information System (INIS)

    Meznarich, H.K.

    1995-01-01

    This document provides quality assurance guidelines and quality control requirements for analytical services. This document is designed on the basis of Hanford Analytical Services Quality Assurance Plan (HASQAP) technical guidelines and is used for governing 222-S and 222-SA analytical and quality control activities. The 222-S Laboratory provides analytical services to various clients including, but not limited to, waste characterization for the Tank Waste Remediation Systems (TWRS), waste characterization for regulatory waste treatment, storage, and disposal (TSD), regulatory compliance samples, radiation screening, process samples, and TPA samples. A graded approach is applied on the level of sample custody, QC, data verification, and data reporting to meet the specific needs of the client

  13. Bats and bat habitats : guidelines for wind power projects

    International Nuclear Information System (INIS)

    2010-03-01

    Bat mortality has been documented at wind power projects in a number of habitats across North America. Wind power projects in Ontario have reported annual estimates ranging from 4 to 14 bat mortalities per turbine per year. This document presented guidance on identifying and addressing potential negative effects on bats and bat habitats during the planning, construction, and operation of wind power projects in Ontario. The guidelines supported the Ministry of Environment's renewable energy approval regulation and applied on both Crown and privately-owned land. The document presented the regulatory framework and discussed the assessment process for bats and bat habitats. This process included project site; records review; site investigation; and evaluation of significance. Other topics that were presented included an environmental impact study and an environmental effects monitoring plan such as post construction monitoring and post construction mitigation. Several appendices were also included regarding the potential effects of wind power project on bats; best management practices; methods for evaluating bat wildlife habitat; and post construction monitoring methods. 10 refs., 1 tab., 2 figs., 4 appendices.

  14. Bats and bat habitats : guidelines for wind power projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-03-15

    Bat mortality has been documented at wind power projects in a number of habitats across North America. Wind power projects in Ontario have reported annual estimates ranging from 4 to 14 bat mortalities per turbine per year. This document presented guidance on identifying and addressing potential negative effects on bats and bat habitats during the planning, construction, and operation of wind power projects in Ontario. The guidelines supported the Ministry of Environment's renewable energy approval regulation and applied on both Crown and privately-owned land. The document presented the regulatory framework and discussed the assessment process for bats and bat habitats. This process included project site; records review; site investigation; and evaluation of significance. Other topics that were presented included an environmental impact study and an environmental effects monitoring plan such as post construction monitoring and post construction mitigation. Several appendices were also included regarding the potential effects of wind power project on bats; best management practices; methods for evaluating bat wildlife habitat; and post construction monitoring methods. 10 refs., 1 tab., 2 figs., 4 appendices.

  15. Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

    DEFF Research Database (Denmark)

    Francolini, Giulio; Thomsen, Mette S; Yates, Esben S

    2017-01-01

    , Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS). Dice similarity scores (DSC) with original delineations were measured....... No deviations in the dosimetric outcome were found in 76% of the patients, 82% and 95% of the patients had successful coverage of breast/chestwall and CTVn_L2-4-interpectoral. Dosimetric outcomes of original delineation and GS were comparable. CONCLUSIONS: QA showed high protocol compliance and adequate dose...... coverage in most patients. Inter-observer variability in contouring was low. Dose parameters were in harmony with protocol regardless original or GS segmentation....

  16. NDMA guidelines on management of nuclear and radiological emergencies

    International Nuclear Information System (INIS)

    Abani, M.C.

    2011-01-01

    The National Disaster Management Authority (NDMA), ever since it's formation as an apex policy making body for the country in the field of disaster management, has formulated a set of guidelines to assist the various ministries, states and stakeholders in preparing their plans to handle different types of disasters. The guidelines on management of nuclear and radiological emergencies assume great importance in the present context, as our country has very ambitious programme to exploit nuclear energy for peaceful uses. Though, we have an enviable and impeccable record of safety and virtually fail-safe operations in all our nuclear establishments, the possibility, however, remote it may be, of human error, systems failure, sabotage, earthquake, floods, terrorist attacks etc leading to the release of radioactive material in the public domain, cannot be entirely ruled out. With this view, it was decided to prepare the national guidelines by NDMA to manage any nuclear/radiological emergency in public domain. Through these guidelines, we aim to further strengthen our existing nuclear/radiological emergency management framework and generate public awareness, which will go a long way in allaying misapprehensions, if any, amongst the public about the country's nuclear programme. Like in all our guidelines for handling of different types of the disasters, in these Guidelines also, maximum emphasis has been laid on the prevention of nuclear and radiological emergencies, along with a detailed consideration of all other elements of the disaster management continuum. The national guidelines have been prepared and a consensus was arrived on various issues, after widespread consultations and elaborates discussions amongst experts as well as stakeholders. It is assumed that once these guidelines are implemented by the stakeholders and converted into action plans followed by SOPs that will further reduce the chances of accidents in the nuclear arena. (author)

  17. The development of seismic guidelines for the Stanford Linear Accelerator Center

    International Nuclear Information System (INIS)

    Huggins, R.

    1996-08-01

    This paper describes the development of Seismic Guidelines for the Stanford Linear Accelerator Center (SLAC). Although structures have always been built conservatively, SLAC management decided to review and update their seismic guidelines. SLAC is about mid-way between the epicenters of the 8.3 Richter magnitude 1906 San Francisco and the 7.2 Loma Prieta Earthquakes. The west end of the two mile long electron/positron particle accelerator lies a half mile from the large San Andreas Fault. Suggestions for seismic planning processes were solicited from local computer manufacturing firms, universities, and federal laboratories. A Committee of the various stakeholders in SLAC's seismic planning retained an internationally known Seismic Planning Consultant and reviewed relevant standards and drafted Guidelines. A panel of seismic experts was convened to help define the hazard, site response spectra, probabilistic analysis of shaking, and near field effects. The Facility's structures were assigned to seismic classes of importance, and an initial assessment of a sample of a dozen buildings conducted. This assessment resulted in emergency repairs to one structure, and provided a open-quotes reality basisclose quotes for establishing the final Guidelines and Administrative Procedures, and a program to evaluate remaining buildings, shielding walls, tunnels, and other special structures

  18. The development of seismic guidelines for the Stanford Linear Accelerator Center

    Energy Technology Data Exchange (ETDEWEB)

    Huggins, R.

    1996-08-01

    This paper describes the development of Seismic Guidelines for the Stanford Linear Accelerator Center (SLAC). Although structures have always been built conservatively, SLAC management decided to review and update their seismic guidelines. SLAC is about mid-way between the epicenters of the 8.3 Richter magnitude 1906 San Francisco and the 7.2 Loma Prieta Earthquakes. The west end of the two mile long electron/positron particle accelerator lies a half mile from the large San Andreas Fault. Suggestions for seismic planning processes were solicited from local computer manufacturing firms, universities, and federal laboratories. A Committee of the various stakeholders in SLAC`s seismic planning retained an internationally known Seismic Planning Consultant and reviewed relevant standards and drafted Guidelines. A panel of seismic experts was convened to help define the hazard, site response spectra, probabilistic analysis of shaking, and near field effects. The Facility`s structures were assigned to seismic classes of importance, and an initial assessment of a sample of a dozen buildings conducted. This assessment resulted in emergency repairs to one structure, and provided a {open_quotes}reality basis{close_quotes} for establishing the final Guidelines and Administrative Procedures, and a program to evaluate remaining buildings, shielding walls, tunnels, and other special structures.

  19. 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...

  20. The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children

    Science.gov (United States)

    Al-Moamary, Mohamed S.; Alhaider, Sami A.; Idrees, Majdy M.; Al Ghobain, Mohammed O.; Zeitouni, Mohammed O.; Al-Harbi, Adel S.; Yousef, Abdullah A.; Al-Matar, Hussain; Alorainy, Hassan S.; Al-Hajjaj, Mohamed S.

    2016-01-01

    This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan. PMID:26933455

  1. Guidelines for the undergraduate psychology major: Version 2.0.

    Science.gov (United States)

    2016-01-01

    The APA Guidelines for the Undergraduate Psychology Major: Version 2.0 (henceforth Guidelines 2.0; APA, 2013) represents a national effort to describe and develop high-quality undergraduate programs in psychology. The task force charged with the revision of the original guidelines for the undergraduate major examined the success of the document's implementation and made changes to reflect emerging best practices and to integrate psychology's work with benchmarking scholarship in higher education. Guidelines 2.0 abandoned the original distinction drawn between psychology-focused skills and psychology skills that enhance liberal arts development. Instead, Guidelines 2.0 describes five inclusive goals for the undergraduate psychology major and two developmental levels of student learning outcomes. Suggestions for assessment planning are provided for each of the five learning goals. (c) 2016 APA, all rights reserved).

  2. Strategies to overcome barriers to implementing osteoporosis and fracture prevention guidelines in long-term care: a qualitative analysis of action plans suggested by front line staff in Ontario, Canada.

    Science.gov (United States)

    Alamri, Sultan H; Kennedy, Courtney C; Marr, Sharon; Lohfeld, Lynne; Skidmore, Carly J; Papaioannou, Alexandra

    2015-08-01

    Osteoporosis is a major global health problem, especially among long-term care (LTC) facilities. Despite the availability of effective clinical guidelines to prevent osteoporosis and bone fractures, few LTC homes actually adhere to these practical recommendations. The purpose of this study was to identify barriers to the implementation of evidence-based practices for osteoporosis and fracture prevention in LTC facilities and elicit practical strategies to address these barriers. We performed a qualitative analysis of action plans formulated by Professional Advisory Committee (PAC) teams at 12 LTC homes in the intervention arm of the Vitamin D and Osteoporosis Study (ViDOS) in Ontario, Canada. PAC teams were comprised of medical directors, administrators, directors of care, pharmacists, dietitians, and other staff. Thematic content analysis was performed to identify the key themes emerging from the action plans. LTC teams identified several barriers, including lack of educational information and resources prior to the ViDOS intervention, difficulty obtaining required patient information for fracture risk assessment, and inconsistent prescribing of vitamin D and calcium at the time of admission. The most frequently suggested recommendations was to establish and adhere to standard admission orders regarding vitamin D, calcium, and osteoporosis therapies, improve the use of electronic medical records for osteoporosis and fracture risk assessment, and require bone health as a topic at quarterly reviews and multidisciplinary conferences. This qualitative study identified several important barriers and practical recommendations for improving the implementation of osteoporosis and fracture prevention guidelines in LTC settings.

  3. UK national guidelines on the management of syphilis 2015.

    Science.gov (United States)

    Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

    2016-05-01

    These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.

  4. The nuclear emergency plans

    International Nuclear Information System (INIS)

    Fuertes Menendez, M. J.; Gasco Leonarte, L.; Granada Ferrero, M. J.

    2007-01-01

    Planning of the response to emergencies in nuclear plants is regulated by the Basic Nuclear Emergency Plan (PLABEN). This basic Plan is the guidelines for drawing up, implementing and maintaining the effectiveness of the nuclear power plant exterior nuclear emergency plans. The five exterior emergency plans approved as per PLABEN (PENGUA, PENCA, PENBU, PENTA and PENVA) place special emphasis on the preventive issues of emergency planning, such as implementation of advance information programs to the population, as well as on training exercises and drills. (Author)

  5. [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

  6. [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.

  7. 42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... printed materials that meet the requirements of § 417.124(b). (ii) Access may not be more restrictive or... benefits plan. 417.155 Section 417.155 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Organizations in Employee Health Benefits Plans § 417.155 How the HMO option must be included in the health...

  8. The appraisal of clinical guidelines in dentistry.

    Science.gov (United States)

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

    2009-01-01

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

  9. Uranium in Aquatic Sediments; Where are the Guidelines?

    Energy Technology Data Exchange (ETDEWEB)

    Iles, M., E-mail: michelle.iles@ewlsciences.com.au [Earth, Water and Life Sciences Pty Ltd, Darwin (Australia)

    2014-05-15

    Sediment data has been collected on and around the Ranger uranium mine for over 20 years. This included studies such as annual routine monitoring of metal concentrations, adsorption-desorption conditions, phase associations, transport mechanism, release potential, bioaccumulation and bioconcentration etc. Building on this, performance-based monitoring of the sediments from on-site water bodies was undertaken to ascertain the spatial and temporal distribution of contaminants as a basis to determine ecological risks associated with the sediments which in turn underpins closure planning. Highlights of these studies are interpreted using an ecological risk assessment approach. Ideally interpretation of aquatic sediment contamination in Australia is guided by the national guidelines for water quality and a weighted multiple lines of evidence approach whereby the chemistry of sediments is compared with reference and guideline values and predictions of bio-availability, and biological effects data allows cause and effect relationships to be derived. However, where uranium in aquatic sediments is concerned there is a lack of national (Australian) and international guidelines that are applicable to tropical sediments and the biological effects data available are limited or confounded by other variables. In the absence of clear uranium guidelines for sediments an internationally reported “Predicted No Effect Concentration” (PNEC) for uranium in temperate sediments was used as a “pseudo-guideline” value to identify sites with concentrations that might present an environmental risk and that should be further investigated. The applicability of the PNEC to the tropical Ranger site was understandably questioned by stakeholders and peers. The issues raised highlighted the need for international guidelines for uranium in aquatic sediments for tropical and temperate climates and an internationally accepted approach for deriving same. (author)

  10. When implementation fails: the case of a nursing guideline for fall prevention

    NARCIS (Netherlands)

    van der Helm, Jelle; Goossens, Astrid; Bossuyt, Patrick

    2006-01-01

    BACKGROUND: Implementing guidelines can be very difficult. No magic bullet or step-by-step implementation plan is available, neither is any single implementation strategy superior. At the Academic Medical Center (AMC) in Amsterdam, a nursing guideline was developed in 1993 on prevention of patient

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

    International Nuclear Information System (INIS)

    Gilmore, W.E.

    1985-07-01

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

  12. Using gEUD based plan analysis method to evaluate proton vs. photon plans for lung cancer radiation therapy.

    Science.gov (United States)

    Xiao, Zhiyan; Zou, Wei J; Chen, Ting; Yue, Ning J; Jabbour, Salma K; Parikh, Rahul; Zhang, Miao

    2018-03-01

    The goal of this study was to exam the efficacy of current DVH based clinical guidelines draw from photon experience for lung cancer radiation therapy on proton therapy. Comparison proton plans and IMRT plans were generated for 10 lung patients treated in our proton facility. A gEUD based plan evaluation method was developed for plan evaluation. This evaluation method used normal lung gEUD(a) curve in which the model parameter "a" was sampled from the literature reported value. For all patients, the proton plans delivered lower normal lung V 5 Gy with similar V 20 Gy and similar target coverage. Based on current clinical guidelines, proton plans were ranked superior to IMRT plans for all 10 patients. However, the proton and IMRT normal lung gEUD(a) curves crossed for 8 patients within the tested range of "a", which means there was a possibility that proton plan would be worse than IMRT plan for lung sparing. A concept of deficiency index (DI) was introduced to quantify the probability of proton plans doing worse than IMRT plans. By applying threshold on DI, four patients' proton plan was ranked inferior to the IMRT plan. Meanwhile if a threshold to the location of curve crossing was applied, 6 patients' proton plan was ranked inferior to the IMRT plan. The contradictory ranking results between the current clinical guidelines and the gEUD(a) curve analysis demonstrated there is potential pitfalls by applying photon experience directly to the proton world. A comprehensive plan evaluation based on radio-biological models should be carried out to decide if a lung patient would really be benefit from proton therapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  13. 41 CFR 102-37.150 - What must a State legislature include in the plan?

    Science.gov (United States)

    2010-07-01

    ... set forth in Appendix B of this part. It may also include in the plan other provisions not inconsistent with the purposes of title 40 of the United States Code and the requirements of this part. [67 FR...

  14. Information for consideration in reviewing groundwater protection plans for uranium mill tailings sites

    International Nuclear Information System (INIS)

    Thorne, P.D.

    1992-05-01

    Guidelines and acceptance criteria were developed for reviewing certain aspects of groundwater protection plans for uranium mill tailing sites. The aspects covered include: (1) leaching and long-term releases of hazardous and radioactive constituents from tailings and other contaminated materials, (2) attenuation of hazardous and radioactive constituents in groundwater under saturated and unsaturated conditions, (3) design and implementation of groundwater monitoring programs, (4) design and construction of groundwater protection barriers, and (5) efficiency and effectiveness of groundwater cleanup programs. The objective of these guidelines is to assist the US Nuclear Regulatory Commission staff in reviewing Remedial Action Plans for inactive waste sites and licensing application documents for active commercial uranium and thorium mills

  15. High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Executive summary: Volume 1

    International Nuclear Information System (INIS)

    Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B.

    1995-06-01

    The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer software used in the safety systems of nuclear power plants. The framework for the work consisted of the following software development and assurance activities: requirements specification; design; coding; verification and validation, including static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire range of software life-cycle activities; the assessment of the technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary, includes an overview of the framework and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; Volume 2 is the main report

  16. Legal consequences of the special development plan 'power plant sites' on regional planning and on guidelines for building plans

    International Nuclear Information System (INIS)

    1978-01-01

    The Special Development Plan 'Power plant sites' was made compulsory by the regulation given by the Land government in Juli 1976. For extending the energy supply system this Special Development Plan intends to provide a sufficient amount of power plant sites suitably located with regard to present and future consumption centres and permitting a cooling by means of river water while safeguarding the interests of water resources policy. The Special Development Plan established in accordance with the articles 25 and 27 of the planning law of the Land lays down that 14 specified areas are to be kept free from utilization purposes which could be opposed to the realization of power plant projects. Thus the securing of these (potential) sites has become an objective of area planning and planning of the Land in the sense of article 5 paragraph 4 of the Federal law on area planning. (orig./HP) [de

  17. Symptom relief in patients with pneumonia and dementia: implementation of a practice guideline.

    Science.gov (United States)

    van der Maaden, Tessa; van der Steen, Jenny T; Koopmans, Raymond T C M; Doncker, Sarah M M M; Anema, Johannes R; Hertogh, Cees M P M; de Vet, Henrica C W

    2017-08-01

    This study aimed to assess the degree of implementation and barriers encountered in the use of a practice guideline for optimal symptom relief for patients with dementia and pneumonia in Dutch nursing homes. A process evaluation included assessment of reach, fidelity, and dose delivered using researcher's observations, and dose received was addressed in a question "use of the practice guideline," which the physicians completed for each patient included in the study. Perceived barriers were assessed with a structured questionnaire (response 69%) and semi-structured interviews (n = 14), which were subject to qualitative content analysis. Of the 55 physicians involved in the intervention phase, 87% attended an implementation meeting; 20 physicians joined the study later (reach). The intervention was implemented as planned, and all intervention components were delivered by the researchers (fidelity and dose delivered). Thirty-six physicians included 109 patients. For 81% of the patients, the treating physician stated to have used the guideline (dose received). The guideline was perceived as providing a good overview of current practice, but some physicians had expected a more directive protocol or algorithm. Further, recommended regular observations of symptoms were rarely performed. Physician's often felt that "this is not different from what we usually do," and with the acute illness, there was not always enough time to (re)familiarize with the contents. The physicians used the practice guideline frequently despite important barriers. Future implementation may involve strategies such as multiple interactive meetings. Further, the greatest potential to alter usual practice should be emphasized, such as using observational instruments. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Sewage epidemiology and illicit drug research: the development of ethical research guidelines.

    Science.gov (United States)

    Prichard, Jeremy; Hall, Wayne; de Voogt, Pim; Zuccato, Ettore

    2014-02-15

    To discuss the need to develop ethical guidelines for researchers using sewage epidemiology to monitor drug use in the general population and specific precincts, including prisons, schools and workplaces. Describe current applications of sewage epidemiology, identify potential ethical risks associated with this science, and identify key means by which these risks may be mitigated through proportionate ethical guidance that allows this science to be fully developed. A rapidly advancing field of research is sewage epidemiology (SE) - the analysis of wastewater samples to monitor illicit drug use and other substances. Typically this research involves low ethical risks because individual participants cannot be identified and, consequently, review has been waived by human research ethics committees. In the absence of such oversight, ethical research guidelines are recommended for SE teams, peer reviewers and journal editors; guidelines will assist them to mitigate any risks in general population studies and studies of prisons, schools and workplaces. Potential harms include the stigmatisation of participants and, in the prison setting, austere policy responses to SE data that impact negatively upon inmate-participants. The risk of harm can be managed through research planning, awareness of the socio-political context in which results will be interpreted (or, in the case of media, sensationalised) and careful relations with industry partners. Ethical guidelines should be developed in consultation with SE scholars and be periodically amended. They should include publication processes that safeguard scientific rigour and be promulgated through existing research governance structures. Guidelines will assist to promote an ethical research culture among SE teams and scholars involved in the publication process and this will work to protect the reputation of the field. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Development of new canine and feline preventive healthcare guidelines designed to improve pet health.

    Science.gov (United States)

    2011-01-01

    The American Veterinary Medical Association (AVMA) and American Animal Hospital Association (AAHA) have jointly introduced the first Canine and Feline Preventive Healthcare Guidelines. These consensus statements provide veterinarians with a new resource for improving patient care by emphasizing the value and scope of regular pet examinations. The two guidelines provide complete recommendations for comprehensive preventive healthcare programs, published as accessible, single-page documents. The guidelines are based on the subjective-objective-assessment-plan (SOAP) methodology of case management, a proven approach traditionally used with sick or injured patients. This logical and disciplined process is equally applicable to healthy patients and is designed to consistently deliver optimal patient care. The guidelines recommend visits for health examinations on at least an annual basis, recognizing that for many pets, more frequent visits may be appropriate, depending on the individual needs of the patient. The guidelines also provide detailed diagnostic, therapeutic, prevention, and follow up plans, to be accompanied by appropriate documentation. The inclusive content and concise format of the guidelines are designed to maximize their practical value and make them easy to implement.

  20. Advanced human-system interface design review guidelines

    International Nuclear Information System (INIS)

    O'Hara, J.M.

    1990-01-01

    Advanced, computer-based, human-system interface designs are emerging in nuclear power plant (NPP) control rooms. These developments may have significant implications for plant safety in that they will greatly affect the ways in which operators interact with systems. At present, however, the only guidance available to the US Nuclear Regulatory Commission (NRC) for the review of control room-operator interfaces, NUREG-0700, was written prior to these technological changes and is thus not designed to address them. The objective of the project reported in this paper is to develop an Advanced Control Room Design Review Guideline for use in performing human factors reviews of advanced operator interfaces. This guideline will be implemented, in part, as a portable, computer-based, interactive document for field use. The paper describes the overall guideline development methodology, the present status of the document, and the plans for further guideline testing and development. 21 refs., 3 figs

  1. Cities and mobility: a planning guideline for community-compatible mobility; Stadtwege: Planungsleitfaden fuer Stadtvertraegliche Mobilitaet in Kommunen

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    So far, municipal transport planning and policy have not really resulted in pioneering concepts for solving problems arising from the transport issue common to all cities. Even individual promising approaches, which mostly relate to singular aspects of municipal transport policy, cannot obscure the fact that the routines of transport planning obviate innovative impulses. Even the research project's two exemplary municipalities, Freiburg and Schwerin, are a long way from having attained a mobility beneficial to the community (as reflected in a report on these cities' transport situation in the annex). In both there are elements of motor-vehicle-oriented planning and transport policy, but also, in part, distinct clues to a decline in car orientation and to the furtherance of alternative, environmentally compatible means of transport. The present guideline wants to open up new perspectives and give concerned planners impulses. It summarizes results from the research project 'Compatibility of urban mobility' and describes new ideas and paradigms in municipal transport planning and policy. (orig.) [German] Kommunale Verkehrsplanung und -politik hat bisher nicht zu wirklich zukunftsweisenden Loesungsentwuerfen der flaechendeckend festzustellenden Verkehrsproblematik in den Staedten gefuehrt. Auch einzelne gute Ansaetze, die meist auf singulaere Aspekte der staedtischen Verkehrspolitik bezogen sind, koennen nicht darueber hinwegtaeuschen, dass die Routinen der Verkehrsplanung den Blick auf innovative Impulse verstellen. Auch die beiden Modellkommunen des Forschungsprojektes, Freiburg und Schwerin, sind um einiges von dem Ziel der Stadtvertraeglichen Mobilitaet entfernt (s. verkehrliche Zustandsbeschreibung im Anhang). In beiden Staedten finden sich Elemente der autoorientierten Planung und Verkehrspolitik, aber auch zum Teil deutliche Hinweise des Zurueckdraengens der Autoorientierung und der Foerderung der umweltvertraeglichen

  2. Reporting of clinical trials: a review of research funders' guidelines

    Directory of Open Access Journals (Sweden)

    Williamson Paula R

    2008-11-01

    Full Text Available Abstract Background Randomised controlled trials (RCTs represent the gold standard methodological design to evaluate the effectiveness of an intervention in humans but they are subject to bias, including study publication bias and outcome reporting bias. National and international organisations and charities give recommendations for good research practice in relation to RCTs but to date no review of these guidelines has been undertaken with respect to reporting bias. Methods National and international organisations and UK based charities listed on the Association for Medical Research Charities website were contacted in 2007; they were considered eligible for this review if they funded RCTs. Guidelines were obtained and assessed in relation to what was written about trial registration, protocol adherence and trial publication. It was also noted whether any monitoring against these guidelines was undertaken. This information was necessary to discover how much guidance researchers are given on the publication of results, in order to prevent study publication bias and outcome reporting bias. Results Seventeen organisations and 56 charities were eligible of 140 surveyed for this review, although there was no response from 12. Trial registration, protocol adherence, trial publication and monitoring against the guidelines were often explicitly discussed or implicitly referred too. However, only eleven of these organisations or charities mentioned the publication of negative as well as positive outcomes and just three of the organisations specifically stated that the statistical analysis plan should be strictly adhered to and all changes should be reported. Conclusion Our review indicates that there is a need to provide more detailed guidance for those conducting and reporting clinical trials to help prevent the selective reporting of results. Statements found in the guidelines generally refer to publication bias rather than outcome reporting bias

  3. 47 CFR 90.1211 - Regional plan.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Regional plan. 90.1211 Section 90.1211... § 90.1211 Regional plan. (a) To facilitate the shared use of the 4.9 GHz band, each region may submit a plan on guidelines to be used for sharing the spectrum within the region. Any such plan must be...

  4. Formalized Combined 2003 European Guidelines on Cardiovascular Disease Prevention and Hypertension

    Czech Academy of Sciences Publication Activity Database

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

    23 Suppl. 2, - (2005), s. 196 ISSN 0263-6352. [European Meeting on Hypertension /15./. 17.06.2005-21.06.2005, Milan] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : European medical guidelines * formalization of combined guidelines Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery

  5. Evidence-based guidelines for the wise use of computers by children: physical development guidelines.

    Science.gov (United States)

    Straker, L; Maslen, B; Burgess-Limerick, R; Johnson, P; Dennerlein, J

    2010-04-01

    Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

  6. A Typology for Modeling Processes in Clinical Guidelines and Protocols

    Science.gov (United States)

    Tu, Samson W.; Musen, Mark A.

    We analyzed the graphical representations that are used by various guideline-modeling methods to express process information embodied in clinical guidelines and protocols. From this analysis, we distilled four modeling formalisms and the processes they typically model: (1) flowcharts for capturing problem-solving processes, (2) disease-state maps that link decision points in managing patient problems over time, (3) plans that specify sequences of activities that contribute toward a goal, (4) workflow specifications that model care processes in an organization. We characterized the four approaches and showed that each captures some aspect of what a guideline may specify. We believe that a general guideline-modeling system must provide explicit representation for each type of process.

  7. 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.

  8. MDT Commissioning Procedures Guidelines for Certifying RFI Chambers

    CERN Document Server

    Beretta, M; Branchini, P; Kourkoumelis, C; Dubbert, J; Gazis, E N; Hertenberger, R; Hurst, P; Kojine, A; Lanza, A; Marin, A; Mockett, P; Petridou, C; Tskhadadze, E G; Valente, P; Wotschack, J; Xie, Y; Zhao, Z

    2004-01-01

    Aim of the document is the definition of a common set of guidelines and test procedures for commissioning the MDT chambers. Commissioning is different for Barrel and Endcap chambers. The former will be tested at a single chamber level before going to the ATLAS pit, ready for the last quick test before final installation, while the latter will be first tested at a single chamber level (phase one), then installed into the Small and Big Wheel sectors (SW and BW), tested after the integration (phase two) and transported to the ATLAS pit for final wheel installation. The present document concerns all tests, including those of phase two for Endcap chambers, but it is possible that some specific tests, at the moment not planned, will be implemented during the Endcap phase two commissioning. It is composed of three sections: 1 â€" Guidelines for checking chamber conformity, where the main rules for declaring that chambers conform to the reference drawings and requirements are described; 2 â€" Commissioning tests,...

  9. Interconnection Guidelines

    Science.gov (United States)

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

  10. Methods of Medical Guidelines Modelling in GLIF.

    Czech Academy of Sciences Publication Activity Database

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

    2005-01-01

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

  11. Organization and planning of conferences

    International Nuclear Information System (INIS)

    Hudson, S.R.

    1976-05-01

    The author uses as an example of conference planning The First International Topical Conference on Electron Beam Research and Technology which was held in Albuquerque, New Mexico, November 3-6, 1975. Guidelines are given through all phases of planning up to and during the meeting

  12. Heat exchanger performance monitoring guidelines

    International Nuclear Information System (INIS)

    Stambaugh, N.; Closser, W. Jr.; Mollerus, F.J.

    1991-12-01

    Fouling can occur in many heat exchanger applications in a way that impedes heat transfer and fluid flow and reduces the heat transfer or performance capability of the heat exchanger. Fouling may be significant for heat exchanger surfaces and flow paths in contact with plant service water. This report presents guidelines for performance monitoring of heat exchangers subject to fouling. Guidelines include selection of heat exchangers to monitor based on system function, safety function and system configuration. Five monitoring methods are discussed: the heat transfer, temperature monitoring, temperature effectiveness, delta P and periodic maintenance methods. Guidelines are included for selecting the appropriate monitoring methods and for implementing the selected methods. The report also includes a bibliography, example calculations, and technical notes applicable to the heat transfer method

  13. Radiological risk comparison guidelines

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  14. A survey on the methodological processes and policies of renal guideline groups as a first step to harmonize renal guidelines

    NARCIS (Netherlands)

    Haller, Maria C.; van der Veer, Sabine N.; Nagler, Evi V.; Tomson, Charlie; Lewington, Andrew; Hemmelgarn, Brenda R.; Gallagher, Martin; Rocco, Michael; Obrador, Gregorio; Vanholder, Raymond; Craig, Jonathan C.; van Biesen, Wim

    2015-01-01

    Worldwide, several bodies produce renal guidelines, potentially leading to duplication of effort while other topics may remain uncovered. A collaborative work plan could improve efficiency and impact, but requires a common approved methodology. The aim of this study was to identify organizational

  15. Marine spatial planning in Cyprus

    Science.gov (United States)

    Hadjimitsis, Diofantos; Agapiou, Athos; Mettas, Christodoulos; Themistocleous, Kyriacos; Evagorou, Evagoras; Cuca, Branka; Papoutsa, Christiana; Nisantzi, Argyro; Mamouri, Rodanthi-Elisavet; Soulis, George; Xagoraris, Zafiris; Lysandrou, Vasiliki; Aliouris, Kyriacos; Ioannou, Nicolas; Pavlogeorgatos, Gerasimos

    2015-06-01

    Marine Spatial Planning (MSP), which is in concept similar to land-use planning, is a public process by which the relevant Member State's authorities analyse and organise human activities in marine areas to achieve ecological, economic and social objectives. MSP aims to promote sustainable growth of maritime economies, sustainable development of marine areas and sustainable use of marine resources. This paper highlights the importance of MSP and provides basic outcomes of the main European marine development. The already successful MSP plans can provide useful feedback and guidelines for other countries that are in the process of implementation of an integrated MSP, such as Cyprus. This paper presents part of the MSP project, of which 80% funded by the European Regional Development Fund (ERDF) and 20% from national contribution. An overview of the project is presented, including data acquisition, methodology and preliminary results for the implementation of MSP in Cyprus.

  16. Development and promotion of Malaysian Dietary Guidelines.

    Science.gov (United States)

    Tee, E-Siong

    2011-01-01

    Development and promotion of dietary guidelines is one of the key activities outlined in the National Plan of Action for Nutrition of Malaysia for the prevention of nutrition-related disorders. The first official Malaysian Dietary Guidelines (MDG) was published in 1999 and was thoroughly reviewed and launched on 25 March 2010. The new MDG 2010 is a compilation of science-based nutrition and physical activity recommendations. These guidelines form the basis of consistent and scientifically sound nutrition messages for the public. There are 14 key messages and 55 recommendations, covering the whole range of food and nutrition issues, from importance of consuming a variety of foods to guidance on specific food groups, messages to encourage physical activities, consuming safe food and beverages and making effective use of nutrition information on food labels. The MDG also has an updated food pyramid. Various efforts have been made to ensure that the revised MDG is disseminated to all stakeholders. The Ministry of Health has organised a series of workshops for nutritionists and other health care professionals, and the food industry. In collaboration with other professional bodies and the private sector, the Nutrition Society of Malaysia has been promoting the dissemination and usage of the MDG to the public through a variety of formats and channels. These include the publication of a series of leaflets, educational press articles, educational booklets, as well as through educational activities for children. It is imperative to monitor the usage and evaluation of these dietary messages.

  17. Operational radioactive waste management plan for the Nevada Test Site

    International Nuclear Information System (INIS)

    1980-11-01

    The Operational Radioactive Waste Management Plan for the Nevada Test Site establishes procedures and methods for the safe shipping, receiving, processing, disposal, and storage of radioactive waste. Included are NTS radioactive waste disposition program guidelines, procedures for radioactive waste management, a description of storage and disposal areas and facilities, and a glossary of specifications and requirements

  18. Waste Minimization and Pollution Prevention Awareness Plan

    International Nuclear Information System (INIS)

    1992-01-01

    The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) and other legal requirements that are discussed in Section C, below. The Pollution Prevention Awareness Program is included with the Waste Minimization Program as suggested by DOE Order 5400.1. The intent of this plan is to respond to and comply with the Department's policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Directorate-, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Directorates, Programs and Departments. Several Directorates have been reorganized, necessitating changes in the Directorate plans that were published in 1991

  19. Model State Plan Characteristics. A Guide for Refining State Plans for Career Education.

    Science.gov (United States)

    Mitchell, Anita

    This guide for refining state plans for career education was developed to assist states in revision of their state plans to satisfy requirements of Public Law 95-207. The guide is divided into fourteen chapters. Chapter 1, the introduction, contains background information on the assessment conducted to develop the guidelines. (A full report of…

  20. Guidelines on Building Regulations 2008

    DEFF Research Database (Denmark)

    Thse guidelines clarify and intepret the provisions of the Building Regulations of 2008 (BR08). The Guidelines, which match BR08 in terms of organisation into Parts, are accompanied by the full text of the regulations and the explanatory notes issued by the Danish Enterprise and Construction...... Authority. The Guidelines refer the reader to sources such as relevant standards, instructions and other background material which provides more detailed information. The Guidelines cover the same ground as BR08, including building control regulations, layout, fitting out, structures, fire safety, indoor...... climate, energy consumotion and services. The Guidelines are aimed at all professionals involved in building projects, particularly building design consultants, contractors and municipal application officers....

  1. Assessing the readiness of a school system to adopt food allergy management guidelines.

    Science.gov (United States)

    Eldredge, Christina; Patterson, Leslie; White, Brenda; Schellhase, Kenneth

    2014-08-01

    The prevalence of potentially fatal food allergies in school-aged children is rising. It is important for schools to have a food allergy management policy and an emergency action plan for each affected student. To examine the current status of food allergy guideline and/or policy implementation and adoption in a large school system in southeastern Wisconsin. A 24-item anonymous electronic survey was developed and completed by school principals and administrators in the Archdiocese of Milwaukee School System (approximately 125 schools) in southeastern Wisconsin. One in 4 responding schools reported no guidelines or policy. Schools that reported having students with special needs due to food allergy were more likely to have a local food allergy policy compared to schools that did not report having students with food allergy special needs (OR 6.3, 1.5-26, P = 0.01). Schools with food allergy guidelines/policies were 3.5 times more likely to require student individual action plans than schools with no guidelines or policies (OR 3.5, 1.00-12.2, P = 0.05). Gaps in evidence-based food allergy policy implementation were found in this school system. Schools with food-allergic children with special needs were more likely to have guidelines/policy, however, they were not more likely to require emergency action plans. The majority of schools (66, 90%) reported interest in receiving further information or training on food allergy management.

  2. A landscape analysis plan

    Science.gov (United States)

    Nancy E. Fleenor

    2002-01-01

    A Landscape Analysis Plan (LAP) sets out broad guidelines for project development within boundaries of the Kings River Sustainable Forest Ecosystems Project. The plan must be a dynamic, living document, subject to change as new information arises over the course of this very long-term project (several decades). Two watersheds, each of 32,000 acres, were dedicated to...

  3. Guidelines for interim storage of low level waste

    International Nuclear Information System (INIS)

    Hornibrook, C.; Castagnacci, A.; Clymer, G.; Kelly, J.; Naughton, M.; Saunders, P.; Stoner, P.; Walker, N.; Cazzolli, R.; Dettenmeier, R.; Loucks, L.; Rigsby, M.; Spall, M.; Strum, M.

    1992-12-01

    This report presents an overview of on-site storage of Low Level Waste while providing guidelines for using the complete Interim On-Site Storage of Low Level Waste report series. Overall, this report provides a methodology for planning and implementing on-site storage

  4. The ASM Curriculum Guidelines for Undergraduate Microbiology: A Case Study of the Advocacy Role of Societies in Reform Efforts.

    Science.gov (United States)

    Horak, Rachel E A; Merkel, Susan; Chang, Amy

    2015-05-01

    A number of national reports, including Vision and Change in Undergraduate Biology Education: A Call to Action, have called for drastic changes in how undergraduate biology is taught. To that end, the American Society for Microbiology (ASM) has developed new Curriculum Guidelines for undergraduate microbiology that outline a comprehensive curriculum for any undergraduate introductory microbiology course or program of study. Designed to foster enduring understanding of core microbiology concepts, the Guidelines work synergistically with backwards course design to focus teaching on student-centered goals and priorities. In order to qualitatively assess how the ASM Curriculum Guidelines are used by educators and learn more about the needs of microbiology educators, the ASM Education Board distributed two surveys to the ASM education community. In this report, we discuss the results of these surveys (353 responses). We found that the ASM Curriculum Guidelines are being implemented in many different types of courses at all undergraduate levels. Educators indicated that the ASM Curriculum Guidelines were very helpful when planning courses and assessments. We discuss some specific ways in which the ASM Curriculum Guidelines have been used in undergraduate classrooms. The survey identified some barriers that microbiology educators faced when trying to adopt the ASM Curriculum Guidelines, including lack of time, lack of financial resources, and lack of supporting resources. Given the self-reported challenges to implementing the ASM Curriculum Guidelines in undergraduate classrooms, we identify here some activities related to the ASM Curriculum Guidelines that the ASM Education Board has initiated to assist educators in the implementation process.

  5. The ASM Curriculum Guidelines for Undergraduate Microbiology: A Case Study of the Advocacy Role of Societies in Reform Efforts

    Directory of Open Access Journals (Sweden)

    Rachel E.A. Horak

    2015-03-01

    Full Text Available A number of national reports, including Vision and Change in Undergraduate Biology Education: A Call to Action, have called for drastic changes in how undergraduate biology is taught. To that end, the American Society for Microbiology (ASM developed new Curriculum Guidelines for undergraduate microbiology that outline a comprehensive curriculum for any undergraduate introductory microbiology course or program of study. Designed to foster enduring understanding of core microbiology concepts, the Guidelines work synergistically with backwards course design to focus teaching on student-centered goals and priorities.  In order to qualitatively assess how the ASM Curriculum Guidelines are used by educators and learn more about the needs of microbiology educators, the ASM Education Board distributed two surveys to the ASM education community. In this report, we discuss results of these surveys (353 responses. We found that the ASM Curriculum Guidelines are being implemented in many different types of courses at all undergraduate levels. Educators indicated that the ASM Curriculum Guidelines were very helpful when planning courses and assessments. We discuss some specific ways in which the ASM Curriculum Guidelines have been used in undergraduate classrooms. The survey identified some barriers that microbiology educators faced when trying to adopt the ASM Curriculum Guidelines, including lack of time, lack of financial resources, and lack of supporting resources. Given the self-reported challenges to implementing the ASM Curriculum Guidelines in undergraduate classrooms, we identify here some activities related to the ASM Curriculum Guidelines that the ASM Education Board has initiated to assist educators in the implementation process.

  6. Guidelines for nuclear reactor equipments safety-analysis

    International Nuclear Information System (INIS)

    1978-01-01

    The safety analysis in approving the applications for nuclear reactor constructions (or alterations) is performed by the Committee on Examination of Reactor Safety in accordance with various guidelines prescribed by the Atomic Energy Commission. In addition, the above Committee set forth its own regulations for the safety analysis on common problems among various types of nuclear reactors. This book has collected and edited those guidelines and regulations. It has two parts: Part I includes the guidelines issued to date by the Atomic Energy Commission: and Part II - regulations of the Committee. Part I has collected 8 categories of guidelines which relate to following matters: nuclear reactor sites analysis guidelines and standards for their applications; standard exposure dose of plutonium; nuclear ship operation guidelines; safety design analysis guidelines for light-water type, electricity generating nuclear reactor equipments; safety evaluation guidelines for emergency reactor core cooling system of light-water type power reactors; guidelines for exposure dose target values around light-water type electricity generating nuclear reactor equipments, and guidelines for evaluation of above target values; and meteorological guidelines for the safety analysis of electricity generating nuclear reactor equipments. Part II includes regulations of the Committee concerning - the fuel assembly used in boiling-water type and in pressurized-water type reactors; techniques of reactor core heat designs, etc. in boiling-water reactors; and others

  7. The conundrum of Hodgkin lymphoma nodes: to be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines

    DEFF Research Database (Denmark)

    Girinsky, Theodore; Specht, Lena; Ghalibafian, Mithra

    2008-01-01

    PURPOSE: To develop easily applicable guidelines for the determination of initially involved lymph nodes to be included in the radiation fields. PATIENTS AND METHODS: Patients with supra-diaphragmatic Hodgkin lymphoma. All the imaging procedures were carried out with patients in the treatment pos...

  8. AsMA Medical Guidelines for Air Travel: stresses of flight.

    Science.gov (United States)

    Thibeault, Claude; Evans, Anthony D

    2015-05-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Modern commercial aircraft are very safe and, in most cases, reasonably comfortable. However, all flights, short or long haul, impose stresses on passengers. Preflight stresses include airport commotion on the ground such as carrying baggage, walking long distances, getting to the gate on time, and being delayed. In-flight stresses include acceleration, vibration (including turbulence), noise, lowered barometric pressure, variations of temperature and humidity, and fatigue among others. Healthy passengers normally tolerate these stresses quite well; however, there is the potential for passengers to become ill during or after the flight due to these stresses, especially for those with pre-existing medical conditions and reduced physiological reserves.

  9. Planning in a climate of change: Choices under uncertainty

    International Nuclear Information System (INIS)

    Etkin, D.

    1993-01-01

    As part of a plan to ensure that potential changes in the Canadian environment as a result of climate change are considered in major projects, the Canadian Climate Centre has developed a set of interim guidelines for consideration of climate change concerns in environmental assessments. One such guideline is to identify the sensitivity of the project to climate variability and change, including increased risks of extreme events. This guideline is discussed in a consideration of different methodologies of assessing possible future impacts, and in an examination of ways to assemble a climate data base. Climatological data sets may be obtained from climate normals, historical or paleoclimate data, global climate models, or spatial analogues. Methodological approaches include selecting the most likely future, selecting a range of scenarios, bounding the problem, or using a probability distribution function. A case study is used for illustration, in which the effects of climate change on a permafrost dyke of a tailings pond at an Arctic mining operation are assessed. 18 refs., 3 figs

  10. Health transformation plan: Goals achievement in Nemazee hospital

    Directory of Open Access Journals (Sweden)

    Ali Akbar Ahmadi

    2016-01-01

    Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

  11. High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Main report, Volume 2

    International Nuclear Information System (INIS)

    Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B.

    1995-06-01

    The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer e following software development and assurance activities: Requirements specification; design; coding; verification and validation, inclukding static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire ran e identification, categorization and prioritization of technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary includes an overview of the framwork and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; this document, Volume 2, is the main report

  12. High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Main report, Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B. [Mitre Corp., McLean, VA (United States)

    1995-06-01

    The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer e following software development and assurance activities: Requirements specification; design; coding; verification and validation, inclukding static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire ran e identification, categorization and prioritization of technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary includes an overview of the framwork and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; this document, Volume 2, is the main report.

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

    Science.gov (United States)

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

    2011-01-01

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

  14. International guidelines for fire protection at nuclear installations including nuclear fuel plants, nuclear fuel stores, teaching reactors, research establishments

    International Nuclear Information System (INIS)

    The guidelines are recommended to designers, constructors, operators and insurers of nuclear fuel plants and other facilities using significant quantities of radioactive materials including research and teaching reactor installations where the reactors generally operate at less than approximately 10 MW(th). Recommendations for elementary precautions against fire risk at nuclear installations are followed by appendices on more specific topics. These cover: fire protection management and organization; precautions against loss during construction alterations and maintenance; basic fire protection for nuclear fuel plants; storage and nuclear fuel; and basic fire protection for research and training establishments. There are numerous illustrations of facilities referred to in the text. (U.K.)

  15. CULTURAL RESOURCE MANAGEMENT PLAN FOR BROOKHAVEN NATIONAL LABORATORY.

    Energy Technology Data Exchange (ETDEWEB)

    DAVIS, M.

    2005-04-01

    The Cultural Resource Management Plan (CRMP) for Brookhaven National Laboratory (BNL) provides an organized guide that describes or references all facets and interrelationships of cultural resources at BNL. This document specifically follows, where applicable, the format of the U.S. Department of Energy (DOE) Environmental Guidelines for Development of Cultural Resource Management Plans, DOE G 450.1-3 (9-22-04[m1]). Management strategies included within this CRMP are designed to adequately identify the cultural resources that BNL and DOE consider significant and to acknowledge associated management actions. A principal objective of the CRMP is to reduce the need for additional regulatory documents and to serve as the basis for a formal agreement between the DOE and the New York State Historic Preservation Officer (NYSHPO). The BNL CRMP is designed to be a ''living document.'' Each section includes identified gaps in the management plan, with proposed goals and actions for addressing each gap. The plan will be periodically revised to incorporate new documentation.

  16. Environmental protection by cost minimization: Least Cost Planning for traffic. Includes a guide for the application in local communities; Umweltentlastung durch Kostenminimierung: Least Cost Planning im Verkehr. Mit Leitfaden fuer die Anwendung in Kommunen

    Energy Technology Data Exchange (ETDEWEB)

    Bracher, T.; Diegmann, V.; Eckart, C.F.; Liwicki, M.; Lobenberg, G.; Wetzel, C. [Gesellschaft fuer Informatik, Verkehrs- und Umweltplanung mbH (IVU), Berlin (Germany); Bergmann, M.; Uricher, A.; Lueers, A. [Oeko-Institut, Inst. fuer Angewandte Oekologie e.V., Freiburg im Breisgau (Germany); Becker, U.; Karl, G.; Karl, B.; Voellings, A. [Technische Univ. Dresden (Germany). Lehrstuhl fuer Verkehrsoekologie

    1999-08-01

    An intermodal approach for the evaluation of transportation services on the municipal level was developed. Both non-motorised and motorised transportation were included. The approach aims at helping communities to provide an economically and ecologically viable transport policy. Least Cost Transportation Planning (LCTP) was developed to transfer the successful concept of Least Cost Planning from the energy sector to transportation. The conclusion from an analysis of LCTP literature and present evaluation methods was that an improved approach should be intermodal and integrate users, public bodies and transport companies as well as all planning sectors. An approach was developed firstly to identify and clarify transportation expenditures and incomes of a city within a year, and secondly for the evaluation of planning alternatives. This was illustrated for the access system of an industrial area with adjacent railway services in the town of Freiburg. Three alternatives were compared: the extension of a tramway line, the upgrading of the present bus system, and the development of a service and bicycle provision concept for rail stations and companies. Besides income and expenditure for each alternative, the effects on transport demand, the impact on air pollution and noise and on space consumption were presented. As a result, the bicycle concept is in most items better than its alternatives. The final report has three volumes and there is an extra guideline for implementing the method within municipalities. It includes a set of excel sheet tables for an easy application (all in German). (orig.) [German] Fuer die Verkehrsplanung wurde ein verkehrstraegeruebergreifendes Bewertungsverfahren fuer Kommunen entwickelt, das motorisierte und nicht motorisierte Verkehrstraeger einbezieht. Das Verfahren soll Gemeinden unterstuetzen, eine oekonomische und oekologisch vertraegliche Verkehrspolitik zu verfolgen. Least Cost Transportation Planning (LCTP) zielt darauf ab, das fuer

  17. ORGEST: Regional guidelines and silvicultural models for sustainable forest management

    Energy Technology Data Exchange (ETDEWEB)

    Piqué, Míriam; Vericat, Pau; Beltrán, Mario

    2017-11-01

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

  18. ORGEST: Regional guidelines and silvicultural models for sustainable forest management

    International Nuclear Information System (INIS)

    Piqué, Míriam; Vericat, Pau; Beltrán, Mario

    2017-01-01

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

  19. Leadership Succession Planning in Catholic Education: An Ongoing Plan for Leadership Development, Identification, and Selection

    Science.gov (United States)

    Fitzgerald, Mary; Sabatino, Anthony

    2014-01-01

    The fundamental elements of successful leadership succession in any organization are recognizing the inevitability of leadership change and the necessity of a plan for leadership succession. This book provides a rationale and planning guideline for board chairs, superintendents, and superiors of religious communities to use when the need arises to…

  20. Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza.

    Science.gov (United States)

    Laar, Amos; DeBruin, Debra

    2015-05-07

    Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza (NISPPI). We critically analyzed the Ghana NISPPI's sensitivity to ethics issues to determine how well it reflects ethical commitments and principles identified in our review of global pandemic preparedness literature, existing pandemic plans, and relevant ethics frameworks. This paper reveals that important ethical issues have not been addressed in the Ghana NISPPI. Several important ethical issues are unanticipated, unacknowledged, and unplanned for. These include guidelines on allocation of scarce resources, the duties of healthcare workers, ethics-sensitive operational guidelines/protocols, and compensation programs. The NISPPI also pays scant attention to use of vaccines and antivirals, border issues and cooperation with neighboring countries, justification for delineated actions, and outbreak simulations. Feedback and communication plans are nebulous, while leadership, coordination, and budgeting are quite detailed. With respect to presentation, the NISPPI's text is organized around five thematic areas. While each area implicates ethical issues, NISPPI treatment of these areas consistently fails to address them. Our analysis reveals a lack of consideration of ethics by the NISPPI. We contend that, while the plan's content and fundamental assumptions provide support for implementation of the delineated public health actions, its consideration of ethical issues is poor. Deficiencies include a failure to incorporate guidelines that ensure fair distribution of scarce resources and a lack of justification for delineated procedures. Until these deficiencies are recognized and addressed, Ghana runs the risk of rolling out unjust and ethically

  1. Operational radioactive defense waste management plan for the Nevada Test Site

    International Nuclear Information System (INIS)

    1981-07-01

    The Operational Radioactive Defense Waste Management Plan for the Nevada Test Site establishes procedures and methods for the safe shipping, receiving, processing, disposal, and storage of radioactive waste. Included are NTS radioactive waste disposition program guidelines, procedures for radioactive waste management, a description of storage and disposal areas and facilities, and a glossary of specifications and requirements

  2. Design guidelines for multi-seam mining at Elliot Lake

    International Nuclear Information System (INIS)

    Hedley, D.G.F.

    1978-04-01

    With the current expansion in uranium mining, multi-seam mining could again be practised at Elliot Lake as it was in the 1960s. Information on the dimensions of stopes, pillars, and parting zone was gathered from plans and sections of the relevant closed mines. Discussions were held with personnel familiar with these mines to establish instances of pillar, roof, and parting zone failures. Design guidelines are formulated for stope and pillar dimensions in multi-seam mining for a range of orebody configurations using past practice in a back-analysis approach. Constraints imposed by dip and seam thickness on the choice of equipment and mining layout are evaluated. An attempt is made to bring together the engineering aspects, including rock mechanics, of multi-seam mine design with uranium recovery and other economic factors for three alternative mine layouts: single-seam mining, double-seam mining, and seams-and-parting mining. A series of examples are worked through, showing how the design guidelines can be applied for typical orebody configurations

  3. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    DEFF Research Database (Denmark)

    Diangelis, Anthony J; Andreasen, Jens O; Ebeleseder, Kurt A

    2012-01-01

    Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines sh...... goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented....

  4. Implementation of a multidisciplinary guideline improves preterm infant admission temperatures.

    Science.gov (United States)

    Harer, M W; Vergales, B; Cady, T; Early, A; Chisholm, C; Swanson, J R

    2017-11-01

    Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team. Clinical practice changes in the guideline included: increasing operating room temperatures, obtaining a 10-min axillary temperature, using an exothermic mattress for all infants <35 weeks, and using a polyethylene wrap for infants <32 weeks. The baseline rate of hypothermia (<36.5 °CC) was 63%. Three PDSA cycles data were completed on 168 consecutive preterm births. The post-implementation rate of hypothermia (<36.5 °C) was reduced to 30% (P<0.001). The incidence of moderate hypothermia (< 36 °C) was reduced from a baseline of 29% to a rate of 9% (P<0.001). Use of a multidisciplinary guideline to increase preterm NICU admission temperatures resulted in a decrease in hypothermic infants.

  5. European Patient Summary Guideline: Focus on Greece.

    Science.gov (United States)

    Berler, Alexander; Tagaris, Anastassios; Chronaki, Catherine

    2016-01-01

    The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.

  6. Guidelines for Including Gorges in the Tourist Offer of the Apuseni Mountains

    Directory of Open Access Journals (Sweden)

    GABRIELA COCEAN

    2014-12-01

    Full Text Available In any tourism development plans, the starting point ought to be the accurate assessment of the tourism resources that can be efficiently put to use. When evaluating the potential for the tourism development of karstic gorges, the most objective criteria were applied: the attractiveness of each gorge, the location and the competitive forms of tourism that can be developed in the area. As a result, we have identified four categories of gorges: primary, secondary, complementary gorges and those of less relevance for the tourism phenomenon. The next step that would have a direct impact on the development of tourism around gorges (building of infrastructure, access roads, etc. is to consolidate and revitalize the brand of each gorge in order to define it as a unique tourist destination. Effective branding of gorges starts with establishing the unique selling proposition, consisting of those attributes of high specificity that determine certain dominant types of tourism. It is only after identifying the strengths that build up their own tourist brands that one can consider including these landmarks in thematic routes, creating synergy and adding value to the whole gorge ensemble.

  7. Underground Test Area Activity Communication/Interface Plan, Nevada National Security Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Farnham, Irene [Navarro, Las Vegas, NV (United States); Rehfeldt, Kenneth [Navarro, Las Vegas, NV (United States)

    2016-10-01

    The purpose of this plan is to provide guidelines for effective communication and interfacing between Underground Test Area (UGTA) Activity participants, including the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) and its contractors. This plan specifically establishes the following: • UGTA mission, vision, and core values • Roles and responsibilities for key personnel • Communication with stakeholders • Guidance in key interface areas • Communication matrix

  8. [China National Lung Cancer Screening Guideline with Low-dose Computed 
Tomography (2018 version)].

    Science.gov (United States)

    Zhou, Qinghua; Fan, Yaguang; Wang, Ying; Qiao, Youlin; Wang, Guiqi; Huang, Yunchao; Wang, Xinyun; Wu, Ning; Zhang, Guozheng; Zheng, Xiangpeng; Bu, Hong; Li, Yin; Wei, Sen; Chen, Liang'an; Hu, Chengping; Shi, Yuankai; Sun, Yan

    2018-02-20

    Lung cancer is the leading cause of cancer-related death in China. The results from a randomized controlled trial using annual low-dose computed tomography (LDCT) in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality. The aim of tihs study is to establish the China National lung cancer screening guidelines for clinical practice. The China lung cancer early detection and treatment expert group (CLCEDTEG) established the China National Lung Cancer Screening Guideline with multidisciplinary representation including 4 thoracic surgeons, 4 thoracic radiologists, 2 medical oncologists, 2 pulmonologists, 2 pathologist, and 2 epidemiologist. Members have engaged in interdisciplinary collaborations regarding lung cancer screening and clinical care of patients with at risk for lung cancer. The expert group reviewed the literature, including screening trials in the United States and Europe and China, and discussed local best clinical practices in the China. A consensus-based guidelines, China National Lung Cancer Screening Guideline (CNLCSG), was recommended by CLCEDTEG appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China. Annual lung cancer screening with LDCT is recommended for high risk individuals aged 50-74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation. A lung cancer screening guideline is recommended for the high-risk population in China. Additional research , including LDCT combined with biomarkers, is

  9. Mexican Asthma Guidelines: GUIMA 2017

    Directory of Open Access Journals (Sweden)

    Désirée Larenas-Linnemann

    2017-04-01

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

  10. EFNS guidelines for the molecular diagnosis of neurogenetic disorders: motoneuron, peripheral nerve and muscle disorders.

    Science.gov (United States)

    Burgunder, J-M; Schöls, L; Baets, J; Andersen, P; Gasser, T; Szolnoki, Z; Fontaine, B; Van Broeckhoven, C; Di Donato, S; De Jonghe, P; Lynch, T; Mariotti, C; Spinazzola, A; Tabrizi, S J; Tallaksen, C; Zeviani, M; Harbo, H F; Finsterer, J

    2011-02-01

    These EFNS guidelines on the molecular diagnosis of motoneuron disorders, neuropathies and myopathies are designed to summarize the possibilities and limitations of molecular genetic techniques and to provide diagnostic criteria for deciding when a molecular diagnostic work-up is indicated. To collect data about planning, conditions and performance of molecular diagnosis of these disorders, a literature search in various electronic databases was carried out and original papers, meta-analyses, review papers and guideline recommendations reviewed. The best level of evidence for genetic testing recommendation (B) can be found for the disorders with specific presentations, including familial amyotrophic lateral sclerosis, spinal and bulbar muscular atrophy, Charcot-Marie-Tooth 1A, myotonic dystrophy and Duchenne muscular dystrophy. For a number of less common disorders, a precise description of the phenotype, including the use of immunologic methods in the case of myopathies, is considered as good clinical practice to guide molecular genetic testing. These guidelines are provisional and the future availability of molecular-genetic epidemiological data about the neurogenetic disorders under discussion in this article will allow improved recommendation with an increased level of evidence. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  11. Experts' perspective on the performance of Chinese technical guidelines for Plan Environmental Impact Assessment

    International Nuclear Information System (INIS)

    He Jia; Sun Sun; Bao Cunkuan; Chen Fan; Jiang Dahe

    2011-01-01

    This research was to evaluate the Technical Guideline (HJ/T130-2003) effectiveness based on data resource from a questionnaire survey and interviews on EIA experts. The result demonstrated that the guideline served mainly as a quality control measure for PEIA products, and only a small proportion of experts considered it effective due to its inconsistency with the newly released Chinese PEIA Regulation (2009) and poor practicability. Current status of SEA implementation in China was also studied in terms of application fields, effectiveness evaluation, and major issues to affect SEA, to conclude that SEA implementation in China is premature, and with limited effectiveness. The major problem was the lack of effective methodologies and technical tools. Recommendations for revising the PEIA Guideline and advices to improving SEA implementation in China were accordingly proposed.

  12. Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Patient Perspective

    Directory of Open Access Journals (Sweden)

    A Hillary Steinhart

    2015-01-01

    Full Text Available A series of clinical practice guidelines were recently developed by the Canadian Association of Gastroenterology (CAG to provide clinicians with recommendations for the medical management of nonhospitalized ulcerative colitis (UC patients. These guidelines were developed, reviewed and agreed on by expert clinicians and methodologists. Following the finalization of the guidelines, a group of patients with UC as well as several inflammatory bowel disease clinicians, were brought together for a half-day workshop to provide feedback from the patient perspective. At the workshop, the guideline development process was described and the guidelines were reviewed to ensure comprehension. Patients then had the opportunity to provide their insight to the relevance of the guideline development process and the content of the guidelines as it related to their personal experiences with UC. The patient group believed that, although the new guidelines will be a tremendous resource for the health care provider community, a more ‘lay-friendly’ version would better facilitate dialogue between patients and their health care practitioners. The importance of the patient/physician relationship is paramount when making decisions regarding treatment plans, in which patient preferences play a key role in determining the most appropriate therapy and dosing regimen, which, in turn, impact the likelihood of adherence to the treatment plan. It was also believed that quality of life issues were not fully addressed in the guidelines. Much could be learned from shared experiences and coping strategies that would empower patients to take charge of their health and become equal partners with their care providers.

  13. Energy Design Guidelines for High Performance Schools: Tropical Island Climates

    Energy Technology Data Exchange (ETDEWEB)

    2004-11-01

    The Energy Design Guidelines for High Performance Schools--Tropical Island Climates provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. These design guidelines outline high performance principles for the new or retrofit design of your K-12 school in tropical island climates. By incorporating energy improvements into their construction or renovation plans, schools can significantly reduce energy consumption and costs.

  14. 40 CFR 256.04 - State plan approval, financial assistance.

    Science.gov (United States)

    2010-07-01

    ... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose, General Requirements, Definitions § 256.04 State plan approval, financial assistance. (a) The...

  15. Guidelines and algorithms for managing the difficult airway.

    Science.gov (United States)

    Gómez-Ríos, M A; Gaitini, L; Matter, I; Somri, M

    2018-01-01

    The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. 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.

  17. Translating international HIV treatment guidelines into local priorities in Indonesia.

    Science.gov (United States)

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Wisaksana, Rudi; Pinxten, Lucas; Pinxten, Juul; Lesmana Putra, Arry; Kurnia Sunjaya, Deni; Jansen, Maarten; Hontelez, Jan; Maurits, Scott; Maharani, Febrina; Bijlmakers, Leon; Baltussen, Rob

    2018-03-01

    International guidelines recommend countries to expand antiretroviral therapy (ART) to all HIV-infected individuals and establish local-level priorities in relation to other treatment, prevention and mitigation interventions through fair processes. However, no practical guidance is provided for such priority-setting processes. Evidence-informed deliberative processes (EDPs) fill this gap and combine stakeholder deliberation to incorporate relevant social values with rational decision-making informed by evidence on these values. This study reports on the first-time implementation and evaluation of an EDP in HIV control, organised to support the AIDS Commission in West Java province, Indonesia, in the development of its strategic plan for 2014-2018. Under the responsibility of the provincial AIDS Commission, an EDP was implemented to select priority interventions using six steps: (i) situational analysis; (ii) formation of a multistakeholder Consultation Panel; (iii) selection of criteria; (iv) identification and assessment of interventions' performance; (v) deliberation; and (vi) selection of funding and implementing institutions. An independent researcher conducted in-depth interviews (n = 21) with panel members to evaluate the process. The Consultation Panel included 23 stakeholders. They identified 50 interventions and these were evaluated against four criteria: impact on the epidemic, stigma reduction, cost-effectiveness and universal coverage. After a deliberative discussion, the Consultation Panel prioritised a combination of several treatment, prevention and mitigation interventions. The EDP improved both stakeholder involvement and the evidence base for the strategic planning process. EDPs fill an important gap which international guidelines and current tools for strategic planning in HIV control leave unaddressed. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  18. Institutional plan FY 1998--FY 2003

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The Institutional Plan has been rearranged this year as a reflection of new Department of Energy (DOE) guidelines and to better illustrate the Laboratory`s mission-oriented focus. In Section 1 of this plan, the authors set forth their vision, mission, core competencies, strategic view, and related material. This section illustrates integration with the vision, mission, priorities, and core businesses of DOE. They define strategies, tactics, and guidelines and describe how they measure progress. In Section 2, they have elaborated on how they plan to address the Laboratory`s mission, describing programs and activities in the context of their role in this mission. Section 3 contains information on their approach to managing their business and operations. First they address the most critical issue safety. In this section, they confirm that Los Alamos is addressing the DOE critical success factors and describe the initiatives and plans that make their mission successful and leads them toward their vision. Section 4 contains details of their resources. 44 figs., 56 tabs.

  19. GUIDELINES FOR TRAINING SITUATION ANALYSIS (TSA). FINAL REPORT.

    Science.gov (United States)

    CHENZOFF, ANDREW P.; FOLLEY, JOHN D., JR.

    THESE GUIDELINES REPRESENT A TEXTBOOK FOR INSTRUCTION IN THREE PHASES OF TRAINING SITUATION ANALYSIS (TSA), A STANDARDIZED PROCEDURE DEVELOPED BY THE NAVAL TRAINING DEVICE CENTER FOR SYSTEMATICALLY GATHERING AND INTERPRETING THE INFORMATION RELEVANT TO THE PLANNING OF TRAINING AND TRAINING DEVICES. THREE PHASES OF TSA ARE DESCRIBED IN…

  20. Teacher Attitudes on Including Students with Behavior Intervention Plans in a High-School Inclusive Classroom

    Science.gov (United States)

    Tucker, Thurman D.

    2017-01-01

    This research examined attitudes to determine factors influencing teachers' attitudes toward including students with behavior intervention plans in inclusive high-school classrooms. For Research Question 1 one-way ANOVAs analyzed quantitative data with no significant differences found and qualitative data discovered common patterns that BIPs are…

  1. Clinical trials radiotherapy treatment plan review software : is this the first quantified assessment

    International Nuclear Information System (INIS)

    Hatton, J.A.; Cornes, D.A.

    2011-01-01

    Full text: Clinical trials require robust quality assurance (QA) procedures to ensure commonality of all treatments, with independent reviews to assess compliance with trial protocols. All clinical trials tools, including QA software, require testing for validity and reliability. enabling inter- and intra-trial comparison. Unlike clinical radiotherapy treatment planning (RTP) systems, review software has no published guidelines. This study describes the design and development of a test suite to quantify the performance of review software in TROG clinical trials. Test areas are image handling and reconstruction; geometric accuracy; dosimetric accuracy; dose-volume histogram (DVH) calculation; display of plan parameters. TROG have developed tests for commissioning plan review software, assessed with SWAN 2.3, and CMS Elekta FocalPro. While image handling tests were based on published guidelines for RTP systems, dosimetric tests used the TROG QA case review requirements. Treatment plans represented systems of all manufacturers (Pinnacle, Eclipse, Xio and Oncentra) used in Australasian centres. The test suite identified areas for SW A software development, including the DVH algorithm, changed to reduce calculation time. Results, in Fig. I, for known volumes of varying shapes and sizes, demonstrate differences between SWAN 2.1 and 2.3 when compared with Eclipse. Liaison with SWAN programmers enabled re-instatement of 2.1 algorithm. The test suite has quantified the RTP review software, prioritised areas for development with the programmers, and improved the user experience.

  2. Guideline for making multi-annual maintenance of municipal real estate sustainable; Leidraad verduurzamen meerjaren onderhoud van gemeentelijk vastgoed

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-01-15

    The title guideline is developed for municipalities on the basis of experiences in pilots and with input from more than ten municipalities in the Netherlands. The guideline includes a roadmap for changing a MOP (Multi-year Maintenance Plan) into a DMOP (Sustainable Multi-annual Maintenance Plan). The DMOP also provides advice on outsourcing management and organizing support and communication within the municipality. With structural sustainability of its properties, a municipality can save lot of energy and money and reduce CO2 emission [Dutch] De titel leidraad is ontwikkeld voor gemeenten op basis van ervaringen in pilots en met input van ruim tien gemeenten in Nederland. De leidraad omvat een stappenplan voor het verduurzamen van een MOP (Meerjaren Onderhoudsplan) tot een DMOP (Duurzaam Meerjaren Onderhoudsplan), en geeft daarnaast adviezen voor het uitbesteden van beheer en het organiseren van draagvlak en communicatie binnen de gemeente. Met het structureel verduurzamen van het eigen vastgoed kan een gemeente veel energie en geld besparen en de uitstoot van CO2 beperken.

  3. Approaches to radiation guidelines for space travel

    International Nuclear Information System (INIS)

    Fry, R.J.M.

    1984-01-01

    There are obvious risks in space travel that have loomed larger than any risk from radiation. Nevertheless, NASA has maintained a radiation program that has involved maintenance of records of radiation exposure, and planning so that the astronauts' exposures are kept as low as possible, and not just within the current guidelines. These guidelines are being reexamined currently by NCRP Committee 75 because new information is available, for example, risk estimates for radiation-induced cancer and about the effects of HZE particles. Furthermore, no estimates of risk or recommendations were made for women in 1970 and must now be considered. The current career limit is 400 rem. The appropriateness of this limit and its basis are being examined as well as the limits for specific organs. There is now considerably more information about age-dependency for radiation and this will be taken into account. Work has been carried out on the so-called microlesions caused by HZE particles and on the relative carcinogenic effect of heavy ions, including iron. A remaining question is whether the fluence of HZE particles could reach levels of concern in missions under consideration. Finally, it is the intention of the committee to indicate clearly the areas requiring further research. 21 references, 1 figure, 7 tables

  4. Energy Design Guidelines for High Performance Schools: Tropical Island Climates

    Energy Technology Data Exchange (ETDEWEB)

    None

    2004-11-01

    Design guidelines outline high performance principles for the new or retrofit design of K-12 schools in tropical island climates. By incorporating energy improvements into construction or renovation plans, schools can reduce energy consumption and costs.

  5. Standard operating procedures for ESPEN guidelines and consensus papers.

    Science.gov (United States)

    Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

    2015-12-01

    The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. 34 CFR 364.42 - What objectives and information must be included in the State plan?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What objectives and information must be included in the State plan? 364.42 Section 364.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

  7. Guidelines for developing transportation management plans in Virginia.

    Science.gov (United States)

    2005-01-01

    A transportation management plan (TMP) is a comprehensive program of traffic control, communication, operation, and demand management strategies designed to maintain acceptable levels of traffic flow in work zones. A systematic procedure and/or check...

  8. NSPWG-recommended safety requirements and guidelines for SEI nuclear propulsion

    International Nuclear Information System (INIS)

    Marshall, A.C.; Lee, J.H.; McCulloch, W.H.; Sawyer, J.C. Jr.; Bari, R.A.; Brown, N.W.; Cullingford, H.S.; Hardy, A.C.; Remp, K.; Sholtis, J.A.

    1992-01-01

    An Interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top- level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of Safety Functional Requirements. In addition the NSPWG reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. Safety requirements were developed for reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, and safeguards. Guidelines were recommended for risk/reliability, operational safety, flight trajectory and mission abort, space debris and meteoroids, and ground test safety. In this paper the specific requirements and guidelines will be discussed

  9. Guideline group composition and group processes: article 3 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

    Science.gov (United States)

    Kunz, Regina; Fretheim, Atle; Cluzeau, Françoise; Wilt, Timothy J; Qaseem, Amir; Lelgemann, Monika; Kelson, Marcia; Guyatt, Gordon; Schünemann, Holger J

    2012-12-01

    Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the third of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases on considerations for group compositions and group processes in guideline development, and how this can be effectively integrated in the context of respiratory disease guidelines on a national and international level. We updated a review of the literature addressing group composition and group process, focusing on the following questions: 1. How to compose a functioning and representative guideline group; Who should be included in a guideline panel?; How to select organizations, groups, and individuals; What expertise is needed?; Consultation with non-included groups. 2. How to assure a functioning group process; How to make the process constructive; Balancing participation and finding agreement; Administrative support; What constitutes sufficient resources? Our conclusions are based on available evidence from published literature, experience from guideline developers, and workshop discussions. Formal studies addressing optimal processes in developing guidelines are limited, and experience from guideline organizations supplement the formal studies. When resources are available, guideline development groups should aim for multidisciplinary groups, including patients. Prerequisites for a multidisciplinary group include: a strong chair experienced in group facilitation with broad acceptance in the group, training the group in guideline methodology, and professional technical support. Formal consensus developing methods have proved effective in reaching agreement on the final recommendations.

  10. NCCN Guidelines® Insights Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines

    Science.gov (United States)

    Clark, Peter E.; Spiess, Philippe E.; Agarwal, Neeraj; Bangs, Rick; Boorjian, Stephen A.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Flaig, Thomas W.; Friedlander, Terence; Greenberg, Richard E.; Guru, Khurshid A.; Hahn, Noah; Herr, Harry W.; Hoimes, Christopher; Inman, Brant A.; Kader, A. Karim; Kibel, Adam S.; Kuzel, Timothy M.; Lele, Subodh M.; Meeks, Joshua J.; Michalski, Jeff; Montgomery, Jeffrey S.; Pagliaro, Lance C.; Pal, Sumanta K.; Patterson, Anthony; Petrylak, Daniel; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Sexton, Wade J.; Siefker-Radtke, Arlene O.; Sonpavde, Guru; Tward, Jonathan; Wile, Geoffrey; Dwyer, Mary A.; Smith, Courtney

    2017-01-01

    These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice. PMID:27697976

  11. Update and revision of WHO air quality guidelines for Europe

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M. [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

    1995-12-31

    The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

  12. Update and revision of WHO air quality guidelines for Europe

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

    1996-12-31

    The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

  13. Test plan for qualification of the S-type fiberglass materials for use as the liquid observation well casing

    International Nuclear Information System (INIS)

    Parra, S.A.

    1995-01-01

    This test plan presents the guidelines and requirements for acceptance of the S-type fiberglass material for use as the liquid observation well casing material. The plan for evaluating the physical properties of the candidate fiberglass materials when subjected to radiation, corrosive chemicals, and high temperatures typically found in the waste tanks are outlined. The tests also include tube connection evaluations. Finally, the test plan identifies the participants, their responsibilities, and the schedule for completion of the work

  14. Hydrogeologic investigations sampling plan: Revision 0

    International Nuclear Information System (INIS)

    1988-11-01

    The goal of this sampling plan is to identify and develop specific plans for those investigative actions necessary to: (1) characterize the hydrologic regime; (2) define the extent and impact of contamination; and (3) predict future contaminant migration for the Weldon Spring Site (WSS) and vicinity. The plan is part of the Weldon Spring Site Remedial Action Project (WSSRAP) sponsored by the US Department of Energy (DOE) and has been developed in accordance with US EPA Remedial Investigation (RI) and Data Quality Objective (DQO) guidelines. The plan consists of a sequence of activities including the evaluation of data, development of a conceptual model, identification of data uses and needs, and the design and implementation of a data collection program. Data will be obtained to: (1) confirm the presence or absence of contaminants; (2) define contaminant sources and modes of transport; (3) delineate extent of contaminant migration and predict future migration; and (4) provide information to support the evaluation and selection of remedial actions. 81 refs., 62 figs., 26 tabs

  15. Vehicle recovery and towing guideline

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-01-15

    This guideline was developed to provide light and medium duty vehicles operators in the oil and gas industry with a set of best practices for avoiding injury and damage during the recovery of stuck vehicles. The aim of the guideline was to increase awareness of safety issues and promote the safe usage of the vehicles by personnel throughout the petroleum industry and to establish minimum standards of practice for vehicle recovery. The guideline included a step-by-step guide for pulling out a vehicle with a recovery strap as well as vehicle-mounted winch procedures. Pre-job checklists for both procedures were provided. Issues related to the strength rating of vehicle tow hooks and hitch receivers were discussed, as well as some of the hazards associated with steep terrains and heavy mud. The guideline also included recommendations for a vehicle recovery kit with instructions on vehicle recovery, a recovery strap, a recovery hitch and shackle, a collapsible shovel, traffic cones and reflector flares, and a heavy blanket and gloves. 7 refs., 2 tabs., 13 figs.

  16. Selecting and Planning for an Automated Library System: Guidelines for Libraries.

    Science.gov (United States)

    Piccininni, James

    Guidelines are given for automating a library. Issues arising in automation are illustrated through the experience of the Doherty Library of the University of St. Thomas, Houston (Texas). The first step is to decide what type of system is right for the needs of the library and its patrons. In considering vendors of systems, it is important to…

  17. Including the public in pandemic planning: a deliberative approach

    Directory of Open Access Journals (Sweden)

    Braunack-Mayer Annette J

    2010-08-01

    Full Text Available Abstract Background Against a background of pandemic threat posed by SARS and avian H5N1 influenza, this study used deliberative forums to elucidate informed community perspectives on aspects of pandemic planning. Methods Two deliberative forums were carried out with members of the South Australian community. The forums were supported by a qualitative study with adults and youths, systematic reviews of the literature and the involvement of an extended group of academic experts and policy makers. The forum discussions were recorded with simultaneous transcription and analysed thematically. Results Participants allocated scarce resources of antiviral drugs and pandemic vaccine based on a desire to preserve society function in a time of crisis. Participants were divided on the acceptability of social distancing and quarantine measures. However, should such measures be adopted, they thought that reasonable financial, household and psychological support was essential. In addition, provided such support was present, the participants, in general, were willing to impose strict sanctions on those who violated quarantine and social distancing measures. Conclusions The recommendations from the forums suggest that the implementation of pandemic plans in a severe pandemic will be challenging, but not impossible. Implementation may be more successful if the public is engaged in pandemic planning before a pandemic, effective communication of key points is practiced before and during a pandemic and if judicious use is made of supportive measures to assist those in quarantine or affected by social isolation measures.

  18. 76 FR 17064 - Shared Use Path Accessibility Guidelines

    Science.gov (United States)

    2011-03-28

    ...] RIN 3014-AA41 Shared Use Path Accessibility Guidelines AGENCY: Architectural and Transportation... (ANPRM) to develop accessibility guidelines for shared use paths. Shared use paths are designed for both... users. The guidelines will include technical provisions for making newly constructed and altered shared...

  19. Payload crew activity planning integration. Task 2: Inflight operations and training for payloads

    Science.gov (United States)

    Hitz, F. R.

    1976-01-01

    The primary objectives of the Payload Crew Activity Planning Integration task were to: (1) Determine feasible, cost-effective payload crew activity planning integration methods. (2) Develop an implementation plan and guidelines for payload crew activity plan (CAP) integration between the JSC Orbiter planners and the Payload Centers. Subtask objectives and study activities were defined as: (1) Determine Crew Activity Planning Interfaces. (2) Determine Crew Activity Plan Type and Content. (3) Evaluate Automated Scheduling Tools. (4) Develop a draft Implementation Plan for Crew Activity Planning Integration. The basic guidelines were to develop a plan applicable to the Shuttle operations timeframe, utilize existing center resources and expertise as much as possible, and minimize unnecessary data exchange not directly productive in the development of the end-product timelines.

  20. Field assessment of a model tuberculosis outbreak response plan for low-incidence areas

    Directory of Open Access Journals (Sweden)

    Pascopella Lisa

    2007-10-01

    Full Text Available Abstract Background For a regional project in four low-incidence states, we designed a customizable tuberculosis outbreak response plan. Prior to dissemination of the plan, a tuberculosis outbreak occurred, presenting an opportunity to perform a field assessment of the plan. The purpose of the assessment was to ensure that the plan included essential elements to help public health professionals recognize and respond to outbreaks. Methods We designed a semi-structured questionnaire and interviewed all key stakeholders involved in the response. We used common themes to assess validity of and identify gaps in the plan. A subset of participants provided structured feedback on the plan. Results We interviewed 11 public health and six community stakeholders. The assessment demonstrated that (1 almost all of the main response activities were reflected in the plan; (2 the plan added value by providing a definition of a tuberculosis outbreak and guidelines for communication and evaluation. These were areas that lacked written protocols during the actual outbreak response; and (3 basic education about tuberculosis and the interpretation and use of genotyping data were important needs. Stakeholders also suggested adding to the plan questions for evaluation and a section for specific steps to take when an outbreak is suspected. Conclusion An interactive field assessment of a programmatic tool revealed the value of a systematic outbreak response plan with a standard definition of a tuberculosis outbreak, guidelines for communication and evaluation, and response steps. The assessment highlighted the importance of education and training for tuberculosis in low-incidence areas.

  1. Wireless application guidelines for usability design and evaluation for developing countries

    International Nuclear Information System (INIS)

    Khoja, S.A.; Ursani, A.A.; Ali, A.

    2009-01-01

    The aim of this paper is to provide guidelines for designing wireless applications. These guidelines are developed with the help of Human Computer Interaction based Usability Evaluation surveys and tests results. These guidelines will help in making wireless applications more usable and attractive for users and will help designers to plan effective interactive applications. The guidelines presented in the paper have been derived from the results of surveys, usability tests and SET (Summative Evaluation Tests) carried out over 200 people of Karachi, Pakistan, from different walks of life with different academic and professional backgrounds, making imperative suggestions not only to improve the usability of exciting features given in wireless and mobile products, but also provide suggestions to improve usability of basic components such as, text, navigation, interactivity, multimedia, control and behavior. (author)

  2. Development of the International Guidelines for Home Health Nursing.

    Science.gov (United States)

    Narayan, Mary; Farris, Cindy; Harris, Marilyn D; Hiong, Fong Yoke

    2017-10-01

    Throughout the world, healthcare is increasingly being provided in home and community-based settings. There is a growing awareness that the most effective, least costly, patient-preferred setting is patients' home. Thus, home healthcare nursing is a growing nursing specialty, requiring a unique set of nursing knowledge and skills. Unlike many other nursing specialties, home healthcare nursing has few professional organizations to develop or support its practice. This article describes how an international network of home healthcare nurses developed international guidelines for home healthcare nurses throughout the world. It outlines how the guidelines for home healthcare nursing practice were developed, how an international panel of reviewers was recruited, and the process they used for reaching a consensus. It also describes the plan for nurses to contribute to future updates to the guidelines.

  3. An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2009-07-01

    Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective

  4. Energy Design Guidelines for High Performance Schools: Arctic and Subarctic Climates

    Energy Technology Data Exchange (ETDEWEB)

    2004-11-01

    The Energy Design Guidelines for High Performance Schools--Arctic and Subarctic Climates provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. These design guidelines outline high performance principles for the new or retrofit design of your K-12 school in arctic and subarctic climates. By incorporating energy improvements into their construction or renovation plans, schools can significantly reduce energy consumption and costs.

  5. Evaluation process of global environmental impact: assessment guidelines

    International Nuclear Information System (INIS)

    Memon, A.R.; Mahar, R.B.

    2001-01-01

    In developed and developing countries, the EIA (Environmental Impact Assessment) is becoming mandatory for the approval of Industrial projects and projects of Environmental hazards. The approving authority of each country has its own guidelines to get projects approved and make project proponents responsible to submit Environmental Impact Statement for the its detailed assessment. In this paper authors have studied an existing EIA Global guidelines and its evaluation process of altogether 40 countries from four continents, Asia, Pacific/Middle East, Europe, Australia and America/Canada. This evaluation process is recorded in the tabulation form and it has been formulated stage wise in which stage one highlights the inception of EIA guidelines of each country and stage two and three gives implementation process. The inception stage of guidelines gives an idea that when EIA was started and an implementation stages provide all information that when EIA become a part of legislation that provide an opportunity to the reader to understand the decision making process for project approvals. The main objective of writing EIA guidelines is to monitor the sustain ability of various types of the projects under different sectoral guidelines, therefore Projects related with different Sectors have been chosen and a detailed record in tabulation form gives an idea to understand the interaction of these guidelines. To make this paper more comprehensive, authors have gone thorough the sectoral guidelines of altogether 64 countries and studied 21 sector oriented project fields. These are of Agriculture/Irrigation, Biodiversity, Coastal/Marine, Community Participation, Extractive industries, Fisheries, Forestry, Hazard Risk, Health, Human settlement, Industry, Multi sectorial, Ports and Harbors, Power, refugees/resettlement, Social, Strategies/Planning, Tourism/Recreational, transportation, Waste Pollution and Wetlands/Water resources. (author)

  6. 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

  7. Individualised advance care planning in children with life-limiting conditions.

    Science.gov (United States)

    Loeffen, Erik A H; Tissing, Wim J E; Schuiling-Otten, Meggi A; de Kruiff, Chris C; Kremer, Leontien C M; Verhagen, A A Eduard

    2018-05-01

    In 2013, the Pediatric Association of the Netherlands launched an evidence-based guideline 'Palliative care for children'. To promote implementation in daily practice and hereby improve quality of paediatric palliative care, we aimed to develop a functional individualised paediatric palliative care plan (IPPCP) that covers physical, psychological, spiritual and social functioning, with great emphasis on the guideline's recommendations, advance care planning and patients' and parents' preferences and desires. A Dutch working group (28 individuals) with a strong multidisciplinary character developed a draft IPPCP, which was piloted retrospectively and prospectively. In the pilots we completed, the IPPCPs for patients who were recently diagnosed with a life-threatening or life-limiting condition and evaluated completeness, usability and user-friendliness. The final IPPCP comprised five domains: (1) IPPCP data, (2) basics, (3) social, (4) psychosocial and spiritual and (5) physical care. Each domain covered various components. In both pilots, the IPPCP was considered a comprehensive document that covered all areas of paediatric palliative care and was experienced as an improvement to the present situation. However, the current form was regarded to lack user-friendliness. We propose a set of essential components of a comprehensive IPPCP for paediatric palliative care with extra attention for advance care planning and anticipatory action. Patients' and parents' preferences and desires are included next to the recommendations of the evidence-based guideline 'Palliative care for children'. © 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.

  8. [Methodology report of the 2017 guidelines on fibromyalgia syndrome].

    Science.gov (United States)

    Häuser, W; Nothacker, M

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was planned for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n = 8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of therapies available were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The guidelines are published in several forms, i.e. complete and short scientific versions and clinical practice and patient versions.

  9. 40 CFR 256.03 - State plan submission, adoption, and revision.

    Science.gov (United States)

    2010-07-01

    ... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose, General Requirements, Definitions § 256.03 State plan submission, adoption, and revision. (a) To be...

  10. Internal Guidelines for interactions with communities and local governments

    International Nuclear Information System (INIS)

    1985-11-01

    These Guidelines provide principles for interactions with local populations. Interaction with communities and local govenments are the responsibility of the Office of Civilian Radioactive Wastes Management program's implementing offices. The Guidelines provide policy direction to these implementing offices, while preserving their ability to tailor local interactions to fit a given situation, taking into account the social and political context and the history of local involvement in the program. Project Offices conduct community and local interactions within overall program resources which must be husbanded prudently. Careful planning by implementing offices should ensure that adequate resources are available to foster effective interactions with local representatives

  11. Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery.

    Science.gov (United States)

    Mommaerts, Maurice Yves

    2016-01-01

    Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. University hospital - prospective registry. Twelve patients and 17 implantation sites were documented and prospectively registered. Malformational, deformational, and purely esthetic indications were encountered. Descriptive. Patient satisfaction was high, probably because the patients had input into the planned dimensions and shape. A serious infection with implant removal occurred in one patient who had six previous surgeries at the same sites. Technical and surgical guidelines were developed including splitting implants into two segments when the mental nerve was at risk, using a three-dimensional (3D) puzzle connection, providing at least two screw holes per segment, using scaffolds at the bony contact side, using a "satin" finish at the periosteal side, referring to anatomical structures where possible, making provisions for transbuccal and transoral fixation, using a high vestibular incision, and using a double-layer closure. Esthetic guidelines are discussed but could not be upgraded. Mirroring techniques and 3D print accuracy up to 0.1 mm allow precise planning of jaw angle implants. Patients are pleased when given preoperative renderings for their consideration. Infections can be managed using technical and operative recommendations and careful patient selection.

  12. Feasibility of implementing a practice guideline for fall prevention on geriatric wards: a multicentre study.

    Science.gov (United States)

    Milisen, Koen; Coussement, Joke; Arnout, Hanne; Vanlerberghe, Virginie; De Paepe, Leen; Schoevaerdts, Didier; Lambert, Margareta; Van Den Noortgate, Nele; Delbaere, Kim; Boonen, Steven; Dejaeger, Eddy

    2013-04-01

    About 40% of all adverse events in hospital are falls, but only about one in three Belgian hospitals have a fall prevention policy in place. The implementation of a national practice guideline is urgently needed. This multicentre study aimed to determine the feasibility of a previously developed guideline. SETTING, PARTICIPANTS AND METHOD: Seventeen geriatric wards, selected at random out of 40 Belgian hospitals who agreed to take part in the study, evaluated the fall prevention guideline. After the one-month test period, 49 healthcare workers completed a questionnaire on the feasibility of the guideline. At the end of the study, 512 geriatric patients had been assessed using the practice guideline. The average time spent per patient on case finding, multifactorial assessment and initiating a treatment plan was 5.1, 76.1 and 30.6 min, respectively. For most risk assessments and risk modifications, several disciplines considered themselves as being responsible and capable. The majority (more than 69%) of the respondents judged the practice guideline as useful, but only a small majority (62.3%) believed that the guideline could be successfully integrated into their daily practice over a longer period of time. Barriers for implementation included a large time investment (81.1%), lack of communication between the different disciplines (35.8%), lack of motivation of the patient (34.0%), lack of multidisciplinary teamwork (28.3%), and lack of interest from the hospital management (15.4%). Overall, the guideline was found useful, and for each risk factor (except for visual impairment), at least one discipline felt responsible and capable. Towards future implementation of the guideline, following steps should be considered: division of the risk-factor assessment duties and interventions among different healthcare workers; patient education; appointment of a fall prevention coordinator; development of a fall prevention policy with support from the management of the hospital

  13. Enhancing usability of augmented-reality-based mobile escape guidelines for radioactive accidents

    International Nuclear Information System (INIS)

    Tsai, Ming-Kuan; Yau, Nie-Jia

    2013-01-01

    When radioactive accidents occur, modern tools in information technology for emergency response are good solutions to reduce the impact. Since few information-technology-based applications were developed for people during radioactive accidents, a previous study (Tsai et al., 2012) proposed augmented-reality-based mobile escape guidelines. However, because of the lack of transparent escape routes and indoor escape guidelines, the usability of the guidelines is limited. Therefore, this study introduces route planning and mobile three-dimensional (3D) graphics techniques to address the identified problems. The proposed approach could correctly present the geographical relationship from user locations to the anticipated shelters, and quickly show the floor-plan drawings as users are in the buildings. Based on the testing results, in contrast to the previous study, this study offered better escape routes, when the participants performed self-evacuation in outdoor and indoor environments. Overall, this study is not only a useful reference for similar studies, but also a beneficial tool for emergency response during radioactive accidents. -- Highlights: ► Enhancing the efficiency when people escape from radioactive accidents. ► The spatial relationship is transparently displayed in real time. ► In contrast to a previous study, this study offers better escape guidelines

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

    Science.gov (United States)

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

    2013-01-01

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

  15. Applying international standards and guidelines on corporate social responsibility: An action plan

    NARCIS (Netherlands)

    Cramer, J.M.

    2005-01-01

    How can a company start the process of corporate social responsibility in an international context, thereby makinge use of diverse standards and guidelines? This question immediately came to the fore emerged after the start of the programme ‘Corporate social responsibility in international context’

  16. Defining robustness protocols: a method to include and evaluate robustness in clinical plans

    International Nuclear Information System (INIS)

    McGowan, S E; Albertini, F; Lomax, A J; Thomas, S J

    2015-01-01

    We aim to define a site-specific robustness protocol to be used during the clinical plan evaluation process. Plan robustness of 16 skull base IMPT plans to systematic range and random set-up errors have been retrospectively and systematically analysed. This was determined by calculating the error-bar dose distribution (ebDD) for all the plans and by defining some metrics used to define protocols aiding the plan assessment. Additionally, an example of how to clinically use the defined robustness database is given whereby a plan with sub-optimal brainstem robustness was identified. The advantage of using different beam arrangements to improve the plan robustness was analysed. Using the ebDD it was found range errors had a smaller effect on dose distribution than the corresponding set-up error in a single fraction, and that organs at risk were most robust to the range errors, whereas the target was more robust to set-up errors. A database was created to aid planners in terms of plan robustness aims in these volumes. This resulted in the definition of site-specific robustness protocols. The use of robustness constraints allowed for the identification of a specific patient that may have benefited from a treatment of greater individuality. A new beam arrangement showed to be preferential when balancing conformality and robustness for this case. The ebDD and error-bar volume histogram proved effective in analysing plan robustness. The process of retrospective analysis could be used to establish site-specific robustness planning protocols in proton therapy. These protocols allow the planner to determine plans that, although delivering a dosimetrically adequate dose distribution, have resulted in sub-optimal robustness to these uncertainties. For these cases the use of different beam start conditions may improve the plan robustness to set-up and range uncertainties. (paper)

  17. Defining robustness protocols: a method to include and evaluate robustness in clinical plans

    Science.gov (United States)

    McGowan, S. E.; Albertini, F.; Thomas, S. J.; Lomax, A. J.

    2015-04-01

    We aim to define a site-specific robustness protocol to be used during the clinical plan evaluation process. Plan robustness of 16 skull base IMPT plans to systematic range and random set-up errors have been retrospectively and systematically analysed. This was determined by calculating the error-bar dose distribution (ebDD) for all the plans and by defining some metrics used to define protocols aiding the plan assessment. Additionally, an example of how to clinically use the defined robustness database is given whereby a plan with sub-optimal brainstem robustness was identified. The advantage of using different beam arrangements to improve the plan robustness was analysed. Using the ebDD it was found range errors had a smaller effect on dose distribution than the corresponding set-up error in a single fraction, and that organs at risk were most robust to the range errors, whereas the target was more robust to set-up errors. A database was created to aid planners in terms of plan robustness aims in these volumes. This resulted in the definition of site-specific robustness protocols. The use of robustness constraints allowed for the identification of a specific patient that may have benefited from a treatment of greater individuality. A new beam arrangement showed to be preferential when balancing conformality and robustness for this case. The ebDD and error-bar volume histogram proved effective in analysing plan robustness. The process of retrospective analysis could be used to establish site-specific robustness planning protocols in proton therapy. These protocols allow the planner to determine plans that, although delivering a dosimetrically adequate dose distribution, have resulted in sub-optimal robustness to these uncertainties. For these cases the use of different beam start conditions may improve the plan robustness to set-up and range uncertainties.

  18. ASSET guidelines. Revised 1991 Edition

    International Nuclear Information System (INIS)

    1991-12-01

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

  19. Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

    Science.gov (United States)

    Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

    2011-01-01

    The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

  20. International Continence Society supported pelvic physiotherapy education guideline.

    Science.gov (United States)

    Bakker, Els; Shelly, Beth; Esch, Fetske H; Frawley, Helena; McClurg, Doreen; Meyers, Peter

    2018-02-01

    To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS. The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis. The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome. © 2018 Wiley Periodicals, Inc.

  1. Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

    Science.gov (United States)

    Song, Kyung Ho; Jung, Hye-Kyung; Kim, Hyun Jin; Koo, Hoon Sup; Kwon, Yong Hwan; Shin, Hyun Duk; Lim, Hyun Chul; Shin, Jeong Eun; Kim, Sung Eun; Cho, Dae Hyeon; Kim, Jeong Hwan; Kim, Hyun Jung

    2018-01-01

    In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS. A librarian created a literature search query, and a systematic review was conducted to identify candidate guidelines. Feasible documents were verified based on predetermined inclusion and exclusion criteria. The candidate seed guidelines were fully evaluated by the Guidelines Development Committee using the Appraisal of Guidelines for Research and Evaluation II quality assessment tool. After selecting 7 seed guidelines, the committee prepared evidence summaries to generate data exaction tables. These summaries comprised the 4 main themes of this version of the guidelines: colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. To adopt the core recommendations of the guidelines, the Delphi technique (ie, a panel of experts on IBS) was used. To enhance dissemination of the clinical practice guidelines, a Korean version will be made available, and a food calendar for patients with IBS is produced. PMID:29605976

  2. How can we improve guideline use? A conceptual framework of implementability

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2011-03-01

    Full Text Available Abstract Background Guidelines continue to be underutilized, and a variety of strategies to improve their use have been suboptimal. Modifying guideline features represents an alternative, but untested way to promote their use. The purpose of this study was to identify and define features that facilitate guideline use, and examine whether and how they are included in current guidelines. Methods A guideline implementability framework was developed by reviewing the implementation science literature. We then examined whether guidelines included these, or additional implementability elements. Data were extracted from publicly available high quality guidelines reflecting primary and institutional care, reviewed independently by two individuals, who through discussion resolved conflicts, then by the research team. Results The final implementability framework included 22 elements organized in the domains of adaptability, usability, validity, applicability, communicability, accommodation, implementation, and evaluation. Data were extracted from 20 guidelines on the management of diabetes, hypertension, leg ulcer, and heart failure. Most contained a large volume of graded, narrative evidence, and tables featuring complementary clinical information. Few contained additional features that could improve guideline use. These included alternate versions for different users and purposes, summaries of evidence and recommendations, information to facilitate interaction with and involvement of patients, details of resource implications, and instructions on how to locally promote and monitor guideline use. There were no consistent trends by guideline topic. Conclusions Numerous opportunities were identified by which guidelines could be modified to support various types of decision making by different users. New governance structures may be required to accommodate development of guidelines with these features. Further research is needed to validate the proposed

  3. Selecting a Risk-Based SQC Procedure for a HbA1c Total QC Plan.

    Science.gov (United States)

    Westgard, Sten A; Bayat, Hassan; Westgard, James O

    2017-09-01

    Recent US practice guidelines and laboratory regulations for quality control (QC) emphasize the development of QC plans and the application of risk management principles. The US Clinical Laboratory Improvement Amendments (CLIA) now includes an option to comply with QC regulations by developing an individualized QC plan (IQCP) based on a risk assessment of the total testing process. The Clinical and Laboratory Standards Institute (CLSI) has provided new practice guidelines for application of risk management to QC plans and statistical QC (SQC). We describe an alternative approach for developing a total QC plan (TQCP) that includes a risk-based SQC procedure. CLIA compliance is maintained by analyzing at least 2 levels of controls per day. A Sigma-Metric SQC Run Size nomogram provides a graphical tool to simplify the selection of risk-based SQC procedures. Current HbA1c method performance, as demonstrated by published method validation studies, is estimated to be 4-Sigma quality at best. Optimal SQC strategies require more QC than the CLIA minimum requirement of 2 levels per day. More complex control algorithms, more control measurements, and a bracketed mode of operation are needed to assure the intended quality of results. A total QC plan with a risk-based SQC procedure provides a simpler alternative to an individualized QC plan. A Sigma-Metric SQC Run Size nomogram provides a practical tool for selecting appropriate control rules, numbers of control measurements, and run size (or frequency of SQC). Applications demonstrate the need for continued improvement of analytical performance of HbA1c laboratory methods.

  4. Systematic review of recent dementia practice guidelines.

    Science.gov (United States)

    Ngo, Jennifer; Holroyd-Leduc, Jayna M

    2015-01-01

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

  5. Standard guidelines for setting up a dermatosurgery theatre

    Directory of Open Access Journals (Sweden)

    Rajendran S

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatologists in India are now increasingly performing surgical and cosmetic procedures in their practice. This calls for minimum standards at the national level with the main focus of patient safety and hence the guidelines for setting up a dermatosurgical theatre. Facility: The dermatosurgery theatre can be created in either physician′s clinic, or a hospital depending on the procedure to be performed. The dermatosurgery theatre requires careful planning with regards to - location, dimension, shell design, lighting, electrical requirements, operation table, chair, trolley, surgical instruments, sterilization of devices, asepsis and advanced life support. Apart from physical considerations, other considerations including theatre etiquettes, consent for surgery, safety of dermatosurgeon, theatre staff and lastly biomedical waste management should be looked into. These issues are discussed in detail in the recommendations.

  6. The NASA competitive placement plan for positions GS-15 and below (including trades and labor positions)

    Science.gov (United States)

    1993-01-01

    This plan provides the framework for selection based on merit from among the best qualified candidates available. Selections will be made without regard to political, religious, or labor organization affiliation or nonaffiliation, marital status, race, color, sex, national origin, nondisqualifying disability, or age. This plan does not guarantee promotion but rather ensures that all qualified available candidates receive fair and equitable consideration for positions filled under these competitive procedures. Announcing a vacancy under this plan is only one method of locating applicants for a position and can be used in conjunction with other methods. Subject to applicable law and regulation, selection of an individual to fill a position is the decision of management, as is the decision as to the method(s) to be used in identifying candidates. This plan is applicable to all NASA Installations. It covers all positions in the competitive service at (and below) the GS/GM-15 level (including all trades and labor positions), except positions in the Office of the Inspector General. The requirements herein are not intended to, nor should they be construed to limit in any way, the independent personnel authority of the Inspector General under the Inspector General Act, as Amended.

  7. Inter-Organisational Systems, Strategy and Structure: the case for planning environments

    Directory of Open Access Journals (Sweden)

    Pat Finnegan

    1998-11-01

    Full Text Available Electronic trade and commerce have brought inter organisational co-operation to the forefront of organisational strategies. However, inter-organisational systems (IOS planning lacks appropriate methodological guidelines, and tends to be practised in an insular manner. This paper examines the development of systems in three interorganisational networks in Ireland in order to ascertain the planning that went into them. The networks studied are representative of three types of structural interdependencies - pooled, reciprocal and sequential. Although it is difficult to identify an activity that can be clearly labelled IOS planning, planning is integral to the development of all networks. The interdependencies influence planning processes and outcomes. For the pooled and reciprocal networks, the planning process gives a focus. For the sequential network, the main planning is done by the hub organisation, and extended to the spokes. Planning interactions across all networks illustrate similarities that reveal that existence of planning environments within which IOS planning takes place. These planning environments are proposed as being an appropriate basis for the development of IOS planning guidelines.

  8. Pandemic planning : oilsands operators and the regional municipality constantly refine strategy

    Energy Technology Data Exchange (ETDEWEB)

    Ball, C.G.

    2008-06-15

    The Alberta government anticipates that between 17 to 43 per cent of the province's population will be affected during a potential influenza pandemic. It is expected that between 3 and 12,000 Albertans will be hospitalized and up to 3000 will die. This article discussed emergency plans made by the oil and gas industry for future pandemics. Oil sands operators in the Wood Buffalo municipality prepared plans based on guidelines made by the World Health Organization (WHO) and various government bodies. The transient nature of the region's population and its limited health resources may increase the level of risk associated with a pandemic. The planning process adopted by the region has been designed to provide staff with the ability to deal with increased numbers of people visiting the hospital. The planning process includes training exercises that range from desktop drills to the setting up of triage areas. Other plans include the identification of operations and processes that would be at risk in the event of a pandemic, as well the identification of key operations and roles. Plans are constantly being refined in order to identify new areas of risk. 1 fig.

  9. Biomedical programs operations plans

    Science.gov (United States)

    Walbrecher, H. F.

    1974-01-01

    Operational guidelines for the space shuttle life sciences payloads are presented. An operational assessment of the medical experimental altitude test for Skylab, and Skylab life sciences documentation are discussed along with the operations posture and collection of space shuttle operational planning data.

  10. The guideline implementability research and application network (GIRAnet: an international collaborative to support knowledge exchange: study protocol

    Directory of Open Access Journals (Sweden)

    Gagliardi Anna R

    2012-04-01

    Full Text Available Abstract Background Modifying the format and content of guidelines may facilitate their use and lead to improved quality of care. We reviewed the medical literature to identify features desired by different users and associated with guideline use to develop a framework of implementability and found that most guidelines do not contain these elements. Further research is needed to develop and evaluate implementability tools. Methods We are launching the Guideline Implementability Research and Application Network (GIRAnet to enable the development and testing of implementability tools in three domains: Resource Implications, Implementation, and Evaluation. Partners include the Guidelines International Network (G-I-N and its member guideline developers, implementers, and researchers. In phase one, international guidelines will be examined to identify and describe exemplar tools. Indication-specific and generic tools will populate a searchable repository. In phase two, qualitative analysis of cognitive interviews will be used to understand how developers can best integrate implementability tools in guidelines and how health professionals use them for interpreting and applying guidelines. In phase three, a small-scale pilot test will assess the impact of implementability tools based on quantitative analysis of chart-based behavioural outcomes and qualitative analysis of interviews with participants. The findings will be used to plan a more comprehensive future evaluation of implementability tools. Discussion Infrastructure funding to establish GIRAnet will be leveraged with the in-kind contributions of collaborating national and international guideline developers to advance our knowledge of implementation practice and science. Needs assessment and evaluation of GIRAnet will provide a greater understanding of how to develop and sustain such knowledge-exchange networks. Ultimately, by facilitating use of guidelines, this research may lead to improved

  11. Adopting Clinical Guidelines for Admission Criteria of Intensive Care Unit: A Measure to Manage Queues of Patients Waiting for This Section

    Directory of Open Access Journals (Sweden)

    Afshin Mohammad Alizadeh

    2018-04-01

    Full Text Available Background: Due to the need of patients to the intensive care unit (ICU for receiving medical and nursing services, these services should be provided in a timely manner. This study aimed to develop the clinical guidelines for admission criteria of intensive care unit.Materials and Methods: This study was observational type study was conducted for nine months in 2015 based on a three-step process of adoption of clinical guidelines including planning, adoption and finalization. After conducting systematic searches, the quality of retrieved clinical guidelines was evaluated by experts from policy makers in the admission of patients in the ICU. Finally, the ultimate version of the guideline was developed after reviewing and organizing expert panel sessions.Results: The criteria for accepting patients were presented in form of seven clauses based on the neurological status, cardiovascular status, respiratory status, water and electrolyte disorders, gastrointestinal disturbances, endocrine disorders, surgery and postoperative care.Conclusion: One of the most important factors of creating demand inducing to the patients is the lack of clinical guidelines. It is recommended that departmental doctors should apply the mentioned clinical guidelines in order to make the resources of the intensive care unit more effective.

  12. Hanford 300 Area Development Plan

    International Nuclear Information System (INIS)

    Daly, K.S.; Seiler, S.W.; Hail, J.C.

    1991-09-01

    The purpose of the Hanford 300 Area Development Plan (Development Plan) is to guide the physical development of the 300 Area in accordance with US Department of Energy (DOE) Order 4320.1B (DOE 1991b) by performing the following: (1) Establishing a land use plan, setting land use categories that meet the needs of existing and proposed activities; (2) Coordinating existing, 5-yr, and long-range development plans and guiding growth in accordance with those plans; (3) Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities; (4) Identifying site development issues that need further analysis; Integrating program plans with development plans to ensure a logical progression of development; and, (6) Integrating DOE plans with local agency plans (i.e., city, country, state, and Tri-Cities Science and Technology Park plans)

  13. 25 CFR 163.81 - Assessment guidelines.

    Science.gov (United States)

    2010-04-01

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

  14. Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality

    Directory of Open Access Journals (Sweden)

    Joslyn S. Kirby

    2015-01-01

    Full Text Available Actinic keratosis (AK is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

  15. Guidelines for indoor air hygiene in school buildings

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-08-15

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

  16. Guidelines for indoor air hygiene in school buildings

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-08-15

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

  17. Digital marketing plan for a news agency

    OpenAIRE

    Do, Thi Minh Chau

    2013-01-01

    In the business world, an effective marketing plan is an important guideline for any company, regardless of how small or big the business scale is, to stay focused to their goals. Moreover, "the written marketing plan gives a common direction to all staff in the company" (McKinlay & O'Connor, 2007). Therefore, formulating a marketing plan prior to utilizing any marketing actions is substantial and necessary. However, producing a marketing plan requires knowledge of marketing. For those re...

  18. Organizational factors, planning capacity, and integration challenges constrain provincial planning processes for nutrition in decentralizing Vietnam.

    Science.gov (United States)

    Lapping, Karin; Frongillo, Edward A; Nguyen, Phuong H; Coates, Jennifer; Webb, Patrick; Menon, Purnima

    2014-09-01

    Translating national policies and guidelines into effective action at the subnational level (e.g., province or region) is a prerequisite for ensuring an impact on nutrition. In several countries, including Vietnam, the focus of this paper, this process is affected by the quality of the decentralized process of planning and action. This study examined how provincial planning processes for nutrition occurred in Vietnam during 2009 and 2010. Key goals were to understand variability in processes across provinces, identify factors that influenced the process, and assess the usefulness of the process for individuals involved in planning and action. A qualitative case-study methodology was used. Data were drawn from interviews with 51 government officials in eight provinces. The study found little variability in the planning process among these eight provinces, probably due to a planning process that was predominantly a fiscal exercise within the confines of a largely centralized structure. Respondents were almost unanimous about the main barriers: a top-down approach to planning, limited human capacity for effective planning at subnational levels, and difficulty in integrating actions from multiple sectors. Provincial-level actors were deeply dissatisfied with the nature of their role in the process. Despite the rhetoric to the contrary, too much power is probably still retained at the central level. A strategic multiyear approach is needed to strengthen the provincial planning process and address many of the key barriers identified in this study.

  19. China National Lung Cancer Screening Guideline with Low-dose Computed 
Tomography (2018 version

    Directory of Open Access Journals (Sweden)

    Qinghua ZHOU

    2018-02-01

    Full Text Available Background and objective Lung cancer is the leading cause of cancer-related death in China. The results from a randomized controlled trial using annual low-dose computed tomography (LDCT in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality. The aim of tihs study is to establish the China National lung cancer screening guidelines for clinical practice. Methods The China lung cancer early detection and treatment expert group (CLCEDTEG established the China National Lung Cancer Screening Guideline with multidisciplinary representation including 4 thoracic surgeons, 4 thoracic radiologists, 2 medical oncologists, 2 pulmonologists, 2 pathologist, and 2 epidemiologist. Members have engaged in interdisciplinary collaborations regarding lung cancer screening and clinical care of patients with at risk for lung cancer. The expert group reviewed the literature, including screening trials in the United States and Europe and China, and discussed local best clinical practices in the China. A consensus-based guidelines, China National Lung Cancer Screening Guideline (CNLCSG, was recommended by CLCEDTEG appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China. Results Annual lung cancer screening with LDCT is recommended for high risk individuals aged 50-74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation. Conclusion A lung cancer screening guideline is recommended for the high-risk population in China

  20. Closed cooling water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Breckenridge, Richard

    2014-01-01

    This second revision of the Closed Cooling Water Chemistry Guideline addresses the use of chemicals and monitoring methods to mitigate corrosion, fouling, and microbiological growth in the closed cooling-water (CCW) systems of nuclear and fossil-fueled power plants. This revision has been endorsed by the utility chemistry community and represents another step in developing a more proactive chemistry program to limit or control closed cooling system degradation with increased consideration of corporate resources and plant-specific design and operating concerns. These guidelines were developed using laboratory data, operating experience, and input from organizations and utilities within and outside of the United States of America. It is the intent of the Revision Committee that these guidelines are applicable to all nuclear and fossil-fueled generating stations around the world. A committee of industry experts—including utility specialists, Institute of Nuclear Power Operations representatives, water-treatment service-company representatives, consultants, a primary contractor, and EPRI staff—collaborated in reviewing available data on closed cooling-water system corrosion and microbiological issues. Recognizing that each plant owner has a unique set of design, operating, and corporate concerns, the Guidelines Committee developed a methodology for plant-specific optimization. The guideline provides the technical basis for a reasonable but conservative set of chemical treatment and monitoring programs. The use of operating ranges for the various treatment chemicals discussed in this guideline will allow a power plant to limit corrosion, fouling, and microbiological growth in CCW systems to acceptable levels. The guideline now includes closed cooling chemistry regimes proven successful in use in the international community. The guideline provides chemistry constraints for the use of phosphates control, as well as pure water with pH control. (author)

  1. Considerations in setting up and planning a graft processing facility.

    Science.gov (United States)

    Koh, Mickey B C

    2017-12-01

    The graft processing facility forms one of the core components of a clinical haematopoietic stem cell transplant program. The quality of a graft is instrumental in leading to consistent and reproducible outcomes of engraftment and other parameters. As such, meticulous planning and consideration is required and will include core elements including physical design and clinical correlates. The successful running of such a facility depends on an overarching quality program and adherence to local and international regulatory guidelines. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

  2. Guidelines for the use of biological monitors in air pollution control (plants). Pt. 1. Methodological guidance for the drawing-up of biomonitoring guidelines (plants)

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, R.D. [Buero fuer Konzeptionelle Bioindikation, Jockgrim (Germany); Wagner, G. [Universitaet des Saarlandes, Saarbruecken (Germany). Inst. fuer Biogeographie; Finck, M.

    2000-04-01

    The main objective of this study is to encourage and promote further development of the methodological basis for a broader and more effective use of biological methods for monitoring the effects of air pollution on plants. It is not intended here to explain or discuss general criteria for the design of environmental monitoring studies and principal statistical methods for dealing with heterogeneously distributed spatial phenomena in detail. A further objective of this study is to give general guidance on how to - select suitable bioindicators, - develop, optimise and validate specific guidelines for the use of these bioindicators, - plan, design and employ biomonitoring studies for different purposes, - develop case-specific study plans determining how to apply an appropriate bioindicator (method-specific guideline) to a given task, case and area, - adapt principles of quality assurance and quality control to biomonitoring studies, - increase the importance and reliability of results obtained by bioindicators with respect to administrative measures. (orig.)

  3. Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.

    Science.gov (United States)

    Itz, Coen J; Willems, Paul C; Zeilstra, Dick J; Huygen, Frank J

    2016-01-01

    When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. The aim of the guideline is to determine which invasive treatment intervention is preferred for each included pain syndrome when conservative treatment has failed. Diagnostic studies were evaluated using the EBRO criteria, and studies on therapies were evaluated with the Grading of Recommendations Assessment, Development and Evaluation system. For the evaluation of invasive treatment options, the guideline committee decided that the outcome measures of pain, function, and quality of life were most important. The definition, epidemiology, pathophysiological mechanism, diagnostics, and recommendations for invasive therapy for each of the spinal back pain syndromes are reported. The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study. © 2015 World Institute of Pain.

  4. Wildland Fire Management Plan for Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Schwager, K.; Green, T. M.

    2014-01-01

    The DOE policy for managing wildland fires requires that all areas managed by DOE and/or Its various contractors which can sustain fire must have a FMP that details fire management guidelines for operational procedures associated with wildland fire, operational, and prescribed fires. FMPs provide guidance on fire preparedness, fire prevention, wildfire suppression, and the use of controlled ''prescribed'' fires and mechanical means to control the amount of available combustible material. Values reflected in the BNL Wildland FMP include protecting life and public safety; Lab properties, structures and improvements; cultural and historical sites; neighboring private and public properties; and endangered, threatened, and species of concern. Other values supported by the plan include the enhancement of fire-dependent ecosystems at BNL. The plan will be reviewed periodically to ensure fire program advances and will evolve with the missions of DOE and BNL.

  5. Wildland Fire Management Plan for Brookhaven National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Schwager, K.; Green, T. M.

    2014-10-01

    The DOE policy for managing wildland fires requires that all areas managed by DOE and/or Its various contractors which can sustain fire must have a FMP that details fire management guidelines for operational procedures associated with wildland fire, operational, and prescribed fires. FMPs provide guidance on fire preparedness, fire prevention, wildfire suppression, and the use of controlled ''prescribed'' fires and mechanical means to control the amount of available combustible material. Values reflected in the BNL Wildland FMP include protecting life and public safety; Lab properties, structures and improvements; cultural and historical sites; neighboring private and public properties; and endangered, threatened, and species of concern. Other values supported by the plan include the enhancement of fire-dependent ecosystems at BNL. The plan will be reviewed periodically to ensure fire program advances and will evolve with the missions of DOE and BNL.

  6. [Ethical principles of management and planning during influenza pandemic].

    Science.gov (United States)

    Kubar', O I; Asatrian, A Zh

    2012-01-01

    The article is dedicated to an actual problem of ethical component inclusion into the system of management and planning of epidemic control measures during threat emergence and in the course of influenza pandemic (epidemic) progress. Data regarding development of international ethical guidelines during influenza including WHO recommendations are presented and analysis of normative documents in Russian Federation is given. A necessity of comprehension and accounting of ethical values in pandemic preparedness is shown, main directions of action and responsibility are revealed. Key ethical positions of planning and implementation of measures during influenza pandemic are outlined, compliance with those determines the level of public support and thus provides the effectiveness of the implemented measures.

  7. Application of The APA Practice Guidelines on Suicide to Clinical Practice.

    Science.gov (United States)

    Jacobs, Douglas G; Brewer, Margaret L

    2006-06-01

    This article presents charts from The American Psychiatric Association Practice Guideline for the Assessment and Treatment of Patients with Suicidal Behaviors, part of the Practice Guidelines for the Treatment of Psychiatric Disorders Compendium, and a summary of the assessment information in a format that can be used in routine clinical practice. Four steps in the assessment process are presented: the use of a thorough psychiatric examination to obtain information about the patient's current presentation, history, diagnosis, and to recognize suicide risk factors therein; the necessity of asking very specific questions about suicidal ideation, intent, plans, and attempts; the process of making an estimation of the patient's level of suicide risk is explained; and the use of modifiable risk and protective factors as the basis for treatment planning is demonstrated. Case reports are used to clarify use of each step in this process.

  8. Recommendations for Guidelines for EMF Personal Exposure Measurements, Rapid Project #4

    Energy Technology Data Exchange (ETDEWEB)

    T. Dan Bracken, Inc.

    1997-08-01

    The purpose of developing guidelines for electric and magnetic field (EMF) personal exposure measurements (lF'EM) is to ensure reliable and comparable data across I?EM studies. Study techniques may vary due to different populations or objectives, but the resulting data should be consistently reported and comparable, to the extent possible. Any guideline must allow creativity by the research-oriented investigator and provide specific guidance to industrial hygienists or other results-oriented investigators, requiring a standard protocol. Recognizing measurement studies with different purposes is an important aspect of these recommendations. The guidelines presented here intend to produce comparable data across studies while remaining flexible. The recommendations for designing and implementing an EMF PEM program describe a three-stage process. The first step is to clearly state the purpose of the PEM program. The next stage addresses the fundamental elements of an EMF PEM study, including an assessment of the scientific and organizational resources that will be required. This process is codified in a written study plan. These stages are described in 1 Section 5 of this report. The third stage of a PEM study involves the design, implementation and documentation of specific procedures and protocols fo~ sampling strategies, selection of measurement parameters; instrumentation, measurement and data collection, data management, data analysis, quality assurance, uncertainty evaluation, and archiving the study methods and results. The methods for designing these elements of an EMF PEM study are described in Section 6: Specific Guidelines for EMF I?EM Study Design.

  9. Maintenance planning for nuclear power plants

    International Nuclear Information System (INIS)

    Mattu, R.K.; Cooper, S.E.; Lauderdale, J.R.

    2004-01-01

    Maintenance planning for nuclear power plants is similar to that in other industrial plants but it is heavily influenced by regulatory rules, with consequent costs of compliance. Steps by the nuclear industry and the Nuclear Regulatory Commission to address that problem include development of guidelines for maintenance of risk-critical equipment, using PRA-based techniques to select a set of equipment that requires maintenance and reliability-centered maintenance (RCM) approaches for determining what maintenance is required. The result of the process is a program designed to ensure effective maintenance of the equipment most critical to plant safety. (author)

  10. 77 FR 43350 - Draft Environmental Assessment and Proposed Habitat Conservation Plan for the San Diego Unified...

    Science.gov (United States)

    2012-07-24

    ... impacts, as described in the applicant's habitat conservation plan (plan). We request data, comments, and..., the Carroll Canyon Preserve on the east and south, and aggregate mining operations on the west. The... compliance with all applicable California Department of Education School Development Guidelines (guidelines...

  11. Dietary Guidelines for the Asia Pacific Region.

    Science.gov (United States)

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

    2017-03-01

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

  12. Planning and Preparation for CD-ROM Implementation: The Citadel Library.

    Science.gov (United States)

    Maynard, J. Edmund

    Management guidelines for library planning and a strategic planning program profile based on the literature were used in the planning process for implementing access to databases on CD-ROM at the Daniel Library of the Citadel, Military College of South Carolina. According to this model, the planning process would consist of five stages: (1)…

  13. Japanese guidelines for childhood asthma 2017.

    Science.gov (United States)

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

    2017-04-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  15. Next generation terminology infrastructure to support interprofessional care planning.

    Science.gov (United States)

    Collins, Sarah; Klinkenberg-Ramirez, Stephanie; Tsivkin, Kira; Mar, Perry L; Iskhakova, Dina; Nandigam, Hari; Samal, Lipika; Rocha, Roberto A

    2017-11-01

    Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. The study steps included a 3 step approach: (1) Process model and clinical scenario development, and (2) Requirements analysis, and (3) Development and validation of information and terminology models. Components of the terminology model include: Health Concerns, Goals, Decisions, Interventions, Assessments, and Evaluations. A terminology infrastructure should: (A) Include discrete care plan concepts; (B) Include sets of profession-specific concerns, decisions, and interventions; (C) Communicate rationales, anticipatory guidance, and guidelines that inform decisions among the care team; (D) Define semantic linkages across clinical events and professions; (E) Define sets of shared patient goals and sub-goals, including patient stated goals; (F) Capture evaluation toward achievement of goals. These requirements were mapped to AHRQ Care Coordination Measures Framework. This study used a constrained set of clinician-validated clinical scenarios. Terminology models for goals and decisions are unavailable in SNOMED CT, limiting the ability to evaluate these aspects of the proposed infrastructure. Defining and linking subsets of care planning concepts appears to be feasible, but also essential to model interprofessional care planning for common co-occurring conditions and chronic diseases. We recommend the creation of goal dynamics and decision concepts in SNOMED CT to further enable the necessary models. Systems with flexible terminology management infrastructure may enable intelligent decision support to identify conflicting and aligned concerns, goals, decisions, and interventions in shared care plans, ultimately decreasing documentation effort and cognitive burden for clinicians and

  16. Basic Concepts Required in the Development of a Planning Information System.

    Science.gov (United States)

    Kennedy, F. D.

    This report, the result of developmental research on a planning information system for North Carolina, describes the planning process at higher levels of State government, defines a general information system and derives a planning information system from various types of planning, provides guidelines for system design and evaluation, and…

  17. Medical Guidelines Presentation and Comparing with Electronic Health Record

    Czech Academy of Sciences Publication Activity Database

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

    2006-01-01

    Roč. 75, č. 3-4 (2006), s. 240-245 ISSN 1386-5056 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : medical guidelines * electronic health record * GLIF model * reminder facility Subject RIV: IN - Informatics, Computer Science Impact factor: 1.726, year: 2006

  18. Planning an Effective Child Care Center.

    Science.gov (United States)

    Wright, Rodney; Wright, Sydney

    This conference presentation offers general guidelines for planning a new child care facility. Particular attention is given to site selection, space requirements, functional requirements, materials, climate, and choosing an architect. (RH)

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

    Science.gov (United States)

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

    2018-04-01

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

  20. Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination.

    Science.gov (United States)

    Faulkner, Guy; White, Lauren; Riazi, Negin; Latimer-Cheung, Amy E; Tremblay, Mark S

    2016-06-01

    Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation.

  1. Corrosion-under-insulation (CUI) guidelines

    CERN Document Server

    Staff, European Federation of Corrosion; Winnik, S

    2014-01-01

    Corrosion under insulation (CUI) refers to the external corrosion of piping and vessels that occurs underneath externally clad/jacketed insulation as a result of the penetration of water. By its very nature CUI tends to remain undetected until the insulation and cladding/jacketing is removed to allow inspection or when leaks occur. CUI is a common problem shared by the refining, petrochemical, power, industrial, onshore and offshore industries. The European Federation of Corrosion (EFC) Working Parties WP13 and WP15 have worked to provide guidelines on managing CUI together with a number of major European refining, petrochemical and offshore companies including BP, Chevron-Texaco, Conoco-Phillips, ENI, Exxon-Mobil, IFP, MOL, Scanraff, Statoil, Shell, Total and Borealis. The guidelines within this document are intended for use on all plants and installations that contain insulated vessels, piping and equipment. The guidelines cover a risk-based inspection methodology for CUI, inspection techniques (including n...

  2. [Practice guideline 'Prostate cancer: diagnosis and treatment'

    NARCIS (Netherlands)

    Reijke, T.M. de; Battermann, J.J.; Moorselaar, R.J.A. van; Jong, I.J. de; Visser, A.P.; Burgers, J.S.

    2008-01-01

    --A national, multidisciplinary practice guideline was developed concerning diagnosis and treatment of patients with prostate cancer. Because of the lack of sufficient scientific evidence at this moment no practice guideline on screening is included. --The diagnosis of prostate cancer is made by

  3. Guidelines for gloveboxes. Section 5.14: Electrical

    International Nuclear Information System (INIS)

    Tollner, R.L.

    1995-07-01

    This is the electric portion of the design guidelines for gloveboxes developed by the American Glovebox Society. The topics include applicable codes/industry standards, penetrations/feedthroughs, wireways, junction boxes, receptacles, derating factors, conductors, conductor insulation and grounding. References for the guidelines are provided

  4. Risk management guidelines for petroleum storage tank sites

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-10-01

    These guidelines provide a site management process designed particularly for soil and groundwater pollution originating from existing or former petroleum storage tank (PST) facilities and provide uniform standards for the remediation of polluted PST sites in Alberta. The numerical criteria, risk management objectives and technical information described in this document were compiled from four documents including Remediation Guidelines for Petroleum Storage Tank Sites 1994, the Canada-Wide Standards for Petroleum Hydrocarbons in Soil, Alberta Soil and Water Quality Guidelines for Hydrocarbons at Upstream Oil and Gas Facilities, and Guidelines for Managing Risks at Contaminated Sites in Alberta. The changes in these updated guidelines reflect new remediation criteria and provide a process for determining alternate site-specific management objectives for more petroleum storage tank sites. The guidelines were developed using a risk-based approach that ensures the protection of human health, safety and the environment. The guidelines apply to aboveground and underground storage tank facilities that contain gasoline, diesel, heating oil, and aviation fuel. The guidelines specify requirements by Alberta Environment and the Alberta Fire Code. The chapter on risk management process included information on site investigation, determination of soil type, pollution source removal, land use assessment, selection of exposure pathways, depth of remediation, human inhalation and groundwater protection pathways, and verification of remediation. figs, 4 tabs., 2 appendices.

  5. Planning for Planetary Science Mission Including Resource Prospecting, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Advances in computer-aided mission planning can enhance mission operations and science return for surface missions to Mars, the Moon, and beyond. While the...

  6. Planning guidance for the Chemical Stockpile Emergency Preparedness Program

    Energy Technology Data Exchange (ETDEWEB)

    Shumpert, B.L.; Watson, A.P.; Sorensen, J.H. [and others

    1995-02-01

    This planning guide was developed under the direction of the U.S. Army and the Federal Emergency Management Agency (FEMA) which jointly coordinate and direct the development of the Chemical Stockpile Emergency Preparedness Program (CSEPP). It was produced to assist state, local, and Army installation planners in formulating and coordinating plans for chemical events that may occur at the chemical agent stockpile storage locations in the continental United States. This document provides broad planning guidance for use by both on-post and off-post agencies and organizations in the development of a coordinated plan for responding to chemical events. It contains checklists to assist in assuring that all important aspects are included in the plans and procedures developed at each Chemical Stockpile Disposal Program (CSDP) location. The checklists are supplemented by planning guidelines in the appendices which provide more detailed guidance regarding some issues. The planning guidance contained in this document will help ensure that adequate coordination between on-post and off-post planners occurs during the planning process. This planning guide broadly describes an adequate emergency planning base that assures that critical planning decisions will be made consistently at every chemical agent stockpile location. This planning guide includes material drawn from other documents developed by the FEMA, the Army, and other federal agencies with emergency preparedness program responsibilities. Some of this material has been developed specifically to meet the unique requirements of the CSEPP. In addition to this guidance, other location-specific documents, technical studies, and support studies should be used as needed to assist in the planning at each of the chemical agent stockpile locations to address the specific hazards and conditions at each location.

  7. Forest planning at territory level: a methodological proposal

    Directory of Open Access Journals (Sweden)

    Agnoloni S

    2009-05-01

    Full Text Available This paper describes goals and methodologies of the Land Plan for Forest and Natural Environment Management Guidance (PFTI stemming from the Ri.Selv.Italia national project (within the “Forest Land Planning” 4.2 subproject. The PFTI geographic range of application is at an intermediate level between single forest-management-unit-level plan and regional forest plans, and deals with forest and pastures resources management. PFTI’s main purposes concern forest resource and forest economy analysis and assessment of the benefits that can be provided to local population through a rational forest management, taking into account also the social structure and potential local conflicts. PFTI’s final task is then to weigh up all these issues in order to give specific participated forest management guidelines at a territorial scale. Unlike the forest-management-unit-level plan, whose specific duties are predetermined and fixed, the PFTI is not necessarily a mandatory plan. On the opposite, PFTI should suggest several specific silviculture guidelines and alternative management scenarios.

  8. Residential neighbourhoods in Kathmandu: Key design guidelines

    Directory of Open Access Journals (Sweden)

    Bijaya K. Shrestha

    2013-01-01

    Full Text Available Residential neighbourhoods developed using various techniques in Kathmandu by both the public and private sectors have not only provided a poor urban setting and failed to address socio-cultural needs, but are also poor at building a community and creating links to the built environment, with the result that the planned areas lack a sense of place and the inhabitants lack a feeling of home. Although traditional neighbourhoods in the historic core area had many features of a good residential neighbourhood in the past, they are currently undergoing rapid destruction. The residents of these neighbourhoods have little awareness of these issues. The existing legal and institutional frameworks are inadequate and ineffective and cannot address these problems, and so the formulation of design guidelines, their strict implementation, and enhancement of socio-cultural events including social networking are recommended for future residential neighbourhood development.

  9. Behavioral factors to include in guidelines for lifelong oral healthiness: an observational study in Japanese adults

    Directory of Open Access Journals (Sweden)

    Shimozato Miho

    2006-12-01

    Full Text Available Abstract Background The aim of this study was to determine which behavioral factors to include in guidelines for the Japanese public to achieve an acceptable level of oral healthiness. The objective was to determine the relationship between oral health related behaviors and symptoms related to oral disease and tooth loss in a Japanese adult community. Methods Oral health status and lifestyle were investigated in 777 people aged 20 years and older (390 men and 387 women. Subjects were asked to complete a postal questionnaire concerning past diet and lifestyle. The completed questionnaires were collected when they had health examinations. The 15 questions included their preference for sweets, how many between-meal snacks they usually had per day, smoking and drinking habits, presence of oral symptoms, and attitudes towards dental visits. Participants were asked about their behaviors at different stages of their life. The oral health examinations included examination of the oral cavity and teeth performed by dentists using WHO criteria. Odds ratios were calculated for all subjects, all 10 year age groups, and for subjects 30 years or older, 40 years or older, 50 years or older, and 60 years or older. Results Frequency of tooth brushing (OR = 3.98, having your own toothbrush (OR = 2.11, smoking (OR = 2.71 and bleeding gums (OR = 2.03 were significantly associated with number of retained teeth in males. Frequency of between-meal snacks was strongly associated with number of retained teeth in females (OR = 4.67. Having some hobbies (OR = 2.97, having a family dentist (OR = 2.34 and consulting a dentist as soon as symptoms occurred (OR = 1.74 were significantly associated with number of retained teeth in females. Factors that were significantly associated with tooth loss in both males and females included alcohol consumption (OR = 11.96, males, OR = 3.83, females, swollen gums (OR = 1.93, males, OR = 3.04, females and toothache (OR = 3.39, males, OR

  10. HOW TO INCLUDE KEY COMPETENCES IN THE COURSE PLAN

    OpenAIRE

    Benito García Peinado

    2009-01-01

    In our school we have decided to develop the teaching approaches to key competences through an organizational model that could be called "the model of the educational basic training". When suggesting new planning, we think that we must offer some solutions which start from the classroom routines and help us to choose the best aspects of these methods to improve them.

  11. Lupus nephritis management guidelines compared.

    Science.gov (United States)

    Wilhelmus, Suzanne; Bajema, Ingeborg M; Bertsias, George K; Boumpas, Dimitrios T; Gordon, Caroline; Lightstone, Liz; Tesar, Vladimir; Jayne, David R

    2016-06-01

    In the past years, many (randomized) trials have been performed comparing the treatment strategies for lupus nephritis. In 2012, these data were incorporated in six different guidelines for treating lupus nephritis. These guidelines are European, American and internationally based, with one separate guideline for children. They offer information on different aspects of the management of lupus nephritis including induction and maintenance treatment of the different histological classes, adjunctive treatment, monitoring of the patient, definitions of response and relapse, indications for (repeat) renal biopsy, and additional challenges such as the presence of vascular complications, the pregnant SLE patient, treatment in children and adolescents and considerations about end-stage renal disease and transplantation. In this review, we summarize the guidelines, determine the common ground between them, highlight the differences and discuss recent literature. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  12. Some Thoughts on Mexican Poverty Viewed from the Perspective of the World Population Plan of Action.

    Science.gov (United States)

    Serron, Luis A.

    The paper summarizes findings of a study of Mexican poverty (SO 010 522), and relates these findings to guidelines of the World Population Plan of Action. The study indicated that poverty in Mexico is based upon national and international economic, political, and social factors. Included among these factors are exploitation of labor, rapid…

  13. Planning for Action: The Impact of an Asthma Action Plan Decision Support Tool Integrated into an Electronic Health Record (EHR) at a Large Health Care System.

    Science.gov (United States)

    Kuhn, Lindsay; Reeves, Kelly; Taylor, Yhenneko; Tapp, Hazel; McWilliams, Andrew; Gunter, Andrew; Cleveland, Jeffrey; Dulin, Michael

    2015-01-01

    Asthma is a chronic airway disease that can be difficult to manage, resulting in poor outcomes and high costs. Asthma action plans assist patients with self-management, but provider compliance with this recommendation is limited in part because of guideline complexity. This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes. eAAP development occurred in 4 phases: web-based prototype creation, multidisciplinary team engagement, pilot, and system-wide dissemination. Medical record and hospital billing data compared frequencies of asthma exacerbations before and after eAAP receipt with matched controls. Between December 2012 and September 2014, 5174 patients with asthma (∼10%) received eAAPs. Results showed an association between eAAP receipt and significant reductions in pediatric asthma exacerbations, including 33% lower odds of requiring oral steroids (P < .001), compared with controls. Equivalent adult measures were not statistically significant. This study supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations. We show the feasibility of leveraging technology to provide guideline-based decision support through an eAAP, addressing known challenges of implementation into routine practice. © Copyright 2015 by the American Board of Family Medicine.

  14. Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Almind, Gert; Mäkelä, Marjukka

    2003-01-01

    OBJECTIVE: To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on dementia. DESIGN: Controlled before and after study using data records from regional laboratories. The guideline was mailed to all GPs. The multifaceted implementation...... strategy was planned with local GPs, and consisted of seminars, outreach visits, reminders and continuing medical education (CME) small group training. SETTING: Primary health care. SUBJECTS: 535 GP practices with 727 physicians in Denmark. MAIN OUTCOME MEASURES: The diffusion and use of the guideline...... of dementia in general practice. CONCLUSION: Although GPs regarded the guideline applicable in primary care, no change in practice adherence to guideline recommendations was detected after a multifaceted implementation....

  15. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water

  16. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water.

  17. Human-system interface design review guideline -- Process and guidelines: Final report. Revision 1, Volume 1

    International Nuclear Information System (INIS)

    1996-06-01

    NUREG-0700, Revision 1, provides human factors engineering (HFE) guidance to the US Nuclear Regulatory Commission staff for its: (1) review of the human system interface (HSI) design submittals prepared by licensees or applications for a license or design certification of commercial nuclear power plants, and (2) performance of HSI reviews that could be undertaken as part of an inspection or other type of regulatory review involving HSI design or incidents involving human performance. The guidance consists of a review process and HFE guidelines. The document describes those aspects of the HSI design review process that are important to the identification and resolution of human engineering discrepancies that could adversely affect plant safety. Guidance is provided that could be used by the staff to review an applicant's HSI design review process or to guide the development of an HSI design review plan, e.g., as part of an inspection activity. The document also provides detailed HFE guidelines for the assessment of HSI design implementations. NUREG-0700, Revision 1, consists of three stand-alone volumes. Volume 1 consists of two major parts. Part 1 describes those aspects of the review process of the HSI design that are important to identifying and resolving human engineering discrepancies. Part 2 contains detailed guidelines for a human factors engineering review which identify criteria for assessing the implementation of an applicant's or licensee's HSI design

  18. Cancer related fatigue: implementing guidelines for optimal management.

    Science.gov (United States)

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

    2017-07-18

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

  19. Effective operational oil spill response planning

    International Nuclear Information System (INIS)

    Meyers, R.J.

    1991-01-01

    An operational Contingency Plan is one of the single most important aspects of effective oil spill response operations. It is a spill control game plan. A thorough contingency plan provides a set of guidelines that can be used to help direct all phases of spill response activities. More than simple a compilation of lists and rosters, the contingency plan reflects strategic and philosophical elements of spill response that help to ensure a viable response to any spill incident. Facilities and oil carrying vessels should have well maintained contingency plans with these features. This paper describes the requirement for effective oil spill response pans and the training required to exercise them

  20. Iskuulpa Watershed Management Plan : A Five-Year Plan for Protecting and Enhancing Fish and Wildlife Habitats in the Iskuulpa Watershed.

    Energy Technology Data Exchange (ETDEWEB)

    Confederated Tribes of the Umatilla Indian Reservation Wildlife Program

    2003-01-01

    The Confederated Tribes of the Umatilla Indian Reservation (CTUIR) propose to protect, enhance, and mitigate wildlife and wildlife habitat and watershed resources in the Iskuulpa Watershed. The Iskuulpa Watershed Project was approved as a Columbia River Basin Wildlife Fish and Mitigation Project by the Bonneville Power Administration (BPA) and Northwest Power Planning Council (NWPPC) in 1998. Iskuulpa will contribute towards meeting BPA's obligation to compensate for wildlife habitat losses resulting from the construction of the John Day and McNary Hydroelectric facilities on the Columbia River. By funding the enhancement and operation and maintenance of the Iskuulpa Watershed, BPA will receive credit towards their mitigation debt. The purpose of the Iskuulpa Watershed management plan update is to provide programmatic and site-specific standards and guidelines on how the Iskuulpa Watershed will be managed over the next three years. This plan provides overall guidance on both short and long term activities that will move the area towards the goals, objectives, and desired future conditions for the planning area. The plan will incorporate managed and protected wildlife and wildlife habitat, including operations and maintenance, enhancements, and access and travel management.

  1. HOW TO INCLUDE KEY COMPETENCES IN THE COURSE PLAN

    Directory of Open Access Journals (Sweden)

    Benito García Peinado

    2009-04-01

    Full Text Available In our school we have decided to develop the teaching approaches to key competences through an organizational model that could be called "the model of the educational basic training". When suggesting new planning, we think that we must offer some solutions which start from the classroom routines and help us to choose the best aspects of these methods to improve them.

  2. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-01-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (Pabsenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

  3. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  4. Methodological guidelines

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Center for Plant Conservation's Best Practice Guidelines for the reintroduction of rare plants

    Institute of Scientific and Technical Information of China (English)

    Joyce Maschinski; Matthew A. Albrecht

    2017-01-01

    Recent estimates indicate that one-fifth of botanical species worldwide are considered at risk of becoming extinct in the wild. One available strategy for conserving many rare plant species is reintro-duction, which holds much promise especially when carefully planned by following guidelines and when monitored long-term. We review the Center for Plant Conservation Best Reintroduction Practice Guidelines and highlight important components for planning plant reintroductions. Before attempting reintro-ductions practitioners should justify them, should consider alternative conservation strategies, under-stand threats, and ensure that these threats are absent from any recipient site. Planning a reintroduction requires considering legal and logistic parameters as well as target species and recipient site attributes. Carefully selecting the genetic composition of founders, founder population size, and recipient site will influence establishment and population growth. Whenever possible practitioners should conduct rein-troductions as experiments and publish results. To document whether populations are sustainable will require long-term monitoring for decades, therefore planning an appropriate monitoring technique for the taxon must consider current and future needs. Botanical gardens can play a leading role in devel-oping the science and practice of plant reintroduction.

  7. Guidelines in lower-middle income countries.

    Science.gov (United States)

    Olayemi, Edeghonghon; Asare, Eugenia V; Benneh-Akwasi Kuma, Amma A

    2017-06-01

    Guidelines include recommendations intended to optimize patient care; used appropriately, they make healthcare consistent and efficient. In most lower-middle income countries (LMICs), there is a paucity of well-designed guidelines; as a result, healthcare workers depend on guidelines developed in Higher Income Countries (HICs). However, local guidelines are more likely to be implemented because they are applicable to the specific environment; and consider factors such as availability of resources, specialized skills and local culture. If guidelines developed in HICs are to be implemented in LMICs, developers need to incorporate local experts in their development. Involvement of local stakeholders may improve the rates of implementation by identifying and removing barriers to implementation in LMICs. Another option is to encourage local experts to adapt them for use in LMICs; these guidelines may recommend strategies different from those used in HICs, but will be aimed at achieving the best practicable standard of care. Infrastructural deficits in LMICs could be improved by learning from and building on the successful response to the human immunodeficiency virus/acquired immunodeficiency syndrome pandemic through interactions between HICs and LMICs. Similarly, collaborations between postgraduate medical colleges in both HICs and LMICs may help specialist doctors training in LMICs develop skills required for guideline development and implementation. © 2017 John Wiley & Sons Ltd.

  8. Planning procedures towards high climatic quality cities. Example referring to Lisbon

    Directory of Open Access Journals (Sweden)

    Maria João Alcoforado

    2006-12-01

    Full Text Available The different stages of research on high climatic quality city are presented in this paper: acquisition of appropriate urban climate information, analysis of different urban climate features and selection of planning strategies (accordingly with the climate zone. Then, with the aid of a GIS, systematic guidelines for planning can be given. As a result, different types of benefits for city dwellers are to be expected (comfort, health, economic. Lisbon is presented as a case study. It is shown how the “translation” of the knowledge of Lisbon’s urban climate into simple guidelines for urban planning in order to mitigate the urban heat island, promote ventilation and increase air quality, was carried out. To this end, maps of the physical features of the city of Lisbon were drawn, synthesised into “urban homogeneous units” map. Climate guidelines are specified for each of the six groups of units (brought together according to urban morphology, topography and position in town.

  9. Coastal Adaptation to Climate Change. Can the IPCC Technical Guidelines be applied?

    International Nuclear Information System (INIS)

    Klein, R.J.T.; Nicholls, R.J.; Mimura, Nobuo

    1999-01-01

    This paper evaluates the IPCC Technical Guidelines for Assessing Climate Change Impacts and Adaptations with respect to the guidance offered for coastal-adaptation assessment. It appears that the IPCC Technical Guidelines focus strongly on implementation. This paper uses both conceptual, and empirical information is used in this paper to show that coastal adaptation embraces more than selecting one of the 'technical' options to respond to sea-level rise (retreat, accommodate or protect). Coastal adaptation is a more complex and iterative process with a series of policy cycles. To be effective, an expanded adaptation framework involving four steps is suggested, including (1) information collection and awareness raising; (2) planning and design; (3) implementation, and (4) monitoring and evaluation. The incomplete coverage of these four steps in existing coastal-adaptation assessments constrains the development of adaptation strategies that are supported by the relevant actors and integrated into existing management. Researchers and policy-makers are recommended to work together to establish a framework for adaptation that is integrated within current coastal management processes and practices and takes a broader view on the subject. 46 refs

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

    Science.gov (United States)

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

    2011-01-01

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

  11. Japanese guidelines for allergic rhinitis 2017

    Directory of Open Access Journals (Sweden)

    Kimihiro Okubo

    2017-04-01

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

  12. SALTO guidelines. Guidelines for peer review of long term operation and ageing management of nuclear power plants

    International Nuclear Information System (INIS)

    2008-01-01

    The average age of nuclear power plants (NPPs) connected to the grid worldwide is increasing. About 20% of all the power reactors operating worldwide have been in operation for more than 30 years, and almost 50% have been in operation for 20 to 30 years, while a rather limited number of new NPPs are being put into operation. In view of this trend, many countries are giving a high priority to continuing the operation of NPPs beyond the time frame originally anticipated (e.g. 30 or 40 years). Long term operation (LTO) for NPPs is operation beyond the established time frame originally set forth by the license term, design limits, standards or regulations. LTO needs to be justified by a safety assessment considering life limiting processes and features for structures, systems and components. Proper and safe LTO is based on the experience and practices of various countries in areas such as plant license renewal, life extension, continued operation and life management. Other activities, including periodic safety review, ageing management and plant modification, are also relevant to LTO. Ageing management of an NPP is an important activity that must be considered before and in conjunction with the decision to enter LTO. Ageing management of NPPs deals with the physical ageing of structures, systems and components (SSCs) that can result in the degradation of their performance characteristics. Thus ageing management helps ensure that SSCs important to safety remain capable of performing their required safety functions. An effective ageing management programme (AMP) is a key element of the safe and reliable operation of NPPs during the originally planned time frame originally planned for their operation, as well as for the period of LTO. In order to assist Member States in managing ageing effectively, the IAEA is developing related safety standards and guidance publications. International peer review is a useful tool for Member States to exchange experience, learn from each

  13. Preparation of site emergency preparedness plans for nuclear installations

    International Nuclear Information System (INIS)

    1999-10-01

    Safety of public, occupational workers and the protection of environment should be assured while activities for economic and social progress are pursued. These activities include the establishment and utilisation of nuclear facilities and use of radioactive sources. This safety guidelines is issued as a lead document to facilitate preparation of specific site manuals by the responsible organisation for emergency response plans at each site to ensure their preparedness to meet any eventuality due to site emergency in order to mitigate its consequences on the health and safety of site personnel. It takes cognizance of an earlier AERB publications on the subject: Safety manual on site emergency plan on nuclear installations. AERB/SM/NISD-1, 1986 and also takes into consideration the urgent need for promoting public awareness and drawing up revised emergency response plans, which has come about in a significant manner after the accidents at Chernobyl and Bhopal

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

    Science.gov (United States)

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

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

  15. Assessment of LANL waste management site plan

    International Nuclear Information System (INIS)

    Black, R.L.; Davis, K.D.; Hoevemeyer, S.S.; Jennrich, E.A.; Lund, D.M.

    1991-04-01

    The objective of this report is to present findings from evaluating the Los Alamos National Laboratory (LANL) Waste Management Plan to determine if it meets applicable DOE requirements. DOE Order 5820.2A, Radioactive Waste Management, sets forth requirements and guidelines for the establishment of a Waste Management Plan. The primary purpose of a Waste Management Plan is to describe how waste operations are conducted, what facilities are being used to manage wastes, what forces are acting to change current waste management systems, and what plans are in store for the coming year

  16. Systematic analysis of the quality of the scientific evidence and conflicts of interest in osteoarthritis of the hip and knee practice guidelines.

    Science.gov (United States)

    Feuerstein, Joseph D; Pelsis, Jonathan R; Lloyd, Samuel; Cheifetz, Adam S; Stone, Kevin R

    2016-02-01

    To determine the validity of the hip and knee osteoarthritis guidelines. A systematic search of PubMed using a combination of Mesh and text terms with limitations to guidelines was performed to identify hip and knee osteoarthritis guidelines. The study was performed from April 17, 2014 to October 1, 2014. Guidelines were reviewed for graded levels of evidence, methods used to grade the evidence, and disclosures of conflicts of interest. Additionally, guidelines were also assessed for key quality measures using the AGREE II system for assessing the quality of guidelines. A total of 13 guidelines relevant to the diagnosis and/or treatment of hip/knee osteoarthritis was identified. The 180 recommendations reviewed were supported by 231 pieces of evidence. In total, 35% (n = 80; range: 0-26) were supported by level A evidence, 15% (n = 35; range: 0-10) were by level B, and 50% (n = 116; range: 0-62) were by level C. Median age of the guidelines was 4 years (±4.8; range: 0-16) with no comments on planned updates. In total, 31% of the guidelines included patients in the development process. Only one guideline incorporated cost consideration, and only 15% of the guidelines addressed the surgical management of osteoarthritis. Additionally, 46% of guidelines did not comment on conflicts of interest (COI). When present, there was an average 29.8 COI. Notably, 82% of the COI were monetary support/consulting. In total, 50% of the hip/knee osteoarthritis guideline recommendations are based on lower quality evidence. Nearly half the guidelines fail to disclose relevant COI and when disclosed, multiple potential COI are present. Future hip/knee osteoarthritis guideline development committees should strive to improve the transparency and quality of evidence used to formulate practice guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Operational environmental monitoring plan for the waste isolation pilot plant

    International Nuclear Information System (INIS)

    Mercer, D.D.; Baker, P.L.; Cockman, J.S.; Fischer, N.T.; Flynn, D.T.; Harvill, J.P.; Knudtsen, K.L.; Louderbough, E.T.

    1989-01-01

    This plan defines the scope and extent of the WIPP effluent and environmental monitoring programs during the facility's operational life. It also discusses the quality assurance/quality control programs which ensure that samples collected and the resulting analytical data are representative of actual conditions at the WIPP site. This plan provides a comprehensive description of environmental activities at WIPP, including: a summary of environmental program information, including an update of the status of environmental permits and compliance activities; a description of the WIPP project and its mission; a description of the local environment, including demographics; a summary of applicable standards and regulatory requirements and brief discussions of potential exposure pathways, routine and accidental releases, and their consequences; a summary of the preoperational environmental monitoring and assessment activities and responses to the requirements (Appendix A) and guidelines presented in the ''Radiological Effluent Monitoring and Environmental Surveillance for US DOE Operations.'' 166 refs., 28 figs., 27 tabs

  18. [Standards and guidelines of radiation protection and safety in dental X-ray examinations].

    Science.gov (United States)

    Guo, X L; Li, G; Cheng, Y; Yu, Q; Wang, H; Zhang, Z Y

    2017-12-09

    With the rapid development of imaging technology, the application of dental imaging in diagnosis, treatment planning, intraoperative surgical navigation, monitoring of treatment or lesion development and assessment of treatment outcomes is playing an essential role in oral healthcare. The increased total number of dental X-ray examinations is accompanied by a relatively significant increase in collective dose to patients as well as to dental healthcare workers, which is harmful to human bodies to a certain degree. Some radiation protection standards and guidelines in dental radiology have been published in European countries, US, Canada and Australia, etc. Adherence to these standards and guidelines helps to achieve images with diagnostic quality and avoid unnecessary and repeated exposures. However, no radiation protection standard or guideline with regard to dental X-ray examinations has been put in force so far in mainland China. Therefore, a literature review on available radiation protection standards and guidelines was conducted to provide reference to the development of radiation protection standards or guidelines in mainland China.

  19. Computed tomography-based treatment planning for high-dose-rate brachytherapy using the tandem and ring applicator: influence of applicator choice on organ dose and inter-fraction adaptive planning

    Directory of Open Access Journals (Sweden)

    Vishruta A. Dumane

    2017-06-01

    Full Text Available Three dimensional planning for high-dose-rate (HDR brachytherapy in cervical cancer has been highly recommended by consensus guidelines such as the American Brachytherapy Society (ABS and the Groupe Européen de Curiethérapie – European Society for Radiotherapy and Oncology (GEC-ESTRO. In this document, we describe our experience with computed tomography (CT-based planning using the tandem/ring applicator. We discuss the influence of applicator geometry on doses to organs at risk (OARs, namely the bladder, rectum, and sigmoid. Through example cases with dose prescribed to point A, we demonstrate how adaptive planning can help achieve constraints to the OARs as per guidelines.

  20. Manual for implementing residual radioactivity guidelines

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Eckerman, K.F.; Hansen, W.R.; Healy, J.W.; Kennedy, W.E.; Napier, B.A.; Solday, J.K.

    1986-01-01

    The US Department of Energy (DOE) has recently issued guidelines for residual radioactivity at Formerly Utilized Sites Remedial Action Program (FUSRAP) and remote Surplus Facilities Management Program (SFMP) sites. A manual for implementing these guidelines has been prepared jointly by four DOE laboratories (ANL, LANL, ORNL, and PNL) and is being issued as a supplement to the guidelines. The manual presents procedures and tables for deriving site-specific guidelines for levels of residual radionuclide concentrations in soil that must not be exceeded if a site is to be released for unrestricted use. Guidance for implementing DOE ALARA policy for remedial actions is also included. The concentration factor method is used in the pathway analysis for deriving soil guidelines. The analysis has been structured in a manner that explicitly identifies all of the factors involved. Tables are provided for dose-conversion factors and pathway factors from which environmental transport factors for each radionuclide and pathway may be calculated. The scenarios used for deriving the environmental transport factors and dose conversion factors, and the manner in which the information provided in the manual is used to derive site-specific soil guidelines will be presented

  1. Surveys on Reporting Guideline Usage in Dental Journals.

    Science.gov (United States)

    Hua, F; Walsh, T; Glenny, A-M; Worthington, H

    2016-10-01

    The objectives of this study were 1) to find out if and how authors and peer reviewers for dental journals are encouraged to use reporting guidelines (RGs); 2) to identify factors related to RG endorsement; and 3) to assess the knowledge, opinions, and future plans of dental journal editors in chief (EICs) on RGs. A total of 109 peer-reviewed and original research-oriented dental journals that were indexed in the MEDLINE and/or SCIE database in 2015 were included. The "instructions to authors" and "instructions to reviewers" of these journals were identified and retrieved from journals' official websites. Any mention of RGs or other related policies were sought and extracted. In addition, an anonymous survey of the EICs of the included journals was conducted with a validated questionnaire. All 109 journals provided "instructions to authors," among which 55 (50.5%) mentioned RGs. Only the CONSORT (45.0%), PRISMA (13.8%), and STROBE (12.8%) guidelines were mentioned by >10% of the included journals. Statistical analyses suggest that RGs were more frequently mentioned by SCIE-indexed journals (P journals (P = 0.002), and journals that endorsed the ICMJE recommendations (P journals (8.3%), 3 of which mentioned RGs. For the EIC survey, the response rate was 32.1% (35 of 109). Twenty-six editors (74.3%) stated that they knew what RGs were before receiving our questionnaire. Twenty-four editors (68.6%) believed that RGs should be adopted by all refereed dental journals where appropriate. RGs are important tools for enhancing research reporting and reducing avoidable research waste, but currently they are not widely endorsed by dental journals. Joint efforts by all stakeholders to further promote RG usage in dentistry are needed. © International & American Associations for Dental Research 2016.

  2. Optimality of profit-including prices under ideal planning.

    Science.gov (United States)

    Samuelson, P A

    1973-07-01

    Although prices calculated by a constant percentage markup on all costs (nonlabor as well as direct-labor) are usually admitted to be more realistic for a competitive capitalistic model, the view is often expressed that, for optimal planning purposes, the "values" model of Marx's Capital, Volume I, is to be preferred. It is shown here that an optimal-control model that maximizes discounted social utility of consumption per capita and that ultimately approaches a steady state must ultimately have optimal pricing that involves equal rates of steady-state profit in all industries; and such optimal pricing will necessarily deviate from Marx's model of equal rates of surplus value (markups on direct-labor only) in all industries.

  3. Approaches to radiation guidelines for space travel

    International Nuclear Information System (INIS)

    Fry, R.J.M.

    1984-01-01

    There are obvious risks in space travel that have loomed larger than any risk from radiation. Nevertheless, NASA has maintained a radiation program that has involved maintenance of records of radiation exposure, and planning so that the astronauts' exposures are kept as low as possible, and not just within the current guidelines. These guidelines are being reexamined currently by NCRP Committee 75 because new information is available, for example, risk estimates for radiation-induced cancer and about the effects of HZE particles. The current career limit is 400 rem to the blood forming organs. The appropriateness of this limit and its basis are being examined as well as the limits for specific organs. There is now considerably more information about age-dependency for radiation effects and this will be taken into account. In 1973 a committee of the National Research Council made a separate study of HZE particle effects and it was concluded that the attendant risks did not pose a hazard for low inclination near-earth orbit missions. Since that time work has been carried out on the so-called microlesions caused by HZE particles and on the relative carcinogenic effect of heavy ions, including iron. A remaining question is whether the fluence of HZE particles could reach levels of concern in missions under consideration. Finally, it is the intention of the committee to indicate clearly the areas requiring further research. 26 references, 1 figure, 7 tables

  4. Methodological Quality of Consensus Guidelines in Implant Dentistry.

    Science.gov (United States)

    Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

    2017-01-01

    Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions.

  5. Readability, suitability, and characteristics of asthma action plans: examination of factors that may impair understanding.

    Science.gov (United States)

    Yin, H Shonna; Gupta, Ruchi S; Tomopoulos, Suzy; Wolf, Michael S; Mendelsohn, Alan L; Antler, Lauren; Sanchez, Dayana C; Lau, Claudia Hillam; Dreyer, Benard P

    2013-01-01

    Recognition of the complexity of asthma management has led to the development of asthma treatment guidelines that include the recommendation that all pediatric asthma patients receive a written asthma action plan. We assessed the readability, suitability, and characteristics of asthma action plans, elements that contribute to the effectiveness of action plan use, particularly for those with limited literacy. This was a descriptive study of 30 asthma action plans (27 state Department of Health (DOH)-endorsed, 3 national action plans endorsed by 6 states). (1) readability (as assessed by Flesch Reading Ease, Flesch-Kincaid, Gunning Fog, Simple Measure of Gobbledygook, Forcast), (2) suitability (Suitability Assessment of Materials [SAM], adequate: ≥ 0.4; unsuitable: typography (30.0%), learning stimulation/motivation (26.7%), and graphics (13.3%). There were no statistically significant differences between the average grade level or SAM score of state DOH developed action plans and those from or adapted from national organizations. Plans varied with respect to terms used, symptoms included, and recommended actions. Specific improvements in asthma action plans could maximize patient and parent understanding of appropriate asthma management and could particularly benefit individuals with limited literacy skills.

  6. Provision of Family Planning Services in Tanzania: A Comparative ...

    African Journals Online (AJOL)

    Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health ...

  7. Preliminary study for the National Energy Plan (PEN) uses the Community market as a reference base. El ante-proyecto del Plan Energetico Nacional (PEN) toma referencia basica del mercado comunitario

    Energy Technology Data Exchange (ETDEWEB)

    1991-11-01

    The National Energy Plan (PEN) for the period 1991 to 2000 lays down basic guidelines for a Spanish energy policy. This includes a wide range of economic measures. The PEN is divided into five main sections with two appendices. The sections are: the international situation; energy demand; energy supply; energy and the environment; and R D policy. The appendices are: Energy-saving and energy-efficiency plan; and General plan for radioactive waste. The PEN provides for 4-year research programmes which aim to reduce the environmental impact of energy production and use. General demand for energy during this period will increase by2.4% and investment in power installations and in the gas sector will be some 1.5 thousand million pesetas. 4 figs., 3 tabs.

  8. Formalized 2003 European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

    Czech Academy of Sciences Publication Activity Database

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

    2004-01-01

    Roč. 25, - (2004), s. 444 ISSN 0195-668X. [ESC Congress 2004. 28.08.2004-01.09.2004, Munich] Institutional research plan: CEZ:AV0Z1030915 Keywords : formalized European guidelines on CVD prevention * computer GLIF model * decision algorithm Subject RIV: BD - Theory of Information

  9. Radon legislation and national guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Aakerblom, G

    1999-07-01

    The International Commission on Radiological Protection (ICRP) and The Council of the European Union have recommended the Member States to take action against radon in homes and at workplaces. Within the EU project European Research into Radon in Construction Concerted Action, ERRICCA, the Topic Group on Legal and Building Code Impact was designated to study the current radon legislation and give advice regarding future enactment of laws and recommendations. On behalf of the Group, a questionnaire on radon legislation was sent out to nearly all European states and a selection of non-European states. Questions were asked regarding reference levels for dwellings, workplaces and drinking water, and about regulations or recommendations for building materials and city planning. All 15 EU Member States, 17 non-EU European countries and 10 non-European countries responded to the questionnaire. Their answers are considered current as of the end of 1998. Most European States and many non-European countries have recommended reference levels for dwellings and workplaces, and some have guidelines for measures against radon incorporated in their building codes and guidelines for construction techniques. However, only a few countries have enforced reference levels or regulations for planning and construction. The reference levels for indoor radon concentration in existing and new dwellings or workplaces are within the range 150-1000 Bq/m{sup 3}. Sweden is the only country (Out of 15 EU member states) which has enforced limits for existing dwellings. Sweden and the UK have both enforced levels for new dwellings. 7 non-European countries (Out of 17 responding countries) have enforced levels for existing dwellings and 9 have them for new dwellings. At the end of 1998, only Finland, Sweden, the Czech Republic, Romania, Russia and the Slovak Republic had limits for radon in water, although 8 countries were planning to introduce such limits. The present limits are within the range for

  10. Radon legislation and national guidelines

    International Nuclear Information System (INIS)

    Aakerblom, G.

    1999-07-01

    The International Commission on Radiological Protection (ICRP) and The Council of the European Union have recommended the Member States to take action against radon in homes and at workplaces. Within the EU project European Research into Radon in Construction Concerted Action, ERRICCA, the Topic Group on Legal and Building Code Impact was designated to study the current radon legislation and give advice regarding future enactment of laws and recommendations. On behalf of the Group, a questionnaire on radon legislation was sent out to nearly all European states and a selection of non-European states. Questions were asked regarding reference levels for dwellings, workplaces and drinking water, and about regulations or recommendations for building materials and city planning. All 15 EU Member States, 17 non-EU European countries and 10 non-European countries responded to the questionnaire. Their answers are considered current as of the end of 1998. Most European States and many non-European countries have recommended reference levels for dwellings and workplaces, and some have guidelines for measures against radon incorporated in their building codes and guidelines for construction techniques. However, only a few countries have enforced reference levels or regulations for planning and construction. The reference levels for indoor radon concentration in existing and new dwellings or workplaces are within the range 150-1000 Bq/m 3 . Sweden is the only country (Out of 15 EU member states) which has enforced limits for existing dwellings. Sweden and the UK have both enforced levels for new dwellings. 7 non-European countries (Out of 17 responding countries) have enforced levels for existing dwellings and 9 have them for new dwellings. At the end of 1998, only Finland, Sweden, the Czech Republic, Romania, Russia and the Slovak Republic had limits for radon in water, although 8 countries were planning to introduce such limits. The present limits are within the range for 50

  11. Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Tsima BM

    2016-08-01

    Full Text Available Billy M Tsima,1 Vincent Setlhare,1 Oathokwa Nkomazana2 1Department of Family Medicine and Public Health, 2Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana Background: Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers.Methods: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list.Results: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed.Conclusion: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better

  12. Including the Consumer and Environment in Occupational Therapy Treatment Planning.

    Science.gov (United States)

    Brown, Catana; Bowen, Robin E.

    1998-01-01

    Occupational therapists (n=29) completed treatment plans based on case study data. Analysis indicated they often identified goals not addressed by the consumer/client. They significantly selected more simulated than real activities and more activities designed to change the person rather than the environment. (SK)

  13. Osteoarthritis guidelines: a progressive role for topical nonsteroidal anti-inflammatory drugs

    Directory of Open Access Journals (Sweden)

    Stanos SP

    2013-04-01

    Full Text Available Steven P Stanos Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, IL, USA Abstract: Current treatment guidelines for the treatment of chronic pain associated with osteoarthritis reflect the collective clinical knowledge of international experts in weighing the benefits of pharmacologic therapy options while striving to minimize the negative effects associated with them. Consideration of disease progression, pattern of flares, level of functional impairment or disability, response to treatment, coexisting conditions such as cardiovascular disease or gastrointestinal disorders, and concomitant prescription medication use should be considered when creating a therapeutic plan for a patient with osteoarthritis. Although topical nonsteroidal anti-inflammatory drugs historically have not been prevalent in many of the guidelines for osteoarthritis treatment, recent evidence-based medicine and new guidelines now support their use as a viable option for the clinician seeking alternatives to typical oral formulations. This article provides a qualitative review of these treatment guidelines and the emerging role of topical nonsteroidal anti-inflammatory drugs as a therapy option for patients with localized symptoms of osteoarthritis who may be at risk for oral nonsteroidal anti-inflammatory drug-related serious adverse events. Keywords: osteoarthritis, nonsteroidal anti-inflammatory drugs, guidelines, topical analgesics, diclofenac

  14. [Pediatric drug development: ICH harmonized tripartite guideline E11 within the United States of America, the European Union, and Japan].

    Science.gov (United States)

    Pflieger, M; Bertram, D

    2014-10-01

    To address the lack of appropriate pediatric drugs available on the global market, in 2000 the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) issued the ICH E11 guideline regarding the Clinical Investigation of Medicinal Products in the Pediatric Population. This guideline considerably changes the environment of drug development for children. It has been written specifically to harmonize, promote, and facilitate high-quality and ethical clinical research for children within the ICH regions, i.e., the United States of America (USA), the European Union (EU), and Japan. This article details the various regulations applicable in each ICH region following the publication of the guideline. The framework of rewards, incentives, and obligations for pharmaceutical companies established for the development of pediatric drugs are compared. It appears that the USA and the EU have both developed specific regulations for pediatric drug development while Japan has not. However, in Japan, pharmaceutical companies (PCs) are encouraged to develop pediatric drugs voluntarily, and they may be granted additional months of market exclusivity or the postponement of the drug re-examination deadline. In both the USA and the EU, regulations aimed to increase the number of clinical studies conducted in children, in order to ensure that the necessary data are generated, determining the conditions in which a drug may be authorized to treat the pediatric population. PCs are encouraged to develop pediatric assessment, including pediatric clinical trials, which is described in a pediatric plan submitted to the relevant authorities. A system of rewards for PCs submitting an application for marketing authorization containing pediatric use information has been put in place to cover the additional investment for testing drugs in children. Subject to conditions, these rewards consist in a 6-month extension of the patent or

  15. A comparative review of pharmacoeconomic guidelines.

    Science.gov (United States)

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

    1995-09-01

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

  16. 340 Facility maintenance implementation plan

    International Nuclear Information System (INIS)

    1995-03-01

    This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements

  17. 340 Facility maintenance implementation plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements.

  18. 42 CFR 81.24 - Guidelines for leukemia.

    Science.gov (United States)

    2010-10-01

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

  19. Towards a national burns disaster plan | Rogers | South African ...

    African Journals Online (AJOL)

    The International Society for Burns Injuries (ISBI) has published guidelines for the management of multiple or mass burns casualties, and recommends that 'each country has or should have a disaster planning system that addresses its own particular needs. The need for a national burns disaster plan integrated with ...

  20. 29 CFR 778.214 - Benefit plans; including profit-sharing plans or trusts providing similar benefits.

    Science.gov (United States)

    2010-07-01

    ... fide plan for providing old age, retirement, life, accident, or health insurance or similar benefits... employee on account of severance of employment (or for any other reason) would not result in any increase... mechanics performing contract work subject to the Davis-Bacon Act and related statutes, the provisions of...

  1. Do we need an emergency planning for contamination with alpha or beta emitting materials and how should this be?

    International Nuclear Information System (INIS)

    Gellermann, Rainer; Kueppers, Christian; Urbach, Michael; Schnadt, Horst; Lange, Florentin

    2016-01-01

    The emergency planning up to now was geared to the consequences of accidents in nuclear facilities. There were no planning guidelines like the recommendations for emergency planning in the vicinity of nuclear facilities for other radiological incidents. According to article 98 of the new European radiation protection standards the member states have to take care for the preparation of emergency plans fir the case of emergency exposure scenarios. The study discusses several scenarios that might induce alpha or beta contamination, existing approaches for guiding contamination values, intervention benchmarks, protection strategies including continuing public information, selected radionuclides that might be involved, exposure paths, guidance benchmarks for person decontamination, and recommendations for new emergency plans.

  2. Human-system interface design review guideline -- Process and guidelines: Final report. Revision 1, Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    None

    1996-06-01

    NUREG-0700, Revision 1, provides human factors engineering (HFE) guidance to the US Nuclear Regulatory Commission staff for its: (1) review of the human system interface (HSI) design submittals prepared by licensees or applications for a license or design certification of commercial nuclear power plants, and (2) performance of HSI reviews that could be undertaken as part of an inspection or other type of regulatory review involving HSI design or incidents involving human performance. The guidance consists of a review process and HFE guidelines. The document describes those aspects of the HSI design review process that are important to the identification and resolution of human engineering discrepancies that could adversely affect plant safety. Guidance is provided that could be used by the staff to review an applicant`s HSI design review process or to guide the development of an HSI design review plan, e.g., as part of an inspection activity. The document also provides detailed HFE guidelines for the assessment of HSI design implementations. NUREG-0700, Revision 1, consists of three stand-alone volumes. Volume 1 consists of two major parts. Part 1 describes those aspects of the review process of the HSI design that are important to identifying and resolving human engineering discrepancies. Part 2 contains detailed guidelines for a human factors engineering review which identify criteria for assessing the implementation of an applicant`s or licensee`s HSI design.

  3. Guideline for fluoroscopy of low gastrointestinal tract in pediatrics

    International Nuclear Information System (INIS)

    Chang, Yun Woo; Jeon, Tae Yeon; Kim, Ji Hye; Lee, Mi Jung; Lim, Yun Jung; Yoon, Hye Kyung; Lim, Gye Yeon; Lee, Hee Jung

    2015-01-01

    Although the availability of CT, MRI and endoscopy has resulted in a marked decline in fluoroscopic procedures in adult patients, fluoroscopy remains an important and frequently used procedure in pediatric patients because there is no appropriate choice of diagnostic imaging or treatment modality for certain diseases. The Korean Society of Pediatric Radiology has formulated evidence-based guidelines for fluoroscopy of the lower intestinal tract in the pediatric population (under age 18 including neonates) in order to assist physicians in clinical practice. The guidelines offer standards of examination practice including radiation doses that are as low as reasonably achievable for children under 18 years old, including neonates, for fluoroscopy of the lower intestinal tract, which has typically used relatively high doses. The recommendations of these guidelines should not be used as an absolute standard, and physicians should always refer to methods that do not adhere to the guidelines when those methods are considered more reasonable and beneficial to an individual patient's medical situation

  4. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Comparison of Western and Asian Guidelines Concerning the Management of Colon Cancer.

    Science.gov (United States)

    Pellino, Gianluca; Warren, Oliver; Mills, Sarah; Rasheed, Shahnawaz; Tekkis, Paris P; Kontovounisios, Christos

    2018-02-01

    Guidelines are important to standardize treatments and optimize outcomes. Several societies have published authoritative guidelines for patients with colon cancer, and a certain degree of variation can be predicted. This study aims to compare Western and Asian guidelines for the management of colon cancer. A literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies published between 2010 and 2017 by the online resources from the official Web sites of the societies/panels. Sources included guidelines by European Society of Medical Oncology, the Japanese Society for Cancer of the Colon and Rectum, and the National Comprehensive Cancer Network. Only full-text studies and the latest guidelines dealing with colon cancer were included. Studies and guidelines were separately assessed by 2 authors, who independently identified discrepancies and areas for further research. These were discussed and agreed with by all the authors. The recommendations of the guidelines of each society were compared, seeking discrepancies and potential areas for improvement. Endoscopic techniques for the management of early colon cancer are discussed in detail in the Asian guidelines. Asian guidelines advocate extended (D3) lymphadenectomy on a routine basis in T3/T4 and in selected T2 patients, whereas such an approach is still under investigation in Western countries. Only US guidelines describe neoadjuvant chemotherapy and radiotherapy. All the guidelines recommend adjuvant treatment in selected stage II patients, but agreement exists that this is performed without solid evidence, because better outcomes are hypothesized based on studies including stage III or stage II/III patients. The role of cytoreductive surgery with intra-abdominal chemotherapy is dubious, and European guidelines only recommend it in the setting of trials. Asian guidelines endorse an aggressive surgical approach to peritoneal disease. Only US

  7. Measure Guideline. High Efficiency Natural Gas Furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L. [Partnership for Advanced Residential Retrofit (PARR), Des Plaines, IL (United States); Rose, W. [Partnership for Advanced Residential Retrofit (PARR), Des Plaines, IL (United States)

    2012-10-01

    This measure guideline covers installation of high-efficiency gas furnaces, including: when to install a high-efficiency gas furnace as a retrofit measure; how to identify and address risks; and the steps to be used in the selection and installation process. The guideline is written for Building America practitioners and HVAC contractors and installers. It includes a compilation of information provided by manufacturers, researchers, and the Department of Energy as well as recent research results from the Partnership for Advanced Residential Retrofit (PARR) Building America team.

  8. Savannah River Site Environmental Monitoring Plan. Volume 1, Section 1000 Addendum: Revision 3

    International Nuclear Information System (INIS)

    Jannik, G.T.

    1994-01-01

    This document -- the Savannah River Site Environmental Monitoring Plan (SRS EM Plan) -- has been prepared according to guidance contained in the DOE 5400 Series orders, in 10 CFR 834, and in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and environmental Surveillance [DOE, 1991]. The SRS EM Plan's purpose is to define the criteria, regulations, and guideline requirements with which SRS will comply. These criteria and requirements are applicable to environmental monitoring activities performed in support of the SRS Environmental Monitoring Program (SRS EM Program), WSRC-3Q1-2, Volume 1, Section 1100. They are not applicable to monitoring activities utilized exclusively for process monitoring/control. The environmental monitoring program requirements documented in the SRS EM Plan incorporate all applicable should requirements of DOE/EH-0173T and expand upon them to include nonradiological environmental monitoring program requirements

  9. Federal guidelines for estimating external exposure of radiation workers in Russia

    International Nuclear Information System (INIS)

    Chizhov, K.; Kryuchkov, V.; Mark, N.K.; Szoeke, I.; Sneve, M.K.

    2017-01-01

    In this paper, an overview of Russian federal guidelines for optimizing work procedures in terms of radiation protection for planned field work is presented. The general provisions, procedures and methods for applying the principles of optimization are provided in accordance with the Radiation Safety Standards (NRB-99/2009) and Basic sanitary rules of radiation safety (OSPORB-99/2010). Jobs in environments with actual or potential radiation hazards shall be planned on the basis of the principle of optimization in order to prevent unexpected exposure of the personnel. Control and optimization of dose to workers is a continuous process, which is carried out at various stages of radiation-hazardous work under constant involvement of the personnel in the planning procedure. Implementation of the principle of optimization should include considerations for human and organizational aspects for ensuring high level safety. The planning and optimization process includes education and training of personnel, estimation of radiation doses for the upcoming work, preparations for unplanned situations, and implementation of practical safety measures within the targeted radiation-hazardous works. The optimization principle is most important in the planning phase where uncertainties in planned exposure must be considered. Variability of radiation risks related to different scenarios (choices) can be managed by modern simulation technology, and use of advanced tools (software) for simulating planned activities and conditions in digital models including the environment (premises of an industrial complex) with dynamic visualization of the radiation exposure conditions. Existing hardware and emerging information technologies allow practical application of such techniques. Application of advanced information technology can reduce uncertainties related to the radiation environment by turning invisible radiation into directly perceivable risk information. In addition, virtual reality

  10. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-10-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

  11. Workplace health and safety during pandemic influenza : CAGC guideline

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-11-15

    Pandemic influenza is a possible biological hazard that employers must take into account during hazard assessment and emergency planning. This report presented a guideline to all workplaces in Alberta and provided information on legislated requirements, best practices, guidelines and strategies in workplace health and safety and employment standards in the event of a pandemic influenza. The report explained the difference between a pandemic and a pandemic influenza, and why scientists expect another pandemic influenza. Pandemic influenza was described as being different from seasonal influenza. This document also explained how pandemic influenza relates to the worker and the workplace, and how the workplace can prepare for and respond to pandemic influenza. Pandemic influenza hazard categories were also listed along with steps in the hazard assessment and control of pandemic influenza. The steps involve listing the types of work and work-related activities; identifying the hazard; assessing the hazards; implementing controls; communicating the information to workers and providing training; and evaluating the effectiveness of controls. The guide also addressed emergency response plan development for pandemic influenza; first aid; and employment standards during pandemic influenza. refs., tabs.

  12. Oxytocin augmentation during labor: how to implement medical guidelines into clinical practice.

    Science.gov (United States)

    Holmgren, Stina; Silfver, Kristina Gren; Lind, Cecilia; Nordström, Lennart

    2011-11-01

    To describe an extensive process to implement guidelines for oxytocin use during labor and to report its effects on compliance to clinical practice guidelines after 1 year. A multifaceted strategy was developed to involve all obstetric staff and identify possible local barriers to change in advance. The process lasted for more than 1 year. To describe the implementation of oxytocin use according to the new guidelines, and to compare management in clinical practice with guideline recommendations from audits performed before and after the project. Identification of possible barriers to change, academic detailing, audits with feedback, and local opinion leaders were important factors for a successful process. Documentation of the indication for oxytocin use increased from 54% before, to 86% after the completion of the project (Pcheck list to monitor oxytocin use. However, audits with feedback need to continue for medical safety, and have been planned to take place every 6 months. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. 2014 UK national guideline for the management of anogenital herpes.

    Science.gov (United States)

    Patel, Raj; Green, John; Clarke, Emily; Seneviratne, Kanchana; Abbt, Naomi; Evans, Ceri; Bickford, Jane; Nicholson, Marian; O'Farrell, Nigel; Barton, Simon; FitzGerald, Mark; Foley, Elizabeth

    2015-10-01

    These guidelines concern the management of anogenital herpes simplex virus infections in adults and give advice on diagnosis, management, and counselling of patients. This guideline replaces the 2007 BASHH herpes guidelines and includes new sections on herpes proctitis, key points to cover with patients regarding transmission and removal of advice on the management of HSV in pregnancy which now has a separate joint BASHH/RCOG guideline. © The Author(s) 2015.

  14. Progress and challenges in freshwater conservation planning

    CSIR Research Space (South Africa)

    Nel, JL

    2009-06-01

    Full Text Available are suggested for promoting effective implementation: assessing socioeconomic and institutional contexts, promoting cooperation, and embedding plans within a monitoring and evaluation framework. These guidelines are based on experiences from integrated water...

  15. Urgent need to reevaluate the latest World Health Organization guidelines for toxic inorganic substances in drinking water.

    Science.gov (United States)

    Frisbie, Seth H; Mitchell, Erika J; Sarkar, Bibudhendra

    2015-08-13

    The World Health Organization (WHO) has established guidelines for drinking-water quality that cover biological and chemical hazards from both natural and anthropogenic sources. In the most recent edition of Guidelines for Drinking-water Quality (2011), the WHO withdrew, suspended, did not establish, or raised guidelines for the inorganic toxic substances manganese, molybdenum, nitrite, aluminum, boron, nickel, uranium, mercury, and selenium. In this paper, we review these changes to the WHO drinking-water guidelines, examining in detail the material presented in the WHO background documents for each of these toxic substances. In some cases, these WHO background documents use literature reviews that do not take into account scientific research published within the last 10 or more years. In addition, there are instances in which standard WHO practices for deriving guidelines are not used; for example, rounding and other mathematical errors are made. According to published meeting reports from the WHO Chemical Aspects Working Group, the WHO has a timetable for revising some of its guidelines for drinking-water quality, but for many of these toxic substances the planned changes are minimal or will be delayed for as long as 5 years. Given the limited nature of the planned WHO revisions to the inorganic toxic substances and the extended timetable for these revisions, we suggest that governments, researchers, and other stakeholders might establish independent recommendations for inorganic toxic substances and possibly other chemicals to proactively protect public health, or at the very least, revert to previous editions of the Guidelines for Drinking-water Quality, which were more protective of public health.

  16. Maintenance implementation plan for fuel supply shutdown

    International Nuclear Information System (INIS)

    Stephenson, R.L.

    1995-06-01

    This Maintenance Implementation Plan is written to satisfy the requirements of DOE Order 4330.4B, ''MAINTENANCE MANAGEMENT PROGRAM'', that specifies the general policy and objectives for the establishment of DOE controlled maintenance programs. These Programs provide for the management and performance of cost-effective maintenance and repair of Department of Energy (DOE) property, which includes facilities. A review of DOE Order 4330.4B, particularly Chapter II the nuclear portion, against existing WHC site programs and policies has provided assurance that most requirements of this order have already been implemented by existing WHC programs. Applicable requirements and guidelines of 4330.4B that are deficient or not implemented are presently being developed and implemented through WHC site policies and programs. Where no program is presently identified or being developed for 4330.4B requirements, responsibility for implementation has been assigned within this plan

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

    Science.gov (United States)

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

    2006-06-01

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

  18. Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul Dlpm; Frith, Peter A; Zwerink, Marlies; Monninkhof, Evelyn M; van der Palen, Job; Effing, Tanja W

    2017-08-04

    Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease. Exacerbation action plans are considered to be a key component of COPD self-management interventions. Studies assessing these interventions show contradictory results. In this Cochrane Review, we compared the effectiveness of COPD self-management interventions that include action plans for acute exacerbations of COPD (AECOPD) with usual care. To evaluate the efficacy of COPD-specific self-management interventions that include an action plan for exacerbations of COPD compared with usual care in terms of health-related quality of life, respiratory-related hospital admissions and other health outcomes. We searched the Cochrane Airways Group Specialised Register of trials, trials registries, and the reference lists of included studies to May 2016. We included randomised controlled trials evaluating a self-management intervention for people with COPD published since 1995. To be eligible for inclusion, the self-management intervention included a written action plan for AECOPD and an iterative process between participant and healthcare provider(s) in which feedback was provided. We excluded disease management programmes classified as pulmonary rehabilitation or exercise classes offered in a hospital, at a rehabilitation centre, or in a community-based setting to avoid overlap with pulmonary rehabilitation as much as possible. Two review authors independently assessed trial quality and extracted data. We resolved disagreements by reaching consensus or by involving a third review author. Study authors were contacted to obtain additional information and missing outcome data where possible. When appropriate, study results were pooled using a random-effects modelling meta-analysis. The primary

  19. Osteoarthritis guidelines: a progressive role for topical nonsteroidal anti-inflammatory drugs.

    Science.gov (United States)

    Stanos, Steven P

    2013-01-01

    Current treatment guidelines for the treatment of chronic pain associated with osteoarthritis reflect the collective clinical knowledge of international experts in weighing the benefits of pharmacologic therapy options while striving to minimize the negative effects associated with them. Consideration of disease progression, pattern of flares, level of functional impairment or disability, response to treatment, coexisting conditions such as cardiovascular disease or gastrointestinal disorders, and concomitant prescription medication use should be considered when creating a therapeutic plan for a patient with osteoarthritis. Although topical nonsteroidal anti-inflammatory drugs historically have not been prevalent in many of the guidelines for osteoarthritis treatment, recent evidence-based medicine and new guidelines now support their use as a viable option for the clinician seeking alternatives to typical oral formulations. This article provides a qualitative review of these treatment guidelines and the emerging role of topical nonsteroidal anti-inflammatory drugs as a therapy option for patients with localized symptoms of osteoarthritis who may be at risk for oral nonsteroidal anti-inflammatory drug-related serious adverse events.

  20. Formalized Medical Guidelines and a Structured Electronic Health Record.

    Czech Academy of Sciences Publication Activity Database

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

    2005-01-01

    Roč. 11, - (2005), s. 4652-4656 ISSN 1727-1983. [EMBEC'05. European Medical and Biomedical Conference /3./. Prague, 20.11.2005-25.11.2005] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : formalization of guidelines in cardilogy * GLIF model * structure electronic health record * algorithm in cardiovascular diagnostics and treatment Subject RIV: BD - Theory of Information

  1. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Eschner, W.; Luster, M.; Reiners, C.; Schober, O.; Muenster Univ.

    2007-01-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131 I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131 I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131 I ablation may be helpful in an individual constellation. Preparation for 131 I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for 131 I-therapy in patients with metastases, higher sensitivity of 131 I whole-body scan) are discussed. In most centers standard activities are used for 131 I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131 I should not exceed 1-10MBq, alternative tracers are 123 I or 124 I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-01

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

  3. Measure Guideline: High Efficiency Natural Gas Furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L.; Rose, W.

    2012-10-01

    This Measure Guideline covers installation of high-efficiency gas furnaces. Topics covered include when to install a high-efficiency gas furnace as a retrofit measure, how to identify and address risks, and the steps to be used in the selection and installation process. The guideline is written for Building America practitioners and HVAC contractors and installers. It includes a compilation of information provided by manufacturers, researchers, and the Department of Energy as well as recent research results from the Partnership for Advanced Residential Retrofit (PARR) Building America team.

  4. Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

    Directory of Open Access Journals (Sweden)

    Samir Gupta

    2016-01-01

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

  5. Procurement guideline for oil recovery boats; Oeljyntorjuntaveneen hankintaohje

    Energy Technology Data Exchange (ETDEWEB)

    Pajala, J.

    2011-12-15

    These guidelines have been compiled to assist in the procurement of oil recovery boats, with the intention of ensuring that new boats meet the future needs of oil spill response operations and that procurement will be carried out in a manner that is economically sound and technologically well-founded. Furthermore, the guidelines are intended to encourage the development and adoption of new solutions for oil recovery boats. The issues covered by these guidelines include: Multiple uses of boats, classification of boats and class-specific requirements, the principle of sustainable development and the boats' lifecycle, qualification to be set for the crews, procurement timeline, regulations and guidelines, inspections and approvals. (orig.)

  6. Effluent monitoring Quality Assurance Project Plan for radioactive airborne emissions data. Revision 2

    International Nuclear Information System (INIS)

    Frazier, T.P.

    1995-12-01

    This Quality Assurance Project Plan addresses the quality assurance requirements for compiling Hanford Site radioactive airborne emissions data. These data will be reported to the U.S. Environmental Protection Agency, the US Department of Energy, and the Washington State Department of Health. Effluent Monitoring performs compliance assessments on radioactive airborne sampling and monitoring systems. This Quality Assurance Project Plan is prepared in compliance with interim guidelines and specifications. Topics include: project description; project organization and management; quality assurance objectives; sampling procedures; sample custody; calibration procedures; analytical procedures; monitoring and reporting criteria; data reduction, verification, and reporting; internal quality control; performance and system audits; corrective actions; and quality assurance reports

  7. 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

  8. Curricular Guidelines for Neuroanatomy.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Presented are the curricular guidelines for Neuroanatomy developed by the Section on Anatomical Sciences of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids. Included are recommendations for primary educational goals, prerequisites, scope, content, behavioral objectives,…

  9. Assessment of EPRI water chemistry guidelines for new nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-01

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

  10. Assessment of EPRI water chemistry guidelines for new nuclear power plants

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  11. 3 CFR - Guidelines for Human Stem Cell Research

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Guidelines for Human Stem Cell Research Presidential Documents Other Presidential Documents Memorandum of July 30, 2009 Guidelines for Human Stem Cell Research..., scientifically worthy human stem cell research, including human embryonic stem cell research, to the extent...

  12. 32 CFR 147.8 - Guideline F-Financial considerations.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline F-Financial considerations. 147.8... INFORMATION Adjudication § 147.8 Guideline F—Financial considerations. (a) The concern. An individual who is... raise a security concern and may be disqualifying include: (1) A history of not meeting financial...

  13. Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery.

    Science.gov (United States)

    Struijk-Mulder, M C; Ettema, H B; Verheyen, C C; Büller, H R

    2010-04-01

    Different guidelines exist regarding the prevention of venous thromboembolism (VTE) in orthopedic surgery. We aimed to compare (inter)national guidelines and analyse differences. MEDLINE, the Cochrane Library and the internet were searched for guidelines on the prevention of VTE in orthopedic surgery. From these, we constructed a table comparing the different antithrombotic regimens during different orthopedic surgical and plaster cast treatments. Eleven guidelines from nine different countries and one international guideline were included. Few guidelines advise on thrombosis prophylaxis after plaster cast immobilization, (prolonged) arthroscopic surgery and isolated lower extremity trauma. Different opinions exist on the sole use of aspirin and mechanical prophylaxis and on the use of vitamin K antagonists after major hip and knee surgery. Based on the same available literature, different guidelines recommend different thromboprophylactic regimens. Ideally, the grade of recommendation should be based on the same level of evidence world-wide. Whilst there is no agreement on the relevance of different endpoints (e.g. asymptomatic DVT), it is very difficult to reach a consensus. Thromboprophylaxis guidelines should be reviewed and updated on a regular basis, because the evidence is evolving rapidly.

  14. Guideline implementation strategies for specialist mental healthcare.

    Science.gov (United States)

    Girlanda, Francesca; Fiedler, Ines; Ay, Esra; Barbui, Corrado; Koesters, Markus

    2013-07-01

    Clinical practice guidelines in mental healthcare are viewed as an essential asset if appropriately developed and implemented. The purpose of this article was to review the existing literature on how guidelines should be implemented to optimize their impact on provider performance and patient outcomes in specialist mental healthcare settings. Findings from recent studies suggest a trend toward an improvement in process and patient outcomes following guideline implementation. However, studies are heterogeneous in terms of design, implementation strategies and outcome measures, making it very difficult to draw firm conclusions about which implementation strategy is effective in different healthcare contexts. Current knowledge about how guidelines should be implemented is still sparse and inconclusive in mental healthcare. Future studies should attempt to employ more rigorous designs, including random allocation of patients or clusters of patients, to shed further light on this compelling issue. Research on guideline implementation strategies should additionally take into account potential barriers to knowledge translation, which can heavily influence the implementability of treatment recommendations.

  15. Hanford 200 Areas Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Rinne, C.A.; Daly, K.S.

    1993-08-01

    The purpose of the Hanford 200 Areas Development Plan (Development Plan) is to guide the physical development of the 200 Areas (which refers to the 200 East Area, 200 West Area, and 200 Area Corridor, located between the 200 East and 200 West Areas) in accordance with US Department of Energy (DOE) Order 4320.lB (DOE 1991a) by performing the following: Establishing a land-use plan and setting land-use categories that meet the needs of existing and proposed activities. Coordinating existing, 5-year, and long-range development plans and guiding growth in accordance with those plans. Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities. Identifying site development issues that need further analysis. Integrating program plans with development plans to ensure a logical progression of development. Coordinate DOE plans with other agencies [(i.e., Washington State Department of Ecology (Ecology) and US Environmental Protection Agency (EPA)]. Being a support document to the Hanford Site Development Plan (DOE-RL 1990a) (parent document) and providing technical site information relative to the 200 Areas.

  16. Hanford 200 Areas Development Plan

    International Nuclear Information System (INIS)

    Rinne, C.A.; Daly, K.S.

    1993-08-01

    The purpose of the Hanford 200 Areas Development Plan (Development Plan) is to guide the physical development of the 200 Areas (which refers to the 200 East Area, 200 West Area, and 200 Area Corridor, located between the 200 East and 200 West Areas) in accordance with US Department of Energy (DOE) Order 4320.lB (DOE 1991a) by performing the following: Establishing a land-use plan and setting land-use categories that meet the needs of existing and proposed activities. Coordinating existing, 5-year, and long-range development plans and guiding growth in accordance with those plans. Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities. Identifying site development issues that need further analysis. Integrating program plans with development plans to ensure a logical progression of development. Coordinate DOE plans with other agencies [(i.e., Washington State Department of Ecology (Ecology) and US Environmental Protection Agency (EPA)]. Being a support document to the Hanford Site Development Plan (DOE-RL 1990a) (parent document) and providing technical site information relative to the 200 Areas

  17. Guidelines for the Pharmacotherapy of Schizophrenia in Adults.

    Science.gov (United States)

    Remington, Gary; Addington, Donald; Honer, William; Ismail, Zahinoor; Raedler, Thomas; Teehan, Michael

    2017-09-01

    The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.

  18. Clinical algorithms to aid osteoarthritis guideline dissemination.

    Science.gov (United States)

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

    2016-09-01

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

  19. 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

  20. 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

  1. Systematic review of guidelines on peripheral artery disease screening.

    Science.gov (United States)

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

    2012-02-01

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

  2. Planned Change in Agrarian Countries.

    Science.gov (United States)

    Niehoff, Arthur H.

    The report provides operationally relevant concepts and guidelines for persons responsible for planning and implementing development projects in agrarian countries. A framework for describing or evaluating the conduct of development projects is proposed, and applied to the results of an analysis of 203 case studies of past projects. Influences,…

  3. Diet quality: associations with health messages included in the Danish Dietary Guidelines 2005, personal attitudes and social factors

    DEFF Research Database (Denmark)

    Biltoft-Jensen, Anja Pia; Groth, Margit Velsing; Matthiessen, Jeppe

    2009-01-01

    Objective: To Study the association between diet quality and the new health messages in the Danish Dietary Guidelines 2005, i.e. 'Eat a varied diet', 'Engage in regular physical activity' and 'Maintain a healthy body weight'. Design/setting/subjects: The study was cross-sectional, comprising a ra...... with healthy eating. The dietary habits reported were strongly influenced by personal intentions. Thus, the biggest challenge for public health nutritionists will be to reach non-compliers who seldom have intentions to eat healthily.......Objective: To Study the association between diet quality and the new health messages in the Danish Dietary Guidelines 2005, i.e. 'Eat a varied diet', 'Engage in regular physical activity' and 'Maintain a healthy body weight'. Design/setting/subjects: The study was cross-sectional, comprising...... a random sample of 3151 Danish adults aged 18-75 years. Dietary intake was estimated using a 7 d pre-coded food diary. information on social background, leisure-time physical activity, height, body weight and intention to eat healthily was Obtained by in-person interviews. Logistic regression models Were...

  4. Teacher Qualification Guidelines, Ecological Literacy and Outdoor Education

    Science.gov (United States)

    Martin, Peter

    2008-01-01

    A key signpost to a profession is clarity of disciplinary knowledge. In this paper I describe the content and outcome of a process to refine the qualification guidelines for outdoor education teachers in Victorian, Australia. The guidelines, developed for the Victorian Institute of Teaching, include both practical skills and disciplinary…

  5. Computational optimization techniques applied to microgrids planning

    DEFF Research Database (Denmark)

    Gamarra, Carlos; Guerrero, Josep M.

    2015-01-01

    Microgrids are expected to become part of the next electric power system evolution, not only in rural and remote areas but also in urban communities. Since microgrids are expected to coexist with traditional power grids (such as district heating does with traditional heating systems......), their planning process must be addressed to economic feasibility, as a long-term stability guarantee. Planning a microgrid is a complex process due to existing alternatives, goals, constraints and uncertainties. Usually planning goals conflict each other and, as a consequence, different optimization problems...... appear along the planning process. In this context, technical literature about optimization techniques applied to microgrid planning have been reviewed and the guidelines for innovative planning methodologies focused on economic feasibility can be defined. Finally, some trending techniques and new...

  6. Waste minimization and pollution prevention awareness plan

    International Nuclear Information System (INIS)

    1991-01-01

    The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs

  7. Waste minimization and pollution prevention awareness plan

    Energy Technology Data Exchange (ETDEWEB)

    1991-05-31

    The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs.

  8. [Materiality Analysis of Health Plans Based on Stakeholder Engagement and the Issues Included at ISO 26000:2010].

    Science.gov (United States)

    Moyano Santiago, Miguel Angel; Rivera Lirio, Juana María

    2017-01-18

    Health plans of the Spanish autonomous communities can incorporate sustainable development criteria in its development. There have been no analysis or proposals about development and indicators. The goal is to add a contribution to help build better health plans aimed at sustainable development and help to manage economic, social and environmental impacts of health systems criteria. We used a variation of the RAND/UCLA or modified Delphi technique method. The process consisted of a bibliographical and context matters and issues related to health and social responsibility analysis based on ISO 26000: 2010. A survey by deliberately to a selection of 70 expert members of the identified stakeholders was carried out and a discussion group was held to determine the consensus on the issues addressed in the survey sample. The research was conducted in 2015. From the literature review 33 health issues included in ISO 26000:2010 were obtained. 7 survey proved relevant high consensus, 8 relevance and average consensus and 18 with less relevance and high level of dissent. The expert group excluded 4 of the 18 subjects with less consensus. 29 issues included 33 at work, divided into 7 subjects contained in the guide ISO 26000 of social responsibility, were relevant stakeholders regarding possible inclusion in health plans. Considering the direct relationship published by ISO (International Organization for Standardization) among the issues ISO 26000 and the economic, social and environmental indicators in GRI (Global Reporting Initiative) in its G4 version, a panel with monitoring indicators related to relevant issues were elaborated.

  9. Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death—Summary Report*

    Science.gov (United States)

    Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.

    2017-01-01

    Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation

  10. Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

    Science.gov (United States)

    Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

    2017-11-01

    Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory

  11. Terrain assessment guidelines : CAGC best practice. Version 3

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

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

  12. Physicians' preferences for asthma guidelines implementation.

    Science.gov (United States)

    Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

    2010-10-01

    Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

  13. The planning of areas near nuclear power stations

    International Nuclear Information System (INIS)

    1977-01-01

    During the past five years national physical planning has been initiated by the Swedish Parliament. Guidelines have been given to the communities how to consider national interests when drawing up local planning and how to produce maps and descriptions of the planning. For the planning of the areas near the nuclear power stations the municipalities have certain guidelines from The Nuclear Power Inspectorate and The National Institute of Radiation Protection. It is advised to keep a low population density near the power plants, to avoid the type of harbour or industry which could have disturbing effects on the power plant and also to avoid to concentrate people, who are difficult to move from the area in case of an accident (i.e., homes for old people, maternity homes and prisons). The plants on the East Coast, Forsmark and Oskarshamn, are located in wooded areas with a very low population density. On the West Coast, near Ringhals and Barsebaeck, the population density is higher, and there is one village with about 2,000 inhabitants, situated at a distance of two (2) km from the Ringhals power plant. The Control Boards are now reluctant to concentrate more people in this village, where schools and shops were earlier planned for 3,000 inhabitants. The building activity near power plants is regulated by law. New buildings are prohibited within a distance of two (2) km from the plants. Some exeptions can be granted by the County Administrative Board after guidance from the Central Board. In a zone reaching 10 kilometers from the power plants there are no regulations by law about new buildings, except the earlier mentioned guidelines from the Central Boards to maintain a low population. (L.E.)

  14. Integrated Human Factors Design Guidelines for Sound Interface

    International Nuclear Information System (INIS)

    Lee, Jung Woon; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul; Cha, Woo Chang

    2004-05-01

    Digital MMI, such as CRT, LCD etc., has been used increasingly in the design of main control room of the Korean standard nuclear power plants following the YGN units 3 and 4. The utilization of digital MMI may introduce various kind of sound interface into the control room design. In this project, for five top-level guideline items, including Sound Formats, Alarms, Sound Controls, Communications, and Environments, a total of 147 detail guidelines were developed and a database system for these guidelines was developed. The integrated human factors design guidelines for sound interface and the database system developed in this project will be useful for the design of sound interface of digital MMI in Korean NPPs

  15. Integrated Human Factors Design Guidelines for Sound Interface

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul [KAERI, Daejeon (Korea, Republic of); Cha, Woo Chang [Kumoh National Univ. of Technology, Gumi (Korea, Republic of)

    2004-05-15

    Digital MMI, such as CRT, LCD etc., has been used increasingly in the design of main control room of the Korean standard nuclear power plants following the YGN units 3 and 4. The utilization of digital MMI may introduce various kind of sound interface into the control room design. In this project, for five top-level guideline items, including Sound Formats, Alarms, Sound Controls, Communications, and Environments, a total of 147 detail guidelines were developed and a database system for these guidelines was developed. The integrated human factors design guidelines for sound interface and the database system developed in this project will be useful for the design of sound interface of digital MMI in Korean NPPs.

  16. Precision IORT - Image guided intraoperative radiation therapy (igIORT) using online treatment planning including tissue heterogeneity correction.

    Science.gov (United States)

    Schneider, Frank; Bludau, Frederic; Clausen, Sven; Fleckenstein, Jens; Obertacke, Udo; Wenz, Frederik

    2017-05-01

    To the present date, IORT has been eye and hand guided without treatment planning and tissue heterogeneity correction. This limits the precision of the application and the precise documentation of the location and the deposited dose in the tissue. Here we present a set-up where we use image guidance by intraoperative cone beam computed tomography (CBCT) for precise online Monte Carlo treatment planning including tissue heterogeneity correction. An IORT was performed during balloon kyphoplasty using a dedicated Needle Applicator. An intraoperative CBCT was registered with a pre-op CT. Treatment planning was performed in Radiance using a hybrid Monte Carlo algorithm simulating dose in homogeneous (MCwater) and heterogeneous medium (MChet). Dose distributions on CBCT and pre-op CT were compared with each other. Spinal cord and the metastasis doses were evaluated. The MCwater calculations showed a spherical dose distribution as expected. The minimum target dose for the MChet simulations on pre-op CT was increased by 40% while the maximum spinal cord dose was decreased by 35%. Due to the artefacts on the CBCT the comparison between MChet simulations on CBCT and pre-op CT showed differences up to 50% in dose. igIORT and online treatment planning improves the accuracy of IORT. However, the current set-up is limited by CT artefacts. Fusing an intraoperative CBCT with a pre-op CT allows the combination of an accurate dose calculation with the knowledge of the correct source/applicator position. This method can be also used for pre-operative treatment planning followed by image guided surgery. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. South African Guidelines Excellence (SAGE): Adopt, adapt, or contextualise?

    OpenAIRE

    Dizon, J M; Grimmer, K; Louw, Q; Kredo, T; Young, T; Machingaidze, S

    2016-01-01

    Clinical practice guideline (CPG) activities must be planned carefully for efficient use of available resources and evidence-based implementation. De novo development of CPGs may sometimes 'recreate the wheel' and delay implementation. Three innovative alternatives to de novo CPG development (adopt, contextualise or adapt) are outlined, which have greater potential than de novo development to best use the limited available resources, personnel and time in settings such as South Africa.

  18. 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

  19. PLACE-BASED GREEN BUILDING: INTEGRATING LOCAL ENVIRONMENTAL AND PLANNING ANALYSIS INTO GREEN BUILDING GUIDELINES

    Science.gov (United States)

    This project will develop a model for place-based green building guidelines based on an analysis of local environmental, social, and land use conditions. The ultimate goal of this project is to develop a methodology and model for placing green buildings within their local cont...

  20. Preoperative teaching and stoma marking in an inpatient population: a quality improvement process using a FOCUS-Plan-Do-Check-Act model.

    Science.gov (United States)

    Zimnicki, Katherine M

    2015-01-01

    Preoperative teaching and stoma marking are supported by research and included in clinical practice guidelines from the WOCN Society and others. Using a FOCUS-Plan-Do-Check-Act model of Total Quality Management, a multidisciplinary team was formed that developed a flow chart outlining the process of care for patients undergoing planned ostomy surgery that included an educational intervention that enabled staff nurses to perform preoperative stoma site marking and education. After 3 months, we found a statistically significant increase in the number of surgical patients who received these evidence-based interventions (14% vs 64%; χ = 9.32; P = .002).

  1. AAPM Medical Physics Practice Guideline 5.a.: Commissioning and QA of Treatment Planning Dose Calculations - Megavoltage Photon and Electron Beams.

    Science.gov (United States)

    Smilowitz, Jennifer B; Das, Indra J; Feygelman, Vladimir; Fraass, Benedick A; Kry, Stephen F; Marshall, Ingrid R; Mihailidis, Dimitris N; Ouhib, Zoubir; Ritter, Timothy; Snyder, Michael G; Fairobent, Lynne

    2015-09-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines:• Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.• Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  2. Time to detoxify medical literature from guideline overdose

    Institute of Scientific and Technical Information of China (English)

    Dinesh Vyas; Arpita K Vyas

    2012-01-01

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

  3. Advanced human-system interface design review guideline. General evaluation model, technical development, and guideline description

    International Nuclear Information System (INIS)

    O'Hara, J.M.

    1994-07-01

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

  4. Advanced human-system interface design review guideline. General evaluation model, technical development, and guideline description

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.

    1994-07-01

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

  5. [Evidence-based therapy guideline of the German Working Group on Obesity in Childhood and Adolescence].

    Science.gov (United States)

    Moss, A; Kunze, D; Wabitsch, M

    2011-05-01

    Obesity in childhood and adolescence has increased worldwide in recent years. A consensus guideline (S2) for treating obesity in childhood and adolescence in Germany was first published by the German Working Group on Obesity in Childhood and Adolescence (AGA) in 2000. The intention is to gradually replace this consensus-based (S2) guideline with an evidence-based (S3) guideline. Following a systematic literature search, 21 recommendations were predominantly approved with "strong consensus" (agreement >95%). Body weight and body fat mass can be significantly influenced by conventional behavior-based measures and also by the currently available drug therapies. However, the extent of the achieved weight reduction is small. Surgical measures (unproven, experimental therapy) to reduce body weight, in contrast, are very successful. In addition to the long version of this evidence-based guideline, an abbreviated version exists and a practice guideline is planned. This guideline should be further developed within the competence network on obesity of the German Federal Ministry of Education and Research. The guideline will be published in the scholarly journals of the professional associations concerned, will be available via the Internet, and will also be distributed through periodicals, congress events, and information at facilities.

  6. A Qualitative Comparison on Guidelines for Construction Workers Accommodation and Facility

    Directory of Open Access Journals (Sweden)

    Khamis Norasyikin

    2017-01-01

    Full Text Available Construction industry in Malaysia covers almost 1.3 million workers. Thus, realizing the importance of human-centred trait, a long-term plan that is led by the Construction Industry Development Board Malaysia (CIDB has been designed to improve accommodation and facilities of workers at construction site. In conjunction to that, the Institute for Industrial Research and Standards Malaysia (SIRIM has developed Malaysia Standard (MS 2593:2015 as the guideline for improvement of accommodation and facilities for workers which is able to contribute to the achievement of the target in the Construction Industry Transformation Programme (CITP. However, a phenomenon that is centred on the level of itscorroboration compared with other similar guidelines has been voiced by some practitioners of construction, especially when the guideline are likely to be the basis of a new related act. Therefore, based on MS 2593:2015, this introductory research is conducted to qualitatively analyse the corroborative level of the guideline compared to its counterpart guidelines. By using a comprehensive document analysis method which anchored to frequency approach and assisted by NVivo v.8 software, the report found out that the Malaysia-based guideline is on par to the restwith some introduction of new variables (especially towards leisure and social aspects. Thus, further research on gauging industry’s willingness and existing compliance rates is deemed appropriate in order to inculcate positive impacts towards the objectives of MS 2593:2015, and subsequently contributes to the formation of the forthcoming corresponding act.

  7. The current state of epilepsy guidelines: A systematic review.

    Science.gov (United States)

    Sauro, Khara M; Wiebe, Samuel; Dunkley, Colin; Janszky, Jozsef; Kumlien, Eva; Moshé, Solomon; Nakasato, Nobukazu; Pedley, Timothy A; Perucca, Emilio; Senties, Horacio; Thomas, Sanjeev V; Wang, Yuping; Wilmshurst, Jo; Jetté, Nathalie

    2016-01-01

    The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development. A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. Two independent reviewers screened abstracts, reviewed full text articles, and performed data abstraction. Descriptive statistics and a meta-analysis were generated. The search identified 10,926 abstracts. Of the 410 articles selected for full text review, 63 met our eligibility criteria for a guideline. Of those included, 54 were in English and 9 were in other languages (French, Spanish, and Italian). Of all guidelines, 29% did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus (n = 7), first seizure (n = 6), drug-resistant epilepsy (n = 5), and febrile seizures (n = 4), among others. Most of the guidelines were therapeutic (n = 35) or diagnostic (n = 16) in nature. The quality of the guidelines using a 1-7 point scale (7 = highest) varied and was moderate overall (mean = 4.99 ± 1.05 [SD]). We identified substantial gaps in topics (e.g., epilepsy in the elderly) and there was considerable heterogeneity in methodologic quality. The findings should offer a valuable resource for health professionals caring for people with epilepsy, since they will help guide the prioritization, development, and dissemination of future

  8. Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

    Science.gov (United States)

    Willems, Mia; Schröder, Carin; Post, Marcel; van der Weijden, Trudy; Visser-Meily, Anne

    2013-10-23

    The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB).This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1.The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention.Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. With this study we will gain insight in when and why knowledge brokers seem to be

  9. British Columbia inland oil spill response plan

    International Nuclear Information System (INIS)

    2005-01-01

    This paper presents an outline of the organization, procedures and duties of the provincial government in response to inland oil spills stemming from pipeline or tank-farm rupture, train derailment and vehicle accidents in British Columbia. Provincial response strategies were reviewed, along with their relationships to various policies and standards. Public, infrastructure and environmental protection were identified as key factors. Incident notification procedures were detailed, including outlines of roles, event criteria and call for incident management teams. Agreements and cost recovery issues were examined. The characteristics of site response were reviewed, including details of communications, tactical planning, and unified command among local and federal governments. The role of First Nations and responsible parties was also addressed. Details of shore cleanup, wildlife rescue, decontamination, and waste handling strategies were presented. The organization, missions and duties for an incident management team were outlined, along with a summary of operational guidelines and information on team positions and the establishment of joint information centres. The involvement of cooperating agencies was examined. An incident command system was also presented, including details of planning, operations, logistics, and organization. A checklist of individual duties was provided, with details of responsibilities, safety issues and general instructions for all team members. tabs., figs

  10. Developing guidelines for incorporating managing demand into WSDOT planning and programming: transportation demand management guidance for corridor planning studies.

    Science.gov (United States)

    2016-02-01

    The Washington State Department of Transportation (WSDOT) regional planning programs address current and forecasted deficiencies of State highways through the conduct of corridor studies. This Guidance for the conduct of corridor planning studies is ...

  11. Research oil guidelines for safety review of category 2 waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    Safety confirmation items and monitoring items for engineered barriers were compiled, considering the current technical status and monitoring plan for the simulated subsurface disposal and its test facilities. In order to develop the guidelines of the safety review for the disposal of LLW generated from RI facilities and research facilities, technical issues relating toxic substances were surveyed. (author)

  12. Survey of Implementation of Antiemetic Prescription Standards in Indian Oncology Practices and Its Adherence to the American Society of Clinical Oncology Antiemetic Clinical Guideline

    Directory of Open Access Journals (Sweden)

    Vijay Patil

    2017-08-01

    Full Text Available Purpose: Adherence to international antiemetic prophylaxis guidelines like those of ASCO can result in better control of chemotherapy-induced nausea and vomiting; however, the extent of implementation of such guidelines in India is unknown. Therefore, this survey was planned. Methods: This study was an anonymized cross-sectional survey approved by the ethics committee. Survey items were generated from the clinical questions given in the ASCO guidelines. The survey was disseminated through personal contacts at an oncology conference and via e-mail to various community oncology centers across India. The B1, B2, and B3 domains included questions regarding the optimal antiemetic prophylaxis for high, moderate, and low-minimal emetogenic regimens. Results: Sixty-six (62.9% of 105 responded and 65 centers (98.5% were aware of the published guidelines. The partial, full, and no implementation scores were 92.5%, 4.5%, and 3.0%, respectively. Full implementation was better for the low-minimal emetogenic regimens (34.8% than the highly emetogenic regimens (6.1%. The three most frequent reasons for hampered implementation of ASCO guidelines in routine chemotherapy practice cited by centers were a lack of sensitization (26 centers; 39.4%, lack of national guidelines (12 centers; 18.2%, and lack of administrative support (10 centers; 15.2%. Conclusion: Awareness regarding ASCO antiemetic guidelines is satisfactory in Indian oncology practices; however, there is a need for sensitization of oncologists toward complete implementation of these guidelines in their clinical practice.

  13. Project summary plan for HTGR recycle reference facility

    International Nuclear Information System (INIS)

    Baxter, B.J.

    1979-11-01

    A summary plan is introduced for completing conceptual definition of an HTGR Recycle Reference Facility (HRRF). The plan describes a generic project management concept, often referred to as the requirements approach to systems engineering. The plan begins with reference flow sheets and provides for the progressive evolution of HRRF requirements and definition through feasibility, preconceptual, and conceptual phases. The plan lays end-to-end all the important activities and elements to be treated during each phase of design. Identified activities and elements are further supported by technical guideline documents, which describe methodology, needed terminology, and where relevant a worked example

  14. Guidelines for control room design reviews

    International Nuclear Information System (INIS)

    1981-09-01

    The control room design review is part of a broad program being undertaken by the nuclear industry and the government to ensure consideration of human factors in nuclear power plant design and operation. The purpose of the control room design review described by these guidelines is to (1) review and evaluate the control room workspace, instrumentation, controls, and other equipment from a human factors engineering point of view that takes into account both system demands and operator capabilities; and (2) to identify, assess, and implement control room design modifications that correct inadequate or unsuitable items. The scope of the control room design review described by these guidelines covers the human engineering review of completed control rooms; i.e., operational control rooms or those at that stage of the licensing process where control room design and equipment selection are committed. These guidelines should also be of use during the design process for new control rooms. However, additional analyses to optimize the allocation of functions to man and machine, and further examination of advanced control system technology, are recommended for new control rooms. Guidelines and references for comprehensive system analyses designed to incorporate human factors considerations into the design and development of new control rooms are presented in Appendix B. Where possible, a generic approach to the control room design review process is encouraged; for example, when control room designs are replicated wholly or in part in two or more units. Even when designs are not replicated exactly, generic reviews which can be modified to account for specific differences in particular control rooms should be considered. Industry organizations and owners groups are encouraged to coordinate joint efforts and share data to develop generic approaches to the design review process. The control room design review should accomplish the following specific objectives. To determine

  15. Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.

    Science.gov (United States)

    De Clercq, Eva; Rost, Michael; Pacurari, Nadia; Elger, Bernice S; Wangmo, Tenzin

    2017-08-01

    Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL. No restrictions were placed on the type of methodology employed in the studies. Concerning barriers, most of the papers focused on gaps within medical practice and the lack of evidence-based research. Common recommendations therefore included: training and education of healthcare staff, formation of a multidisciplinary PPC team, research on the benefits of PPC, and raising awareness about PPC. A small number of publications reported on the absence of clear guidance in PPC documents regarding bereavement care, as well as on the difficulties and challenges involved in multidisciplinary care teams. Our results indicate that a critical assessment of both the research guidelines and medical practice is required in order to promote timely implementation of PPC for pediatric patients.

  16. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

    Science.gov (United States)

    Ha, U-Syn; Lee, Seung-Ju; Yeo, Jeong Kyun; Min, Seung Ki; Lee, Heeyoung

    2018-01-01

    Urinary tract infections (UTIs) are infectious diseases that commonly occur in communities. Although several international guidelines for the management of UTIs have been available, clinical characteristics, etiology and antimicrobial susceptibility patterns may differ from country to country. This work represents an update of the 2011 Korean guideline for UTIs. The current guideline was developed by the update and adaptation method. This clinical practice guideline provides recommendations for the diagnosis and management of UTIs, including asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, complicated pyelonephritis related to urinary tract obstruction, and acute bacterial prostatitis. This guideline targets community-acquired UTIs occurring among adult patients. Healthcare-associated UTIs, catheter-associated UTIs, and infections in immunocompromised patients were not included in this guideline. PMID:29637759

  17. Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.

    Science.gov (United States)

    Gordon, Catherine M; Ackerman, Kathryn E; Berga, Sarah L; Kaplan, Jay R; Mastorakos, George; Misra, Madhusmita; Murad, M Hassan; Santoro, Nanette F; Warren, Michelle P

    2017-05-01

    The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA). The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline. FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation. Copyright © 2017 Endocrine Society

  18. Guidelines for performance-based supplier audits (NCIG-16)

    International Nuclear Information System (INIS)

    Lauderdale, J.R.; Mattu, R.K.; Roman, W.S.

    1990-06-01

    This document provides guidelines for planning and conducting performance-based audits of suppliers of items used in nuclear power plants. A common purpose of audits is to provide a basis for confidence in the supplier's controls to ensure that products received will perform their intended functions satisfactorily. Performance-based audits offer means of raising the level of confidence. This confidence comes from evaluation of important features of the product and the processes and activities that produce it. This document does not add requirements to those in existing codes, standards, or regulations. The guidance herein is intended to complement the information in existing industry standards and practices. Performance-based audits are one element of an effective procurement program. A companion EPRI/NCIG document, EPRI NP-6629, Guidelines for the Procurement and Receipt of Items for Nuclear Power Plants (NCIG-15), provides guidance for other elements of an effective procurement program

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

    Science.gov (United States)

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

    2011-02-01

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

  20. Slovenian spatial planning system: Key changes of past decade

    Directory of Open Access Journals (Sweden)

    Lavrenčić Valentina

    2002-01-01

    Full Text Available Spatial planning has a long tradition in Slovenia. It was always a part of the integrated planning process, first institutionalized in 1968. The planning system was quite unique, combining economic, social, and spatial aspects in one, a so called long-term and medium-term social plan. At the national level its spatial part consisted of the national spatial plan, the defining concept for settlement management and growth, public service delivery, use of space and landscape transformation, protection of the environment, and guidelines for conflict management. Today, this form of planning is substituted by the national strategies and programs of each sector.